This article first appeared in Malta Today

I have always maintained that we take our free health care too much for granted, and often do not appreciate what it means in real terms. I still believe this to be true, especially when one looks over to the other side of the Atlantic where the thought of providing affordable (let alone) free health care is still considered a strange notion. If you get sick in the US and do not have some kind of health insurance (usually provided by your employer as part of your salary package), then God be with you.

Here we take it for granted that we can show up at any health centre and be seen by a doctor for any ailment. With the drop in temperatures and our damp, very difficult to heat homes, plus the spread of germs because people do not wash their hands, comes the inevitable cold and flu season, and as new strains of the flu virus continue to mutate, our health services are stretched to breaking point. This is on top of the more serious illnesses such as meningitis and the daily traffic accidents which bring in emergency patients who need to be treated urgently at our national hospital.

Just to give you an idea of the numbers, on 17 January, Ivan Falzon, the CEO Mater Dei issued a statement pointing out that “For the last few days our people were faced with a deluge of sick patients requiring inpatient care, to the tune of 200 new inpatients (+65% on average) every 24 hours.”

Within this scenario, we have the added influx of citizens from other EU countries who work here and pay social security contributions, so they are also entitled to use the health services. British citizens who are self-sufficient are covered by the Reciprocal Health Agreement which Malta has with the UK. According to the European Commission’s website:

“Emergency health care services are provided free of charge in general public hospitals or in primary health care settings. EU citizens requiring emergency health care services need to present a valid European Health Insurance Card (EHIC). Planned health care in public hospitals and primary health care centres are provided free of charge to persons living in Malta who are covered by social security and to EU nationals holding a certificate of entitlement under EU Regulations 883/2004 and 987/2009”.

Those who hold an e-Residence card are given a certificate of entitlement which qualifies them to free health services. You would think that all this would be in a centralized computer system at the hospital’s reception desk, with the information only a few mouse clicks away right? Wrong. It seems that recently at Mater Dei a rule is being enforced whereby the minute someone who is not Maltese appears at reception they are greeted by the phrase: Go to the Billing section. Actually, you are lucky to get that full phrase because apparently sometimes you are only greeting by the one word which is not so much as spoken as barked: “Billing!”

Let us start with the attitude. The stories I have read describing the sheer rudeness by front office staff who seem unable to communicate in a polite way, do not do any favours to Mater Dei’s image. If they have been instructed to direct non-Maltese patients to the billing department, then so be it, but surely they should be trained on how to speak to members of the public properly? Good manners go a long way especially in a place like the hospital where those turning up are already anxious to begin with.

The next point concerns the lack of correct information and what seems like a communication breakdown between non-Maltese nationals and those who run our health care system. The onus is on Mater Dei to inform all those living here of what documentation is required before they show up for a hospital appointment. They need to do this through any communication means possible to make sure it reaches all those who are affected. As has been pointed out, no one goes around carrying last month’s pay slip with them to prove that they have paid their national insurance, and the last thing one needs when one is waiting for an operation or outpatient care is to be faced with the choice of either going back home and missing one’s appointment, or coughing up the amount being demanded. This is causing undue stress and chaos, not to mention lengthy queues of upset, confused people who cannot understand why they are being treated in this way.

This is just another classic example of how our bureaucracy has not caught up with the reality of our changing demographics. We are constantly being told that more and more workers need to be imported to keep the economic wheel turning, however, it seems that someone forgot to tell those civil servants who actually deal with the public. This has to be a top-down communication where each department ensures that those who fall under its remit are properly briefed on how to deal with certain situations. It should definitely not be reduced to those working here, who are paying their dues, being treated in a way which can only be described as discriminatory.

And speaking of discrimination…

Environmental activist Cami Appelgren, originally from Sweden, is the first non-Maltese to be running for MEP – she is contesting on the PD ticket. Because she is not Maltese, she is probably more attuned than most to the concerns of nationals from other EU countries. One thing she has picked up on is that registering to vote is made unnecessarily complicated. According to the Electoral Commissioner, the Electoral Office is in agreement with Identity Malta Agency to fill in and pass required forms to the Electoral Register for every person that applies for an ID card or a Residence Card, as long as they are Maltese or a member of an EU member state. The registration application form can be handed in at any local council or police station but once received, then the applicant is informed that they have to go to Evans building or Identity Malta.

As she rightly pointed out, why make it so difficult for people, by asking them to take time off work to trudge all the way to Evans building, which is not exactly a convenient place to get to? It seems that all this rigamarole is done to make it harder for EU nationals to bother to register, thus making them ineligible to vote. Registration should be made as easily as possible to ensure that everyone who is entitled to can participate in the democratic process.