The impact of the EU Directive on patients' rights and cross border health care in Malta. Issue 10 (October 2015)

• Record Type: Journal Article
• Authors: Azzopardi-Muscat, Natasha; Aluttis, Christoph; Sorensen, Kristine; Pace, Roderick; Brand, Helmut
• Is Part Of: Health policy. Volume 119:Issue 10(2015)
• Page Start: 1285
• Page End: 1292
• Publication Date: 2015-10
• Subjects: Cross-border health care -- Patients' rights -- Europeanisation -- Case study -- Health policy -- Malta; Medical education -- Periodicals; Medical policy -- Periodicals; Delivery of Health Care -- Periodicals; Education, Medical -- Periodicals; Health Education -- Periodicals; Health Planning -- Periodicals; Public Policy -- Periodicals; Enseignement médical -- Périodiques; Politique sanitaire -- Périodiques; Medical education; Medical policy; Periodicals; Electronic journals; Electronic journals; 362.1
• DOI: 10.1016/j.healthpol.2015.08.015
• Languages: English
• ISSNs: 0168-8510

Abstract

Highlights: Fear of a patient exodus shaped Malta's response to the directive. Restrictive implementation was chosen to retain power of at national level. The directive provided an opportunity to introduce domestic health system reforms. The early impact on patient experienced mobility in practice was minimal. Abstract: The patients' rights and cross-border health care directive was implemented in Malta in 2013. Malta's transposition of the directive used the discretionary elements allowable to retain national control on cross-border care to the fullest extent. This paper seeks to analyse the underlying dynamics of this directive on the Maltese health care system through the lens of key health system stakeholders. Thirty-three interviews were conducted. Qualitative content analysis of the interviews reveals six key themes: fear from the potential impact of increased patient mobility, strategies employed for damage control, opportunities exploited for health system reform, moderate enhancement of patients' rights, negligible additional patient mobility and unforeseen health system reforms. The findings indicate that local stakeholders expected the directive to have significant negative effects and adopted measures to minimise these effects. In practice the directive has not affected patient mobility in Malta in the first months following its implementation. Government appears to have instrumentalised the implementation of the directive to implement certain reforms including legislation on patients' rights, a health benefits package and compulsory indemnity insurance. Whilst the Maltese geo-demographic situation precludes automatic generalisation of the conclusions from this case study to other Member States, the findings serve to advance our understanding of the mechanisms through which European legislation on health services is influencing health systems, particularly in small EU Member States.