Over half of the population struggles with accessing healthcare services because they cannot afford the costs, despite free public health care, a report has found.

The financial barriers were flagged by a European Union agency, Eurofound, in an analysis of the quality of health and care services across EU member states.

According to the report, published this month, 51% of the population in Malta claimed the cost of healthcare makes access to it difficult. 

The rate is among the highest in Europe, the data shows, with Cyprus and Greece joint top of the list, where 62% find it difficult to access healthcare.

Asked to explain how Malta’s numbers could be so high despite all public healthcare services being free, Charles Pace, a lecturer in social policy at the University of Malta said that analyses of Malta’s health systems often ignored “an important factor”. 

“Thirty-seven per cent of what we Maltese spend on health comes from our own pockets. Only Bulgaria, Cyprus and Latvia in the EU spend more than we do. The other 63% is financed by government,” Dr Pace said. 

And while hospital services and the use of health centres are free to all, many patients still preferred visiting their family doctor for most of their ailments, he said. 

“We have to dig into our own pockets when buying most medicines, and seeing family doctors and specialists, and that costs a lot.

“There are general practitioners and some specialists at health centres but, many people still prefer to visit their own doctor for something more serious,” he said. 

This is also the case with visiting specialists and that is why more than 50 per cent claim cost is a worrying factor, Dr Pace said. 

We have to dig into our own pockets when buying most medicines

He added that for a pensioner, for instance, expenses could be tough, especially seeing that retirement, for about half the population, brings less than a “two-thirds pension”.

The social policy expert pointed to a number of factors why people still opted to use private services instead of making use of the free services. 

Population growth is one factor, he said, pointing out that with more people on the island, the demand at health centres had naturally increased. 

Another issue that is deterring patients from using free services could be the fact that continuity of care has been weak when visiting health centres as it is with private doctors.

Noting that continuity of care, through the use of computer records, has improved, Dr Pace pointed out that many still preferred visiting a doctor who has treated them for years rather than a different one each time they fell ill. 

“One thing leads to another. You have a pension that is eroded and more people on the island. It’s a combination of things that results in people unable to afford certain medical costs,” Dr Pace said.

 Contacted about the issue, a government spokeswoman told Times of Malta the question asked as part of the study “specifically refers to primary care providers”. 

“It is a well-known fact that the largest element contributing to out of pocket expenditure in the health sector is for ambulatory [outpatient] care including general practitioners. 

“While GP services are provided free of charge across the community clinics and health centres all around the islands, people often still choose to consult a private GP,” she pointed out.

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