A European Commission report has warned that the sustainability of Malta’s long-term care (LTC) services such as homes for the elderly could be threatened due to the country’s ageing population which is driving expenditure upwards. In, turn this could result in higher taxes.

“There are no ad hoc insurance funds for any aspect of social security (including LTC) in Malta and if this increase in expenditure materialises, it will have to be offset either from general taxation or an increase in the compulsory weekly contributions to social security made by the population in gainful employment,” the report said.

This prospect is being forecast in the 2021 Long-Term Care Report ‘Trends, challenges and opportunities in an ageing society’ which was published by the European Commission and the Social Protection Committee. It notes that Malta’s ageing population is a “major concern” for policy makers and in 2021 public spending on LTC is expected to increase substantially on 2019. According to its projections by 2050 annual expenditure is forecast to double and reach 2% of GDP.

Four main challenges

The report outlines four main challenges for the future of long-term care services in Malta:

Access: Institutional services need to be expanded to meet demand. This can be done by rolling out incentives for home-based long-term care like fiscal incentives to make it more affordable to employ carers and the adoption of modern technology such as video surveillance to provide more security to beneficiaries. There is also a pressing need to improve LTC for those with mental illnesses which are still stigmatised.

Affordability: More financial support is required for people who cannot afford to pay for a personal carer at home. The stringent means test currently applicable for family members who are caring for a relative need to be relaxed heavily.

Quality: Increased professional training opportunities to expand the workforce and to

attract locals to take up the newly created jobs, rather than having to depend on imported labour, are necessary. More training opportunities need to be offered also to informal carers to improve their chances of returning to the formal labour market after stints away from paid work because of LTC needs in their family.

Sustainability: Volunteering needs to be encouraged more, as they can support LTC

professionals in tasks where no specialised knowledge is needed. Volunteers already

organised in groups, like the church-run Djakonija, ought to be incorporated into official programmes of care at local level. Young Maltese need to be encouraged to opt for better insurance coverage for eventual LTC, since government pensions may not be able to cover all their requirements when they eventually need them.