Author
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 three 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 2024 the Migrant Women Association (Malta) and the NGO Tama 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.
NGOs further report an increase in situations where holders of international protectional granted in other EU MS were required to pay for public medical services. This was seen in situations where the holder of protection granted in Malta held subsidiary status and was not able to present three recent payslips. Cases included medical services for pregnant women.
JRS reported that in 2023 and 2024, 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.[5]
[1] Social Security (U.N. Convention Relating to the Status of Refugees) Order, S.L. 318.16, 2001, available at: http://bit.ly/2kvoIaz.
[2] Regulation 20 Procedural Regulations, S.L. 420.07.
[3] Regulation 20 Procedural Regulations, S.L. 420.07; 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] Information provided by JRS Malta in June 2024.