The Stumbling Nurse of the Mediterranean: Malta's Healthcare System at the Crossroads
This case looks at the challenge the Maltese Ministry for Health faced. The public healthcare system of Malta was modeled after the British NHS and provided a comprehensive package of medical services. Healthcare was free at the point of delivery for all Maltese citizens. Operating in parallel was the Maltese private sector, which accounted for a third of total health expenditures and provided most primary care. Healthcare was undergoing a paradigm shift from a focus on disease to a focus on systems. Governments were, therefore, increasingly scrutinizing returns on healthcare expenditures and pushing health actors to reorganize inefficient and badly functioning public systems. Malta was no exception. Its healthcare system was at a crossroads. The country had two seemingly different healthcare value chains operating in parallel, an increased reliance on private care, an overburdened public care system, and a population with chronic health issues and a history of taking advantage of the system.