Health sector sustainability challenges outlined
The Minister for Health, Godfrey Farrugia has launched a comprehensive review of Malta’s Health System. The report forms part of the Health Systems in Transition produced and edited by the European Observatory on Health Systems and Policies.
The Health Systems in Transition report allows a comparative analysis with other European countries using a standard template and definitions as defined by the World Health Organisation. This report crystallizes in an analytical format of a snap shot, of how our national health system faired in the past decade and highlights challenges that still need to be addressed.
Among the key findings:
- An aging population and a decreased fertility rate are living proof that we are victims of our improved standards of living.
- Non-communicable diseases pose a major concern with obesity being increasingly prevalent among both adults and children.
- A steadily ageing population presents rapidly growing demand for a variety of services, including increased chronic ill-health and incidence of cancer, increased consumption of medicines and increased long term care.
- Mortality rates due to circulatory diseases have decreased over time from 426 per 100 000 in 1990 to 232 per 100000 in 2011, but are still higher than those of the EU-15 (161 per 100 000).
- Mortality rates for cancers are also showing a downward trend and compare well with the EU-15 and survival rates for common types of cancer such as breast cancer are improving
- Total health expenditure as a percentage of gross domestic product (GDP) was 8.7% in 2012. This is below the EU average of 9.6% (WHO 2013: HFA).
- In recent years the increase in private spending outpaced public health expenditure growth, particularly in primary health care.
- Average length of stay in acute hospitals is slightly below the EU average but has been rising.
- Waiting times are a long-standing challenge, with typical waiting times for some procedures being between 24 and 36 months.
The number of functioning diagnostic imaging technologies such as CT scanners and PET scans is among the highest per capita; however, Malta has comparatively few MRI units.
The Government is committed to deliver strategic investments underpinned by a revision of existing processes and that maximise efficiency. A shift in the focus of care with investment in primary and community based health care has to be a priority.
The report provides a starting point for the elaboration of a systematic monitoring framework for health system performance.