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Refugees have access to state medical services free of charge. They have equal rights compared with Maltese citizens and are, therefore, entitled to all the benefits and assistance to which Maltese citizens are entitled to under the Maltese Social Security Act,[1] as defined in the Procedural Regulations.[2] Access to medication and to non-core medical services is not always free of charge, in the same way as it is also not always free of charge for Maltese nationals. All low-income individuals may be given a Yellow Card to indicate entitlement to free medication. The main public mental health facility, Mount Carmel Hospital, also offers free mental health services to refugees.
Beneficiaries of subsidiary protection and THP have access to state medical services too, according to national legislation and guidelines provided by the Healthcare Entitlement Unit[3]. Furthermore, NGOs report that all third-country nationals are entitled to full access to public health services if they are able to present at least 3 most recent payslips to the hospital payment desk.
Although the Home Affairs Ministry reports that public officials working on migration are trained to effectively identify and assist migrants victims of torture[4], in practice, specialised treatment for victims of torture or traumatised beneficiaries is generally not available. As no special referral system is in place, when officers come across someone who was tortured and is in need of assistance, they refer the individual to national mental health services and to the psychiatric hospital for in-depth support. The NGO Richmond Foundation provides mental health support, on a referral basis. Since the organisation’s services are largely based on a public service agreement with the Government, referrals need to be of persons having access to social support. Nonetheless, NGOs report that free services are often also provided by the NGO. JRS Malta also provides psychological support to persons referred to the organisation, whilst in 2022 the Migrant Women Association (Malta) started offering support to women. NGOs report coming across several people who have suffered torture and various forms of extreme violence, including sexual violence. Long-term support is extremely difficult to secure and where the impact impedes access to employment, victims tend to struggle due to the limited available financial and other support.
Incidents of neglect have been reported to happen, including in 2022. The African Media Association Malta reported the death of a 22-year-old migrant after she was allegedly refused hospital treatment. Her relatives testified to her repeated experience of negligence at the Mater Dei emergency room, and the police opened an investigation to determine the exact cause of her death. MaltaToday reported that a Somali man who was reported missing had died in a hospital after suffering serious injuries at work. His identity had not been established until nurses identified him from a photo issued by the police. When the police issued the missing person report, social media were flooded with racist jokes and abusive comments celebrating the man’s disappearance, according to Lovin Malta, which were condemned by the Minister for Inclusion and the Equality Minister.[5]
No such incidents were reported for 2023.
JRS reported that in 2023, despite the improvements made, a significant number of the individuals followed by the organisation, or members of their immediate family, have had trouble accessing healthcare on one or more occasions. The cause of these difficulties was not always clear, however they seemed rooted in questions regarding individual entitlement to free healthcare, lack of knowledge of the rights of the different categories of migrants living and working in Malta, lack of understanding of information among migrants about how the system works and the services offered, limited available information, language barriers, and cultural issues such as obstacles relating to shame and stigma. [6]
[1] Social Security (U.N. Convention Relating to the Status of Refugees) Order, Subsidiary Legislation 318.16, 2001, available at: http://bit.ly/2kvoIaz.
[2] Regulation 20 Procedural Regulations, Subsidiary Legislation 420.07 of the Laws of Malta.
[3] Regulation 20 Procedural Regulations, Subsidiary Legislation 420.07 of the Laws of Malta; Entitlement Unit Malta, available at: https://bit.ly/4eaeDeD. The guidelines are available here: https://tinyurl.com/4dsr6n3j.
[4] Information provided by Home Affairs Ministry in January 2024.
[5] FRA, Migration: Key fundamental rights concerns, quarterly bulletin October – December 2021, available at: https://bit.ly/3ENks1k, 30.
[6] Information provided by JRS Malta in June 2024.