Issue link: https://maltatoday.uberflip.com/i/1517228
4 maltatoday | SUNDAY • 10 MARCH 2024 NEWS THE Maltese are twice as likely as other Europeatns to pay for health services out of their own pockets, a recently published OECD 'State of Health in the EU' report reveals. One main reason for this is the 'cultural preference' of high-in- come earners to opt for private doctors and specialists. Out-of-pocket (OOP) spending as a share of total health spending in Malta in 2020 dropped from 34.3% in 2018 to 30% but remains considerably higher than the EU average of 14%. Moreover, at 7.1% in 2019, OOP spending on health as a share of final household consumption was the highest in the EU, and more than twice the EU average of 3.3%. Spending on private primary and outpatient specialist care remains the main driver of OOP expend- iture in Malta. In fact, 42% of pri- vate care expenditure in Malta is attributable to services provided by generalists and specialists in the outpatient sector. And while in Malta 52% of the total expenditure on outpatient care is paid from patient's pockets, in the European Union only 21% of this expenditure is paid for by patients or their families. The OECD report attributes this phenomenon to longer wait- ing lists for public specialists and elective care, and to "longstand- ing cultural preferences, as people with higher educational and in- come levels commonly seek care from the private sector". Another significant chunk of private health expenditure in Mal- ta is spent in buying medicines (28%). This is attributed to the fact that "many prescribed phar- maceuticals for acute conditions are not covered by the Maltese benefits package". In fact, 86% of spending on medicines in Malta is privately paid in contrast to 63% in the EU. But the Maltese are less likely to pay for expensive therapeutic ap- pliances from their own pockets. While in the EU, 62% of this ex- pense is paid directly by patients, the percentage drops to 28% in Malta. And while spending on long term care accounts for 25% of private health expenditure in the EU, it only accounts for 9% in Malta. 42% of Maltese spending on den- tal care is also paid from patient's pockets but in this case OOP spending is just 1% above that in the EU as a whole. Despite the greater reliance on the private sector for a number of health services, with nearly universal health coverage, unmet needs for medical care in Malta were well below the EU average in 2022. Malta spending more on health The report also shows that health spending in Malta has grown at the highest rate in the EU in real terms over the last dec- ade. While in 2010-11, the aver- age annual growth rate in current health spendintal g in Malta was 5.4 %; by 2018-19 this had risen to 14.7 %. Nevertheless, per capi- ta health expenditure was €3,055 in 2020, below the EU average of €3,719 for that year. And while most countries raised expenditure on preventive care significantly during the COV- ID-19 pandemic, Malta's spend- ing on prevention remained low. In 2020 Malta's per capita expend- iture on prevention amounted to just €44 which was significantly below the EU average of €128. Class inequalities in breast can- cer screening But the report also shows that Malta's breast cancer rates ex- ceeded the EU averages for the period 2018-21. But as in many other countries, there is wide vari- ation in the screening rate accord- ing to income group: in 2019, 74 % of women in the highest income quintile reported being screened in the previous two years com- pared to only 51 % in the lowest quintile. Moreover, women are still undertaking cervical cancer screening in the private sector rather than through public pro- grammes, which accounts for the low rates recorded. Although in- creasing slightly from 22 % in 2018 to 23 % in 2020 and 24 % in 2021, national rates of cervical screening in the past two years among wom- en aged 20-69 remain well below the EU average. Maltese spend on private healthcare is more than double that of other Europeans ME Investment committee 'misled' by management on construction project that killed Jean Paul Sofia MALTA Enterprise's Investment Committee, the entity tasked with assessing and assisting expansion proposals by small businesses and startups, claims it was misled by Malta Enterprise's managment, insisting that it had never ap- proved a five-storey factory and had only approved a one-floor workshop. The Committee was reacting to the scathing criticism it received in the final report of the Sofia inquiry, which described the as- sessment that was carried out as "superficial." The statement was signed by former Investment Committee members Peter Borg, Frank Far- rugia, Paul Abela, Victor Carachi and Dana Farrugia, all of whom had resigned after the publication of the Jean Paul Sofia Public In- quiry Report. The Inquiry Board observed that Malta Enterprise had not request- ed the architect's drawings of the proposed building site at Corrad- ino, saying that "this means that Malta Enterprise would not know whether, in a 300sqm site, there will be a single-storey, two-storey, or five-storey building." But in a statement on Saturday, the Committee said the project that was being built bore no re- semblance to the one that it had given the green light to. "This is what the Investment Committee approved. A work- shop of 300 m2 on one floor and nothing more. We wish to make it absolutely clear that at no point did the Investment Committee approve a five-floor factory, and that once the Investment Com- mittee had approved the alloca- tion proposed by Malta Enter- prise management, its role in this matter, as in every other propos- al, terminated. The Investment Committee's role is to approve proposals for industrial aid, not to supervise its use. That task falls within the remit of other bodies." "Since the Committee's incep- tion, proposals were always as- sessed on whether the proposed projects had a reasonably good chance of business success, and in the absence of any red flags, the allocation of industrial space would be approved." The Committee lamented the fact that it had not been given an opportunity to explain this to the inquiry, saying that "since no member of the Investment Committee was ever asked by the Public Inquiry to testify or supply information or documents, we were not in a position to clarify these matters." "We believe that, in the light of the above facts, the conclusion that our intervention in this mat- ter was, in any way whatsoever, superficial is with, all due respect, unwarranted and incorrect.". The clarification ended with a veiled threat of legal action, stat- ing that "the fact that the conclu- sion of the Inquiry Board that we acted in a "superficial" manner affects our right to enjoy a good reputation within the meaning of Article 6 § 1 of the Convention for the Protection of Human Rights and Fundamental Freedoms. We reserve all our rights in this re- gard." Out-of-pocket health spending in Malta stood at 30%, while the EU average was 14% JAMES DEBONO jdebono@mediatoday.com.mt Spending at GPs and specialists for outpatient care in Malta accounts for 42% of private care expenditure, according to the OECD The collapsed construction site at Corradino where Jean Paul Sofia died MATTHEW AGIUS magius@mediatoday.com.mt