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Guide to Healthcare in Malta - Costs, Treatments & Quality of Care

home visit doctor malta

By Kathleen Evans

The ease of access and affordability of healthcare should always be one of the top criteria when looking for a place to retire . One never knows when a medical emergency or a need for long-term treatment might crop up, regardless of age. Therefore, having your ducks in a row and being well-informed is a necessity before embarking on any travels.

Malta has a healthcare system backed by an excellent track record of providing public-financed care since 1372. That’s when Malta’s first hospital became operational. When the Knights of St. John came to the country in the early 16th century, they started building hospitals as one of their fundamental objectives.

Today Malta offers some of the best healthcare in the world, despite its size. The World Health Organization, in 2023, ranked Malta #26, and Statista.com puts Malta at #19 – ahead of countries renowned for their healthcare programs, such as Portugal , Korea, UAE, and Costa Rica . Other indexes rank Malta’s healthcare in the top 10. Life expectancy in Malta is high, and the population spends, on average, 90% of their lifespan in good health, longer than any other EU country.

Malta, like most countries, has both a public and private healthcare system. We’ll focus primarily on the private one for much of this article, since third-country nationals (from outside the EU) and digital nomads are required to purchase private healthcare insurance to qualify for a visa or residency.

Even with a policy responsible for only major medical needs, covering smaller health issues out-of-pocket is still relatively affordable compared to what one would pay in the US or Canada through the private system.

Healthcare System

Malta’s strong public healthcare system provides free services to all Maltese citizens and European Union residents with a European Health Insurance Card (EHIC). Malta’s public healthcare system is funded via taxes. The islands have eight public hospitals, including one on the island of Gozo , and a network of health clinics and pharmacies that offer preventative, rehabilitative, and curative care. Thanks to Malta’s small size, it’s easy to access a hospital or health clinic when needed, regardless of where you live.

The Mater Dei Hospital (MDH), more famous as Mater Dei, is the main public hospital of Malta, located in Msida. It functions as a specialty facility as well as a training institute. In terms of infrastructure, it has one of the most significant facilities in Europe. Patients are admitted via referrals by a doctor or the emergency department. Expats can utilize this public hospital, but they will have to pay out of pocket. But depending on the policy, they may be eligible for reimbursement through their private insurance.

As more and more residents in Malta purchase private health insurance, the number of private healthcare clinics and hospitals is also on the rise. Most GPs employed with the public healthcare system also work in private practice.

Malta also has three private hospitals on the main island – St. James Hospital , St. Thomas Hospital , and the DaVinci Health Clinics. They offer a broad range of services, from blood tests to diagnostic scans to complex surgery. Having the latest medical technology, such as a 4D ultrasound, a comprehensive digital radiology system, laser-assisted surgery, and MRI and CT spiral scan. As well as 24/7 emergency room and ambulatory services at both St. James and St. Thomas.

Non-EU citizens living in Malta must obtain private healthcare insurance. Naturally, the cost of policies varies depending on your age, health, and deductibles. The price of a private insurance policy is much lower than in the U.S

A growing number of Maltese and EU citizens are purchasing private insurance, despite having access to free public care, which may be a testament to the reasonable cost of private health insurance. Many prefer to have some additional insurance coverage because it allows access to a greater range of physicians and services, and because private care usually offers much shorter wait times.

Most insurance companies, such as Laferla and Bupa, offer a variety of plans to suit individual or family needs. For example, Laferla’s basic “bronze” plan provides limited coverage for private hospital treatment, and full coverage for CT and MRI scans, outpatient doctor visits, and cancer treatment. The top-tier international “gold” plan covers everything, including funeral expenses.

Steve Spada, originally from Austin and now splitting time between Malta and Costa Rica , recently requested a quote from Laferla for himself and his wife. “We are both in our 60s and want an international policy since we are outside of Malta for half of the year. The International Silver plan is €3100 ($3430) for both of us annually, and it covers us for worldwide medical treatment up to €750,000. With it, we also have emergency coverage in the USA and Canada up to €20,000.”

Saul and Gail Klarke, originally from New York, purchased a private insurance policy through Mapfre. “It cost €2300 ($2543) for both of us. They did not raise our rates this year, but they probably will when Saul turns 70. It’s the minimum policy we could buy and qualify for residency.” They are both currently in their 60s. This policy doesn’t cover them outside Malta or for wellness care. “It also doesn’t cover pre-existing conditions. I had breast cancer, which wouldn’t be covered if it returned. But we have kept our Medicare in the US, and I would travel back there for treatments, if needed.”

For expats, purchasing an international or worldwide health insurance policy rather than a local Maltese plan is a good idea. It helps you get access to hospitals and doctors of your preference, and it applies not just to Malta but in other countries where you travel or live part-time.

Which is the best health insurance in Malta is always subjective. Depending on its coverage and your essential needs, it will be different for every expat. Various aspects, like pre-existing medical conditions, age, specific requirements of medical insurance, and the situation in Malta, among other criteria, need to be considered. Yet, you can find insurance plans offered by internationally-known names like Cigna and Allianz. It’s best to research and compare the policies these companies provide to expats in Malta before choosing the best one for you.

Quality of Care

Malta’s private hospitals are known for the excellence of their specialty clinics. Da Vinci Health, for example, has multiple clinics, including a well-respected breast care clinic, a dentistry department, and an orthopedic specialty. St. James Hospital group owns four state-of-the-art clinics and one 80-bed hospital with a renowned eye care clinic. St. Thomas is the newest boutique hospital, stressing comfort and boasting the latest technology.

Besides the three main private hospital groups, nearly 100 smaller private medical clinics specialize in everything from osteopathy to optical.

There are currently no Joint Commission International (JCI)-certified hospitals on the island. An independent, not-for-profit organization, the JCI identifies, measures, and shares best practices in quality and patient safety around the world for medical centers. That said, Malta’s healthcare system is set to gain access to the latest medical technologies and clinical treatments thanks to a deal with Vitals Global Healthcare, in collaboration with Barts and The London School of Medicine and Dentistry and Partners HealthCare International from the US. Vitals will be investing €220 million in revamping Malta’s medical infrastructure following the award of a service concession from the Government of Malta.

The total number of doctors registered in Malta is approximately 1150, serving a population of just over half a million people. Many of the doctors in Malta have studied or worked in the UK or other EU countries. The doctors and staff in Malta speak English, which is a huge advantage for any English-as-a-first-language patient compared to many of the other popular International Living retirement countries showcased.

In Hasmita’s knee injury case, she was very happy with the surgery and the quality of care. “In all I had five visits to the hospital, and I had a pre-surgery consultation where they measured blood pressure and took a blood test. I would definitely recommend the private over the public hospital as treatment was very good and quick other than the initial X-ray. My consultant authorized ten amazing physio sessions, and they have all the rehab equipment to try different exercises.”

Popular Treatments

While Malta is not especially known as a medical tourism destination, compared to places like Turkey, Mexico, Costa Rica, India, and Thailand, there is the beginnings of an emerging medical tourism sector.

The most common procedures for tourists include:

  • Orthopedic Surgery
  • Dental Work
  • Cosmetic Surgery
  • Blood Tests
  • Diagnostic Scans
  • Laser Hair Removal
  • Cardiac Surgery

The following are a few cost comparisons between medical procedures in Malta and equivalent procedures in the United States:

Since Gail Klarke’s Mapfre insurance does not cover wellness, she and Saul pay the affordable out-of-pocket prices. “A visit to a primary care physician at St. James is €85 ($94) - the best private care hospital in the country. The oncologist is about €60 ($66), eye exams are €35 ($39), dermatologist €65 ($72), and a gynecologist visit is €80 ($88). Blood tests are around €280-300 ($309-33). I was due for a mammogram, and 3D imaging only cost €125 ($138) at St. James Hospital.” The average cost for a 3D imaging mammogram in the US starts at $560 without insurance. And blood work can be upwards of $1000.

Dental care is also cheaper than in the US. For example:

Availability of medications.

There are more than 200 pharmacies in the 122 square miles of Malta, with at least one in each village, and a few dozen in each town. Therefore, you’ll find a pharmacy nearby anywhere you live in Malta, just look for the international green cross.

Many medications can be bought over the counter, and GP’s or specialists issue prescriptions if necessary. In most pharmacies, no ID is required. There is no proper customer file, and your prescription is not scanned, as would be the case in many other countries.

You can typically find any medication you are looking for in Malta—or a generic substitute. Most medicine boxes will have information written in English, but you may also find some brands in foreign languages, such as Turkish or Spanish.

You can also go directly to the pharmacy and ask the pharmacistfor advice if you haven’t already seen a doctor. They can provide you with authorized medicine if it doesn’t need a prescription.

Most pharmacies have General Practitioners available for consultation – typically, you will need to make an appointment, but not always. It’s extremely convenient if you need to see a professional about a non-urgent problem and get a prescription.

Steve Spada, a part-time Malta expat, shared, “I needed to have a consultation to see if I should change my blood pressure medication, and I was able to get a doctor’s appointment at a pharmacy the next day. It only cost me €20 out of pocket ($22) for the consultation and check-up. It would probably be 5x that in the States, and double that in Costa Rica with a private GP.”

I checked with the pharmacist at Stella Maris pharmacy in Sliema to get up-to-date prices for some of the most common drugs taken by typical retirees.

Azithromycin antibiotic used for treating pneumonia, ear/nose/throat infections—€12 ($13) for three tablets

Levothyroxine used to treat hypothyroidism—€3 ($3.30) for 28 days

Lisinopril used alone or together with other medicines to treat high blood pressure—€10-20 ($11-22) for a 30-day supply depending on dosage

Metformin used for type 2 diabetes to lower blood sugar levels—€5-9 ($5.50-10) based on dose for a 90-day supply

Omeprazole used to treat excess stomach acid causing acid reflux, ulcers, etc.—€12 ($13) for a 30-day supply

Simvastatin commonly used to treat high cholesterol and fat levels in the blood to avoid heart attack and stroke—€4-7 ($4.40-8) for a 30-day supply

Emergency Services

With a highly-ranked healthcare system, it only makes sense that medical emergency services are available. Like other EU member nations, people across Malta can dial the toll-free number 112 for 24/7 emergency services. Both St. James Hospital and St. Thomas Hospital have full-service emergency rooms and much of the population can get to an emergency room within 20 minutes or less. However, there are reports of long ambulance wait times (30+ minutes), and during high traffic (which is often), the ambulance may be further delayed.

If you’re on the island of Gozo and you have a critical emergency, you may need to be life-flighted to the main island of Malta (there is no bridge, so one must take a ferry). This could be quite costly; meaning it is a good idea to have health insurance to cover those type of situations.

Malta’s Ministry of Health website provides information from the latest news regarding health alerts to formulary lists and a list of resources. The expats who weighed in feel that the high EU standard of health in Malta for the relatively inexpensive cost is one of the reasons this Mediterranean country is a great place to consider for retirement in Europe.

Malta Deep Dives

Climate in Malta

Cost of Living in Malta

Economy in Malta

Living in Malta

Moving to Malta

Real Estate in Malta

Retire in Malta

Visa and Residency in Malta

City and Area Guide

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Healthcare in Malta: free and paid treatment, insurance, and cost

Malta has a high level of healthcare effectiveness, ranking 10th in the world. Due to sufficient governmental funding, citizens and EU nationals get treatment in state hospitals for free.

You will find the key information to prepare for a safe trip, medical tourism or relocation to Malta in this article.

home visit doctor malta

  • Overview of Malta’s healthcare system

Primary care

Secondary care, tertiary care.

  • Cost of medical care in Malta
  • Who is entitled to free healthcare in Malta?
  • Medical insurance in Malta
  • Malta healthcare for foreigners
  • How foreigners can get free medical treatment in Malta

Memo about Malta’s healthcare system

Frequently asked questions, overview of malta’s healthcare system.

Despite the country’s relatively small size, Malta’s healthcare system is trustworthy and has proven its effectiveness. Malta was ranked 10th among 166 countries, according to a study by Wisevoter. The country was given 79.8 points, considering the global average care system score is 54.

The other proof of Malta’s healthcare quality is its current life expectancy index of 83.06 years — four years higher than the EU average. Malta is one of the few countries that did not experience a considerable reduction in life expectancy between 2019 and 2021.

Malta’s healthcare system provides all residents with a wide range of medical services and almost universal coverage. It is divided into public and private sectors. Both offer regular check-ups, tests, and free and paid medical care services. The majority of doctors tend to work in both public and private healthcare facilities at the same time.

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The public sector is funded by tax revenues as well as contributions to national insurance from employers, employees, and self-employed. Due to this fact, Maltese citizens and EU nationals can use medical services for free or at a nominal cost. The same advantage is available for foreigners who obtained Malta citizenship by naturalisation for exceptional services by direct investment .

Publicly provided healthcare in Malta covers the majority of essential services: from specialist treatment and prescribed medicine to emergency care, surgery, prenatal care and childbirth. However, the waiting time for non-emergency hospital treatment can be quite long.

Private healthcare is funded by private insurance or paid for by the patients themselves. It is a popular option among both Maltese and foreign residents, because getting an appointment in private clinics is usually quicker than in public hospitals.

The private sector delivers a broader choice of specialised services. For example, the largest private hospital in Malta, Saint James Hospital Group, provides most kinds of in-patient and out-patient services, surgical interventions, immediate medical care, and physiotherapy.

Malta’s healthcare system covers medical treatment on three main levels of care: primary, secondary and tertiary. Before exploring how these types work in Malta, let’s find out the difference between them:

  • Primary care is the first point of medical consultation, which is provided by general practitioners and family doctors.
  • Secondary care is delivered by medical specialists and other health professionals who typically don’t have initial contact with patients.
  • Tertiary care services are for patients who require advanced medical treatment and investigation, such as cancer management, neurosurgery, cardiac surgery, or plastic surgery.

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Primary care in Malta is provided by both public and private hospitals. There are eight medical centres which deliver government-sponsored primary healthcare. Nevertheless, the private sector plays an important role, too. Private clinics allow patients to choose their doctor and set appointments, whereas public hospitals mainly offer care on a walk-in basis. That is why private general practitioners account for 70% of primary care visits.

General practitioners in Malta offer treatment, give referrals to other specialists where needed and prescribe medications. Home visits are available after 8 PM and provided for urgent cases.

The doctors can be found not only in public or private facilities but also in pharmacies. In Malta, almost all of them offer paid general practitioner services at specific hours. These consultations usually apply to minor ailments: a general practitioner can prescribe medication or write a referral to a hospital.

Emergency care is provided at public hospitals, as well as private clinics. These services are only to be used if you need immediate attention, your doctor has referred you, or there is no GP available to treat you. The main state emergency department is located in the Mater Dei Hospital. It is open to everyone and operates 24 hours a day.

Among private hospitals with emergency departments, Saint James Hospital Group is the biggest one. It has three Immediate Medical Care Units around Malta. Each provides immediate first aid, medical assessment and treatment for emergencies and accidents. Notice that insurance is required once a patient’s condition has been brought under control.

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Visiting a general practitioner or family doctor first is not obligatory in Malta. Patients can go directly to any specialist, especially in private practice. Secondary care is also offered by most public hospitals over the country.

Specialist doctors can combine work in state facilities with practice in private ones. Private hospitals have high-quality clinics and departments which cover all medical care needs — there can be up to 15 outpatient care services within one hospital. A few pharmacies in Malta have a consulting room not only with general practitioners but also with specialised doctors.

Dental care . Most dental care services in Malta are provided in private facilities at the patient’s own expense. Free dental treatment is available only in emergency cases and to a limited extent. Malta health centres offer a comprehensive range of general dental procedures but charge different fees.

Malta has an advanced level of highly specialised medical care in both public and private facilities. At the same time, it is more affordable than in some European countries.

Inpatient care is provided mainly by state facilities like the Mater Dei Hospital. It has over 1,000 beds, an intensive care unit, a surgical unit, and a recovery centre. The state rehabilitation hospital Karin Grech Hospital in Pieta has 293 beds.

The only hospital on the island of Gozo, Gozo General Hospital, also delivers inpatient medical and surgical services. It is a 302-bed hospital connected with health facilities on mainland Malta with an air ambulance service.

Surgery is performed both in public and private hospitals. Operating theatres at private clinics are equipped with the latest technology and provide a wide range of surgical procedures — from minor surgery to complex major interventions. The most notable private facilities with surgical units are Saint James Hospital Group and Saint Thomas Hospital.

Cosmetic surgery. Private clinics like Da Vinci Health or Saint James Hospital Group perform most kinds of reconstructive and plastic surgery, such as body or face lifts, fat reduction, breast augmentation and more. There are also highly-rated clinics which specialise only in plastic surgery.

Cancer treatment is offered for free in Malta’s public hospitals. The main specialised hospital for oncology is Sir Anthony Mamo Oncology Centre, which is physically and organisationally interconnected to Mater Dei Hospital.

Apart from comprehensive treatment, the hospital implemented a “Nurse Navigation” program. Its purpose is to guide cancer patients through treatment and support for months after it stops. This system was recognised by the World Health Organisation in 2022 and advised to other countries.

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Cost of medical care in Malta

Clinics and hospitals do not usually show prices on their websites, so here you find the approximate price range of popular medical services in Malta. It is better to clarify the details about the selected facility by phone.

Approximate prices of medical services in Malta:

  • general practitioner consultation — from €15 to €30;
  • general practitioner’s home visit — from €30;
  • family doctor online consultation — around €25;
  • specialised doctor’s consultation — from €30 to €80;
  • laser eye correction — from €1,800 to €3,100;
  • MRI — from €150;
  • ultrasound — from €50 to €200;
  • blood test — from €10.

Dental treatment:

  • root canal treatment — from €200;
  • teeth whitening — from €250 to €465;
  • fillings — from €55.

Overnight stay at Mater Dei Hospital:

  • a general ward bed — around €260 per day;
  • a high dependency care bed — around €490 per day;
  • an intensive care bed — around €930 per day.

Private healthcare insurance plans offer to cover the expenses for any treatment — from doctors’ consultations and diagnostic procedures to hospital accommodation fees and cancer treatment.

Malta healthcare: how it works

Who is entitled to free healthcare in Malta?

Due to Malta’s developed public healthcare, its citizens can receive medical treatment completely free of charge. State hospitals provide all the necessary services, including out-patient and in-patient services, specialist consultations, immunisation and vaccination services, emergency dental work, surgery, oncology care, and prenatal and postnatal care.

Patients are supplied with free medicine during hospitalisation and three days after discharge. Below you can find groups of people eligible for free healthcare in Malta.

How to obtain Maltese citizenship

Expats who work legally in Malta also pay social security contributions. It allows them to have the same healthcare privileges as Maltese nationals.

Self-employed. In Malta, they are people who earn passive income from investment, rents and interests. Their remuneration must not come from occupation or trade.

Self-occupied. This term refers to people who are not employed and earn money from trade or skill. Their annual income must exceed €910. If employed workers in Malta earn €910+ a year, but work less than 8 hours a week, they are also considered self-occupied.

Travellers from another EU or Schengen Area state must provide their valid European Health Insurance Card for free medical treatment in Malta. If EU nationals plan to stay in Malta for over 90 days, they must get an S1 form in their country and register it with the Maltese Entitlement Unit.

Australian travellers . Australia has a Reciprocal Health Care Agreement with Malta, so its nationals can get free essential care in Malta. To receive treatment, Australian citizens must provide their country’s passport and Medicare card. The Agreement applies to up to six-month stays.

UK travellers . Due to a Reciprocal Health Care Agreement with Malta, the British have the same advantage as Australians, but within one month of stay. If UK nationals stay in Malta longer than one month, they must obtain a Reciprocal Health Care Certificate.

If a stay takes longer than three months, UK citizens must register as residents and their UK-issued S1 form with the Maltese Entitlement Unit. In this case, they will get access to the whole range of medical treatment, not only essential care.

Medical insurance in Malta

Malta’s national insurance covers in-patient and out-patient treatment, emergency care, diagnostic services, and management of pregnancy and childbirth. It allows citizens, working expats and residents to use public healthcare services for free.

National insurance is financed by contributions to the Department of Social Security from employees, employers, self-employed, and self-occupied persons.

Social Security contribution rates in Malta:

  • employee and the employer — 10% of the basic weekly wage before tax;
  • self-employed and self-occupied — 15% of the taxable weekly earnings.

Private insurance. Maltese citizens access public healthcare for free, so purchasing a private policy is completely optional. They can buy additional insurance to cover expenses in private clinics.

Some categories of people are obliged to purchase private healthcare insurance in Malta. Among them are:

  • Third-country travellers. Visitors from outside the EU or Schengen Area, the UK, or Australia are not eligible for free healthcare treatment. They need to buy a private healthcare plan. Travel insurance with health coverage is also required to obtain a Schengen visa. Its average price in Malta doesn’t usually exceed 6% of the trip cost.
  • Investors applying for  Maltese residency or citizenship . Annual prices per plan typically start at €400 for the investor and €1,600 for a family of four.
  • Holders of European Health Insurance Cards, Global Health Insurance Cards, or Reciprocal Health Care Certificates. As these documents do not cover private treatment and have limits for public medical services, their holders are advised to purchase private healthcare insurance.

Prices on private insurance plans depend on the number of services included and the age and chronic diseases of the insured. The average cost ranges from €275 to €700+ per year. Comprehensive policies give full coverage, while the most affordable ones can be limited to an in-patient cash benefit for some instances of hospitalisation.

Check the websites of the leading health insurance providers in Malta to find detailed information about their medical plans. Some popular insurers are MAPFRE MSV Life , Laferla , Atlas , Elmo Insurance , and Bupa Global .

Malta healthcare for foreigners

Third-country travellers can visit a hospital for a fee, as they are not eligible for free medical care in Malta. Alternatively, tourists can buy private healthcare insurance to compensate for medical treatment.

Short-term visitors from another EU or Schengen Area state, the UK, or Australia get essential medical care in Malta for free. To get free healthcare without additional requirements, the travelling period must be limited to 90 days for EU citizens, 6 months — for Australian nationals, and 1 month for visitors from the UK.

Expats receive free medical treatment in Malta if they pay taxes and make contributions to the Department of Social Security. Employees and employers pay 10% of the weekly earnings, self-employed and self-occupied — 15%.

How foreigners can get free medical treatment in Malta

Foreigners can obtain a Malta residence permit  — by investment, starting a business, marriage, family reunification, employment or for studying. Non-EU citizens who receive a  residence permit by investment not only get access to local clinics and hospitals but also pay taxes under a special regime. The minimum annual tax rate is €15,000.

To acquire residency in Malta, investors buy or rent real estate and pay an administrative fee. Foreigners must also purchase health insurance for each family member in the application.

Third-country nationals, non-EU, non-EEA and non-Swiss, can participate in the  Malta Permanent Residence Programme . The investors must fulfil several investment conditions:

  • pay €40,000 for the administration fee;
  • rent a residential property for 5 years or buy one;
  • pay €58,000 or €28,000 of the contribution fee for renting or buying real estate;
  • donate €2,000 to a charitable organisation.

Malta citizenship can be obtained by registration, ordinary naturalisation or naturalisation for exceptional services by direct investment. The last one allows foreigners to apply for a passport after 1 or 3 years of holding a Maltese residence permit.

The residence period depends on a contribution sum. The residence permit must be kept for 3 years if an investor contributes €600,000 and for 1 year if the contribution amounts to €750,000.

There are three mandatory requirements to obtain Malta citizenship for exceptional services by direct investment :

  • Contribute at least €600,000 to the National Development and Social Fund.
  • Donate €10,000 to a non-governmental organisation.
  • Rent a property for 5 years for €16,000 per year or buy one for €700,000.

Moreover, there is an additional payment of €50,000 for each family member in the application. Investors’ spouses, children up to 29 years old and parents or grandparents over 55 can also get Malta citizenship. All investors and their family members undergo a strict Due Diligence check.

  • Malta provides all types of high-quality healthcare at affordable prices — from general practitioners’ consultations to cancer treatment.
  • Malta has public healthcare, which is available free of charge for its citizens, legally working residents, EU, UK and Australian nationals.
  • A lot of patients opt for private healthcare to reduce the waiting time, choose a particular specialist, or get access to a specific treatment.
  • Private insurance is necessary for third-country travellers and applicants for  Malta residency or citizenship .
  • Foreigners access free medical treatment in Malta by obtaining Malta citizenship by naturalisation for exceptional services by direct investment .

The quality of the country’s healthcare is of a high standard. Malta’s healthcare is ranked 10th out of 166 countries for its effectiveness. Also, Malta’s life expectancy index is four years more elevated than the EU average. The country’s healthcare system works well enough to support people’s health.

Yes, but it is available only for Malta and EU citizens. Most foreigners must purchase health insurance .

Yes, foreigners can visit hospitals in Malta for a fee or after purchasing medical insurance. Citizens from the EU or Schengen Area state, the UK, or Australia are eligible for  free medical care in Malta .

Yes, Malta is on the list of European countries with universal healthcare. Malta provides access to free medical treatment for all citizens. People with low income or certain chronic diseases are entitled to receive essential medicines and medical devices free of charge.

Prices depend on the hospital and the chosen medical service  — from €15 for a general practitioner consultation to €3,100 for laser eye correction. Most expenses can be fully or partially covered by private insurance policies.

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Family Doctors in Malta and Gozo - Page 1 of 9

Dr domnic agius.

Attends Tarxien Pharmacy (Tarxien).

Dr Francis Agius

Attends Medicaid Pharmacy (Gudja).

Dr Charmaine Apap

Attends Beta Pharmacy (Għaxaq), CarePlus Medics….

Dr Martina Aquilina

Attends Mackie's Pharmacy (Birkirkara).

Dr Michael Asciak

Attends Brown's Pharmacy (Birkirkara).

Dr John Attard

Attends St. Bartholomew Pharmacy (Santa Venera).

Dr Lucienne Attard

Attends St. Andrews Clinics (Swieqi).

Dr Peter Attard

Attends Cosmed Pharmacy (Ħamrun).

Family Doctors

Your family doctor is usually the first healthcare professional to see when having any health issues. There are some conditions that can be diagnosed and treated by a family doctor, however, in more serious cases they give referrals to other medical professionals . Once a diagnosis is in place, family doctors can help to manage chronic conditions such as arthritis or heart disease.

When to see a family doctor

You should see your family doctor if you have any symptoms or questions regarding your health. It is also advisable to visit your family doctor every year for routine exams and screenings. There are however many symptoms that should not be ignored and if you experience any from the list, visit your family doctor:

  • Worse than usual cold
  • Unexplained changes in weight
  • Short of breath
  • Extreme chest, pelvic, or abdominal pain
  • Any other persistent symptoms that are unusual

English in Malta, by the English in Malta, for the English in Malta

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General Practitioners in Malta

Have you recently fallen ill? Do you have young children, or would you like to know as a precaution where to find a doctor near you? Here is a guide listing the best general practitioners in Malta and Gozo , so you can seek treatment without apprehension.

Before starting:

If you are an EU national, either on holiday in Malta or working on the island, you can access healthcare at public hospitals free of charge. Do not forget to take your European health insurance card or your Maltese social security number. You can also visit our “ Hospitals in Malta ” article to find more information.

In this article, we will focus on physicians outside hospitals and health centres.

In Malta, you will find a lot of pharmacy doctors . Consultation costs are on average between €8 and €15, but doctors are not always available during pharmacy opening hours.

For private clinics, you can be expected to pay at least €20 for a consultation .

In the event of a general practitioner making a house-visit, the cost will usually be between €30 and €50.

General practitioners in Malta

General practitioners located in the east (swieqi, st julia’s, sliema, gzira, qormi…), dr. timmy camillieri.

He works in a clinic in Sliema: Regent House, Suite 15 Triq Bisazza, SLM15 Sliema  

It is open Monday to Friday from 8:00 a.m. to 7 p.m. and Saturday 8 a.m. to 12:30 p.m.

Contact him on the following number to make an appointment: + 356 2133 0468. You can also contact him directly on his website:  Camilleri Clinic

St Andrews Clinic

In this medical clinic located in Swieqi, you will find several general practitioners .

It is located at the following address: 40, Triq Il-Qasam Swieqi SWQ, 3020

As for its opening hours, you can go there from Monday to Friday from 9:00 a.m. to 1:00 p.m. then from 4:00 p.m. to 7:00 p.m.

You will find a list of their GPs directly on their website: St Andrews Clinic

You can contact them on +356 2135 5205

General practitioners located in the North (St Paul Bay, Mellieha, Mgarr…)

Pjazza medics clinic.

Located in St Paul’s Bay: Triq Halel, San Pawl Il-Baħar

It is open from 9:00 a.m. to 7:30 p.m. Monday to Friday, and from 9:00 a.m. to 1:30 p.m. on Saturday

To contact them you can call:  +356 7975 2992 or visit their website:  pjazzamedics

General practitioners located in the South (Marsaskala, Zurrieq, Marsaxlokk, Luqa, Siggiewi…)

Klinika santa marija zurrieq.

Located in Zurrieq: Triq ir-Rettur Dun Salv Farrugia, Iż-Żurrieq

Opening hours: 7:00 a.m. to 7:00 p.m. Monday-Tuesday-Thursday, 7:00 a.m. to 6:00 p.m. Wednesday, 7:00 a.m. to 5:00 p.m. Friday, 7:00 a.m.

To contact them you can call: +356 7970 3208

Marthese Sciortino Family Doctor

This doctor is located in Paola Zabbar, Road

It is open from 9:00 a.m. to 1:00 p.m. Monday-Wednesday-Thursday, 9:00 a.m. to 11:00 a.m. Tuesday, Friday and Saturday

To contact them you can call: +356 2169 7082

General practitioners located in the West (Rabat, Mdina, Dingli…)

Family health centre.

This medical clinic is located in Rabat Ace Bldgs Triq il-Hobbejza, Rabat Malta RBT 1864

It is open from 8:30 a.m. to 7 p.m. Monday-Tuesday-Thursday, 8:30 a.m. to 3 p.m. on Wednesday, from 8:30 a.m. to 4 p.m. on Friday

To contact them you can call: +356 2145 3213

General practitioners located in the Center (Mosta, Attard, Birkirkara…)

Sweet valley family clinic.

This medical clinic is located in Balzan: Triq il-Ferrovija l-Qadima, Triq P.P. Castagna, Ħal Balzan

It is open from 9:00 a.m. to 7:00 p.m. Monday to Friday and from 9:00 a.m. to 1:30 p.m. on Saturday

To contact them you can call: +356 7942 4234

General practitioners in Gozo

Dr. martin cutajar.

Located in Victoria: Triq l-Ewropa, Ir-Rabat Għawdex

Available Monday to Friday from 8:00 a.m. to 1:00 p.m. then from 5:00 p.m. to 7:00 p.m. and Saturday from 8:00 a.m. to 1:00 p.m. on Sunday

To contact him you can call: +356 9949 3533.

To conclude:

This list is not exhaustive. If you want to go further and find other General Practitioners closer to your home, you can go to a pharmacy where many doctors will be listed.

You may also be interested in:

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Seeing a Doctor in Malta

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Seeing a Dentist in Malta

Dental clinics in Malta are privately run. To see a dentist, contact a local dental clinic for an appointment.

Dental work in Malta is fairly inexpensive compared to the rest of Europe and North America, with routine exams and cleaning from €35, extractions from €35, and fillings starting from €45. As such, some dental clinics, such as Demajo Dental , the Regional Dental Clinic , and the Savina Clinic , market towards both locals and tourists, and publish their price lists online. Many dentists will offer oral examinations or give general advice for free. Dental clinics can also arrange accommodation for tourists seeking their services.

Dental clinics are generally clean, modern, and well-maintained, offering high quality professional services and well-trained, attentive practitioners.

Upon payment (cash or credit card), dental clinics can issue a receipt to submit for reimbursement to insurance companies.

By Jess Gerrow, who traded city life in Canada for island life in the Mediterranean two years ago. She is a postgraduate marketing student, blogger, and freelance writer.

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HealthMark Malta

Need Home Assistance?

Perhaps you have had a fall, or need assistance following an operation or an admission to hospital?

Do you work full time and find it difficult to provide the support an elderly parent needs?

At Healthmark we provide fully trained and carefully vetted home assistants to help clients to feel in control. A Home Helper can visit for a few hours or for the day. We can also provide night companionship who can provide reassurance by staying overnight.

Visiting Home Helper can assist with:

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General Practices Malta

All 6 clinics that provide general practice in malta, popular locations, looking for a different clinic, popular treatments, why do tourists visit malta.

Malta is a sunny Mediterranean country with a rich history and culture. The Knights of Malta built hospitals and churches in Malta and many of these buildings are beautifully preserved. The Saint John's Cathedral in the country’s capital Valletta is one of the most elaborately decorated churches in the world. Malta has its own local cuisine and restaurants serving international fare. The climate in Malta is mild throughout the year. Malta is well-known for performing arts and hosts arts festivals, music festivals and ballet performances.  Malta has large shopping malls and small stores selling souvenirs and local Maltese arts and crafts. Accommodation options include luxury hotels, budget hotels, villas, farm stays, bed and breakfasts and apartments.   

Why do International patients visit Malta?

Malta has a history of offering high quality medical services for patients. The Knights of Malta also called the Knights Hospitaller established hospitals in Jerusalem and other parts of Europe, including Malta, to care for the sick and ailing. Today, Malta has well-equipped hospitals and private clinics that offer high quality healthcare services at affordable prices for overseas patients. All staff and doctors speak at Maltese hospitals and clinics English.     

Does Malta have international airports?

All Maltese islands are served by the Malta International Airport.

What are the visa requirements for patients travelling for medical treatments to Malta?

There is no specific visa for patients travelling for medical treatments to Malta. Patients can get short stay visas to travel for treatments to Malta. Details on how to obtain a short stay visa to Malta are available at the website:   https://identitymalta.com/visa-types-validity/

We have all the information you need about public and private Maltese general practices. Compare all the general practices and contact the gp in Malta who's right for you.

Prices from 1455 ₽ - Enquire for a fast quote ★ Choose from 6 General Practices in Malta with 10 verified patient reviews. See popular locations and treatments.

CHIC Med-Aesthetic Clinics - Dr Charlene Scicluna CHIC Med-Aesthetic Clinics Malta

CHIC Med-Aesthetic Clinics

Very well served by the Chic Clinic. Highly recommended and will surely visit again. Well done.

St.  Brigids Centre - CENTRE LOGO

St. Brigid's Centre

The Pilates Studio - General Practice in Malta

The Pilates Studio

St. Edwards Clinic - General Practice in Malta

St. Edwards Clinic

DaVinci Health - Dental Clinic in Malta

DaVinci Health

I did a number of tests recently at Da Vinci hospital and I was very happy with the professional service received. No waiting time was involved and the results were fast and accurate!

St. Philips Hospital - General Practice in Malta

St. Philip's Hospital

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Camilleri Dental Clinic and Medical Clinic

Family doctor services, what is family medicine.

Family medicine (FM), formerly  family practice (FP) is dedicated to overseeing general health in people of all ages. Amongst other things, they provide wellness checks, immunizations, screening tests as well as the diagnosis and treatment of diseases and illnesses. If you have any health concerns or wish to simply have a health check, make an appointment with one of our doctors .

What age of patients do you see?

We see patients of all ages, from newborn to the elderly.

What conditions do you treat?

We will see and treat patients with any acute or chronic illness or condition

Do I need an appointment?

Yes you would need an appointment to visit the doctor. Kindly  contact our clinic to book an appointment.

What about if I need to see a doctor urgently?

We understand and have often be faced with this scenario. If you urgently need a doctor, contact our clinic immediately. We are used to handling emergency situations and will see what we can do to accommodate you as soon as possible or suggest alternative doctors.

What is the cost of a medical check up in Malta?

The price for a medical check up will vary from clinic to clinic – different doctors have different rates in Malta. If you require a home visit there will also be an extra charge. Expect to pay in the region of 15-25 euros for an in-clinic medical visit/ check up. Keep in mind that if you require treatment at he same time as your visit, the cost will increase.

Do you accept walk-in patients?

Yes, Camilleri Medical clinic does accept walk-ins but you may need to wait. Ideally you contact our clinic before to check availability. We really hate letting our patients down and will do our very best to see them but in some cases we just won’t be able to. Our receptions are high efficient and will be able to tell you whether you can be seen and the approximate time you will get to see your doctor.

Can I get a prescription over the phone?

Many medications are tightly controlled in Malta and require a medical prescription. Generally most doctors will not issue a prescription over the phone as they cannot be sure they are giving the right prescription without seeing the patient.

What are your clinic hours?

11.30 to 1.00pm and 5.30 to 7.00pm Monday to Friday. Saturday 10.30 – 12.00

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NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.

Kringos DS, Boerma WGW, Hutchinson A, et al., editors. Building primary care in a changing Europe: Case studies [Internet]. Copenhagen (Denmark): European Observatory on Health Systems and Policies; 2015. (Observatory Studies Series, No. 40.)

Cover of Building primary care in a changing Europe

Building primary care in a changing Europe: Case studies [Internet].

D. Rotar Pavlič , J.K. Soler , and M.R. Sammut .

1. The context of primary care

Country and population.

Malta is the smallest country in the EU25 (315 km 2 ), principally consisting of three inhabited islands: Malta (the largest), Gozo and Comino. Malta became a Republic in 1974 (Azzopardi Muscat & Dixon, 1999 ; Pace Asciak, Camilleri & Azzopardi Muscat, 2002 ) and a member of the EU in 2004. Malta’s population is estimated at around 405 200 (Pirjol, 2010 ). The proportion of the population aged 0–14 years fell from 19% in 2002 to 15.4% in 2008 and the proportion of the population aged 65 years and over is in 2008 around 14.4% (WHO Regional Office for Europe, 2010a).

Development and economy

Malta is divided into 68 local council districts where elections for local councils are held every three years. The national government is responsible for providing health care services. The Maltese Parliament is unicameral. A steady increase in GDP and health expenditure as a percentage of GDP has been observed in Malta, with GDP per capita of US$ 13 256 in 2004 (Pirjol, 2010 ). Total expenditure on health as a proportion of GDP was 8.5% in 2005. Between 1985 and 2007 Malta’s Human Development Index rose by 0.50% annually and from 0.809 to 0.902 in 2009. Malta has been ranked 34th out of 175 United Nations countries according to HDI (UNDP, 2010 ). The 6828 registered unemployed people in July 2010 decreased by 693 when compared to the corresponding month in 2009 (National Statistics Office Malta, 2010 ).

The adult illiteracy rate for the population aged 15 years and over in the year 2000 was 8% of the total population (Pace Asciak, Camilleri & Azzopardi Muscat, 2002 ). Based on 1995 census data, an estimated 50% of men and 44% of women have completed at least the secondary level of education (Pace Asciak, Camilleri & Azzopardi Muscat, 2002 ).

Population’s health

Life expectancy in males is 77 years and 82 years in females (2008). During the year 2008 there were 47 perinatal deaths reported to the National Mortality Registry, consisting of 26 fetal deaths and 21 early neonatal deaths. There were 34 infant deaths. These deaths do not include fetal deaths weighing less than 500 g. During the year 2008 there were 3243 deaths in residents: 1668 male deaths and 1575 female deaths. There has been a downward trend in mortality rate in Malta in the past 10 years. This trend is also reflected in mortality rates in those aged less than 65 years. The standardized mortality rate (SMR) in Malta is comparable to that of the EU15 (countries that joined the EU before May 2004) and lower than that of the new EU member states. Deaths due to diseases of the circulatory system, namely ischaemic heart disease, stroke and heart failure, are the leading causes of death accounting for 40% of all deaths. Despite a downward trend in mortality rates from ischaemic heart disease, rates are higher than the EU15 average. Diabetes mellitus is an important risk factor for ischaemic heart disease, and accounts for nearly 5% of all deaths. Neoplasms are the next commonest cause of death, accounting for 26% of all deaths. While the overall number of deaths is increasing, Malta’s SMR compares well with the EU15 and is better than that of the EU12 (i.e. the countries that were members in 1986) in all age groups and in those aged less than 65 years. However the average age at death due to neoplasms is 70 years, much younger than that for circulatory diseases. There were 298 deaths due to respiratory conditions accounting for 9.2% of all deaths. Mortality rates from traffic accidents and suicides show a predominance in the younger age groups but Malta fares better than both the EU15 and EU12 in this respect (Department of Health Information and Research, 2008 ).

There are 10.2 births/1000 population. The natural population growth rate has been declining, mainly because the crude birth rate is falling. There has also been a concomitant decrease in the total fertility rate to 1.5 in 2001 (Pace Asciak, Camilleri & Azzopardi Muscat, 2002 ).

In 2007 the rate of acute care hospital admissions was 10.7%, which is below EU15 level (European Hospital and Healthcare Federation, 2009 ).

Characteristics of the health care system

The health system in Malta is characterized by highly centralized structures. General taxation provides the main source of health care funding but the general trend until recently has been towards increasing the private share under the form of voluntary premiums or user charges. In Malta, due to the small size of the health market, the production of some highly specialized services is not financially viable. Consequently the Maltese government funds overseas treatment for conditions necessitating such highly specialized care (McKee, MacLehose & Nolte, 2004 ). The hospital sector dominates the health expenditure of the nation and absorbs the major part of the health budget. In Malta the number of hospital beds almost doubled after 2004. The total number of hospital beds in 2001 was 1950 and 3192 in 2007, which represents 63.7% difference (European Hospital and Healthcare Federation, 2009 ).

While health care practitioners in Malta are allowed to exercise their profession in both public and private health care services, the government of Malta is not responsible in any way for any treatment or care given to EU citizens in private hospitals or health centres, or by practitioners of any sort in their private capacity. Health care in public services is generally free at the point of use. A patient may access public health care services directly on presentation of the health card. The patient will have to pay for the cost of any prosthesis and any follow-up prescribed medication, excluding medication prescribed for the first three days after discharge from hospital. Only acute emergency dental care is offered free of charge in hospital outpatient and health centres, and to a limited extent. Most dental care is provided in private dental clinics at the patient’s own expense. All drugs used in inpatient treatment and for the first three days after discharge are free of charge for the patient. Otherwise, prescribed drugs must be paid for in full.

Primary care is provided by the state health services and by private family physicians. These two primary care systems function independently of one another. It has been estimated that the private sector accounts for about two-thirds of the workload in primary care. Of respondents to a recent population survey, 80% confirmed that they use a private family doctor as their primary provider of health care (Soler et al., 2009 ). The state-run primary care system covers family medicine, community care, immunization and the school health service. These services are mainly delivered and coordinated from eight government health centres that cover an extensive range of preventive, curative and rehabilitative services (Ministry of Health the Elderly and Community Care, 2008 ). There are company doctors working in Malta as well. Company doctors are hired by companies mainly to verify the illness of employees who report sick by visiting them at home. The role of company doctors is mainly verification of sickness, since in Malta a sick leave certificate is mandatory from the first day of absence. Increasingly, the role of company doctors involves important involvement in occupational medicine and health and safety at the workplace. Company doctors are an important provider of primary medical care for employees who report sick from work. Services in the private sector are open to all those who can afford to pay the fees, and also to a growing sector of the population which has private health insurance (Sammut, 2000 ).

Table A19.1 compares the development of health resources and utilization in Malta with the EU averages.

Table A19.1. Development of health care resources and utilization.

Table A19.1

Development of health care resources and utilization.

2. Structure of the primary care system

2.1. primary care governance.

In 2003, with Malta’s entry into the EU and a reform of the health care professions act, Family Medicine became a separate medical speciality (Malta College of Family Doctors, 2006 ).

The first government health centres were established in 1979. Today family physician services in Malta are provided by about 150 full-time equivalent family physicians, who work in private practice and 57 full-time equivalent family physicians, who work in government practice (2009). There is no patient registration in Malta and family physicians have no formal patient lists. Eighty per cent of patients report that they have one private family doctor as their main primary care provider. Only 4% report that a health centre doctor is their first provider of choice, but 13% report using various doctors depending on the particular need (Soler et al., 2009 ; Sciortino, 2010 ). The publicly employed family physicians have a limited gatekeeping role. For instance, patients can bypass the family physician and visit a specialist or other health providers without referral. In addition, the family practice services are limited. For instance, a community-based internal medicine specialist checks out the range of chronic diseases, and family physicians have limited prescribing rights as against other specialists. The publicly funded family physicians are usually visited free of charge in emergency situations or for routine cases, while for most difficult situations patients seek the help of the private family physicians or specialists (Department of Health Information and Research Strategy and Sustainability Division MfSP, 2010 ).

2.2. Economic conditions of primary care

There are no official statistics available regarding the total expenditure on primary care. The hospital sector dominates the health expenditure of the nation and absorbs a major part of the health budget. Over the years it has grown incrementally to accommodate increased demand and developments in technology. A precise estimate of the proportion spent on primary care is difficult to make as secondary care physicians on a part-time basis provide certain services at health centres. Resource allocation is carried out by the Ministry of Finance, the Ministry for Health and its four subsidiary divisions responsible for Health Care Services, Public Health Regulation, Resources and Support, and Strategy and Sustainability. Total expenditure on health as a percentage of GDP was 7.7% in 2008 (see Table A19.1 ).

In Malta, the government provides a comprehensive free health service to all residents. This health service is funded from general taxation. All residents have access to preventive, investigative, curative and rehabilitative services in government health centres and hospitals (Exposure jobs, 2010 ). Providers in health centres are paid by salary. Annual earnings of a private family physician range from €25 000 to €75 000. Few family doctors would earn more than €50 000 a year, but some (a very small minority) would earn more than €60 000. Annual earnings of hospital doctors are different in different private hospitals/practices or specialist consultancy services (Reed Specialist Recruitment, 2009 ). There are no data available comparing the incomes between primary and secondary care providers.

2.3. Primary care workforce development

Family physicians work exclusively in primary care. Specialist training in family medicine in Malta takes place under the auspices of the government’s Primary Health Department, with the Malta College of Family Doctors responsible for ensuring the quality of academic training and assessment. As a result of Malta’s accession to the EU in 2004, family medicine was accepted as a specialty and a three-year “Specialist Training Programme in Family Medicine – Malta” was drawn up by the Malta College of Family Doctors (MCFD) in 2005 and approved by the Ministry of Health’s Specialist Accreditation Committee in 2006 (Sammut et al., 2006 ). The “Curriculum for Specialist Training in Family Medicine for Malta” was published in 2009 by the MCFD’s Curriculum Board. The programme comprised 29 family physician trainees in 2010: 12 who entered the programme in 2008, 6 in 2009 and another 11 in 2010. In 2010 the first cohort of 11 trainees has undertaken the summative examination at the end of specialist training, which is being delivered by the MCFD with the collaboration of the UK Royal College of Family physicians.

The Health Care Services Standards Directorate (DHCSS) was established in September 2007. This is a new Directorate within the Department of Public Health Regulation. The licensing process which was previously within the remit of the Department of Institutional Health is now part of the responsibility of DHCSS but its breadth and scope have expanded with the added responsibilities specific to this new regulatory Directorate’s portfolio. The principal purpose of the DHCSS is to achieve improvement in the quality of care and ensure patient safety through regulation. To achieve the main objective of improving health care services in the Maltese islands, the DHCSS formulates and recommends national standards for hospital services, homes for older people and community care with the active participation of the relevant stakeholders and interested parties. It promotes a quality and patient safety culture within public and private service providers, inspects and licences hospital services, clinics, community and primary care services, homes for older people, blood establishments, hospital blood banks and tissue establishments. The DHCSS also monitors hospital and medical services’ clinical performance and outcome indicators as part of the health care licensing and regulatory mechanisms, and enforces health care laws and regulation through advice, education, persuasion and legal action if necessary

The total number of doctors registered in Malta is around 1150. This includes 60 foreign physicians/surgeons engaged by the government to occupy certain posts within the Department of Health. Eighty-one per cent of listed doctors are males and 19 per cent are females. One thousand and twenty doctors are registered as Malta residents and 130 as overseas residents. Out of the 1020 doctors in Malta, 560 are employed by the government (Sciortino, 2010 ). The rest are either in private practice or retired.

The Medical Association of Malta has warned that doctors are finding it increasingly difficult to cope with a growing demand for their services and has appealed to the authorities to be more sensitive to the needs of patients (Medical Association of Malta, 2007 ). There is a shortage of nurses and pharmacists as well (Ministry of Health the Elderly and Community Care, 2006 ) and a call was made for 200 nurses and 30 pharmacists. Most (96%) patients find it easy to reach and gain access to family physicians (TNS Opinion & Social, 2007 ). The Primary Health Care Department has to deal with a shortage of health care manpower, although towards the end of 2007 the nursing vacancies were all filled. There was also some improvement in the number of family physicians in 2010 when 11 family physicians trainees completed the Specialist Training Programme in Family Medicine, which they started in 2007. This intake of about a dozen trainees a year is expected to continue in the medium to long term.

3. Primary care process

3.1. access to primary care services.

Free access to comprehensive primary care services is possible by visiting a health centre. The health centres are the hub of the primary care services provided by the government. Besides the family physician and nursing services, various specialized health services are provided. These include immunization, speech therapy, dental services, antenatal and postnatal clinics, well baby clinics, diabetes clinics and paediatric clinics. At present there are eight health centres. Floriana Health Centre has two satellites, Gzira Health Centre and Qormi Health Centre. Paola Health Centre has one satellite, Cospicua Health Centre. Mosta Health Centre has one satellite, Rabat Health Centre. The public is requested to attend the health centre that serves his/her locality of residence. The Director is responsible for the provision of services at primary care level by organizing and coordinating all functions relating to health centres. The Director ensures the development and maintenance of an accessible, integrated continuum of primary care services. S/he plays a leading role in the development and implementation of the strategic plan for the strengthening of primary care. The Director ensures that services within the Directorate are operating in line with the Ministry’s policy, strategy, regulations and standards. The Director also ensures that services are delivered according to the needs of the user and that users’ rights are respected.

In the public service it is only possible to see a family physician, gynaecologist, podologist, speech-language pathologist, or practice and immunization nurse without a referral. For physiotherapists, optometrists, the diabetes clinic, the well baby clinic, the medical consultant and the home care nurse, a referral is required.

In the private sector, direct access for the patient is possible as the costs of the visit are paid directly to various professionals, such as the gynaecologist/ obstetrician, paediatrician, specialist in internal medicine, ophthalmologist, ENT specialist, cardiologist, neurologist, surgeon, occupational therapist, physiotherapist, psychologist and speech-language pathologist.

The opening hours for health centres varies, with some opening from 08:00 to 20:00 hours with family medicine services stopping at 17:00 and limited openings at weekends, while others are open for 24 hours, with family medicine services switched over to “emergencies only” between 17:00 hours and 08:00 hours during week days and from 13:00 hours on Saturday to 08:00 hours the following Monday.

Figure A19.1 shows the extent to which patients have access to organizational arrangements in primary care practices or centres.

The extent to which organizational arrangements commonly exist in primary care practices or primary care centres.

3.2. Continuity of primary care services

Continuity of care in the private family medicine sector is good (Soler et al., 2009 ). In contrast there is poor continuity of care provided by the state family doctor services. As there is no patient registration system in Malta, a client can walk into a health centre at any time to see the doctor who happens to be on duty. Moreover, as most clients attend for minor problems, entries are not always made in the health centre medical records that were introduced in 1997. Medical record keeping in private practice cannot be said to be optimal and formal registration is non-existent (Sammut, 2000 ). The fact that people shop around between family physicians, specialists and health centres is a fault of the system (Mallia, 2001 ). The main weaknesses that need to be addressed are: the lack of continuity of care, the need for a stronger doctor–patient relationship, the duplication of resources, the lack of a robust patient record and IT system, limited access by family doctors to state facilities, the lack of a multidisciplinary approach to primary care, the paucity of investment in the sector and client abuse of the system (Ministry for Social Policy (Health, Elderly and Community Care) 2009 ).

3.3. Coordination of primary care

The government’s health centre system works side by side with a thriving private sector and many residents opt for the services of private family physicians and specialists who work in the primary care setting. Most people (almost 85%) have only one family doctor. This relationship was of five years or more duration in most cases (75%) (Soler et al., 2009 ).

Although coordination between primary care services provided by the public and private sectors is limited, private family doctors do have some access to investigative services provided by government health centres (certain blood and urine tests, ECGs and chest X-rays). Private family doctors may also refer patients for most services provided by the various clinics held in government health centres. Access to these services for private family doctors and their patients has been recently increased. Fig. A19.2 shows how primary care practices are shared between medical professionals in the private sector.

Shared practice.

While patients can self-refer themselves to hospital specialists working in the private sector, official referrals from public or private family physicians are required for specialist services in public hospitals. The issue of discharge letters from specialists to family physicians is mandatory following inpatient care in government hospitals; however such letters often reach the family physicians some time after the patient has been discharged.

3.4. Comprehensiveness of primary care services

Private family doctors are able to provide a broad range of services, including minor surgery, imaging modalities and access to private specialist services. These services have been improved by recent courses for family doctors with special interests in such areas as women’s health, diagnostic ultrasound, minor surgery and others. The family medicine and nursing services are supplemented by various specialized services that include antenatal and postnatal clinics, well baby clinics, immunization clinics, gynaecology clinics, diabetes clinics, medical consultant clinics, ophthalmic clinics, psychiatric clinics, podiatric clinics, physiotherapy clinics and speech-language pathology clinics. Community nursing and midwifery services are provided by the Malta Memorial District Nursing Association (MMDNA) on a contract basis.

Table A19.2 lists examples of GPs’ involvement in the delivery of various primary care services.

Table A19.2. GPs’ involvement in delivery of various primary care services.

Table A19.2

GPs’ involvement in delivery of various primary care services.

4. Outcome of the primary care system

4.1. quality of primary care.

Immunization against diphtheria, tetanus and polio is obligatory. Immunization against pertussis is also offered though not obligatory. Immunization rates are believed to be very high, although information about the number of immunizations given in private practice is incomplete. Diphtheria and polio are considered to be diseases that have been eliminated in the local population. The last recorded case of diphtheria occurred in 1969, while that of polio occurred in 1964. The continued existence of pertussis cases is the price Malta is paying for low immunization rates against this disease. Measles epidemics used to occur every four years in the Maltese islands. An intensive immunization campaign in 1989 not only aborted the expected 1990 epidemic, but also enhanced the practice of immunization against measles as a routine measure.

In the first national health interview survey in Malta (HIS) 24.9% participants answered that they have a long-standing illness or health problem: 18.7% allergy (except asthma), 17.2% high blood pressure, 8.9% high cholesterol, 8.0% chronic bronchitis, 7.26% asthma and 7.1% diabetes mellitus. Data about how often these patients are reviewed in primary care are scarce. About 89% of asthma patients are reviewed at least once a year and 74% every six months by their family physicians (Pace Asciak et al., 2003 ).

4.2. Efficiency of primary care

The analyses of performance of state family medicine services in 2006 shows that there were 357 100 episodes of care in health centres, 197 100 episodes in district clinics, 13 200 home visits by day and 2019 home visits by night. The total number of health centre family physician encounters in 2006 was 569 429 (Ministry of Health the Elderly and Community Care, 2006 ).

Patients who were asked “Thinking of the last time you consulted a Family or Health Centre or Casualty or Outpatients doctor, within the past 12 months, where or how did you consult the doctor?” answered that they consulted the doctor’s private clinic in 40.0% of attendances, private hospital/clinic in 5.76%, a health centre in 8.65%, the casualty/outpatients department in 4.55%, while 15.77% consulted the doctor through home visits and 0.7% consulted by telephone (Pace Asciak et al., 2003 )

  • Acknowledgements

The authors would like to thank Dr Miriam Gatt MD, MSc (Public Health) Specialist, Public Health, Department of Health Information and Research, Malta, who contributed to the data collection on Malta.

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  • Department of Health Information and Research Strategy and Sustainability Division MfSP. European health survey 2008: utilisation of health care services. G’Mangla: Ministry for Social Policy; 2010.
  • European Hospital and Healthcare Federation. Hospitals in Europe: healthcare data. Brussels: HOPE; 2009.
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  • McKee M, MacLehose L, Nolte E. Health policy and European Union enlargement. New York: Open University Press; 2004.
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  • Malta College of Family Doctors. Malta College of Family Doctors policy document: Membership of the Malta College of Family Doctors (MMCFD). Valletta: Malta College of Family Doctors; 2006.
  • Medical Association of Malta. MAM raises alarm over doctor shortage. The Times. 2007. 21 January, ( http://www ​.mam.org.mt/newsdetail ​.asp?i=845&c=1 , accessed 1 October 2010)
  • Ministry for Social Policy (Health, Elderly and Community Care). Strengthening primary care services. Implementation of a personal primary health care system in Malta. Valletta: Ministry for Social Policy; 2009. Consultation document.
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  • Ministry of Health, the Elderly and Community Care. Primary health. Valletta: Ministry of Health, the Elderly and Community Care; 2008. ( https://ehealth ​.gov.mt ​/HealthPortal/health_institutions ​/primary_healthcare ​/health_centres.aspx , accessed 1 October 2010)
  • National Statistics Office Malta. News release. Registered unemployed. 2010. July ( http://www ​.nso.gov.mt ​/statdoc/document_file.aspx?id=2832 , accessed 26 August 2010)
  • Pace Asciak R, Camilleri M, Azzopardi Muscat N. Public health report Malta 2002. Malta: Department of Health Information; 2002. pp. 2–90.
  • Pace Asciak R, et al. Preliminary results of the first National Health Interview Survey (HIS Malta). Malta: Department of Health Information; 2003.
  • Pirjol D. Amsterdam: VU University of Amsterdam MSc Management; 2010. National health policies’ influence on Maltese General Practitioners Service Profile. An update of the situation from 2002 and 2008.
  • Reed Specialist Recruitment. Malta – Salary and labour market guide 09. London: Reed Global; 2009.
  • Sammut MR. Primary health care services in Malta. Journal of the Malta College of Family Doctors. 2000; 19 :4–11.
  • Sammut MR, et al. Specialist training programme in family medicine – Malta. Valletta: Malta College of Family Doctors; 2006.
  • Sciortino P. General practice/family medicine in Malta: radical change by 2000? Brussels: UEMO; 2010. ( http://www ​.uemo.org/text ​_nationalsections ​.php?sec=7&cat=17 , accessed 1 October 2010)
  • Soler JK, et al. Malta: Mediterranean Institute of Primary Care; 2009. Mediterranean Institute of Primary Care Patient Questionnaire 2009.
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  • Cite this Page Rotar Pavlič D, Soler JK, Sammut MR. Malta. In: Kringos DS, Boerma WGW, Hutchinson A, et al., editors. Building primary care in a changing Europe: Case studies [Internet]. Copenhagen (Denmark): European Observatory on Health Systems and Policies; 2015. (Observatory Studies Series, No. 40.) 19.
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Trump’s Voters vs. Haley’s Donors

A class war is playing out inside the republican party..

This transcript was created using speech recognition software. While it has been reviewed by human transcribers, it may contain errors. Please review the episode audio before quoting from this transcript and email [email protected] with any questions.

From The New York Times, I’m Michael Barbaro. This is “The Daily.”

[MUSIC PLAYING]

Inside the Republican Party, a class war is playing out between the pro-Trump base, who’s ready for the nomination fight to be over, and the anti-Trump donor class, who thinks it’s just getting started.

Today, my colleague, Astead Herndon, a political correspondent and host of “The Run-Up,” reports on that clash.

It’s Tuesday, January 30th.

Hey, how are you?

Good. Let me know when you’re ready.

OK. So Astead, at this moment in the Republican presidential race, two kind of baffling things are occurring at the same time.

This race is far from over. There are dozens of states left to go.

The first is that former South Carolina governor Nikki Haley is behaving as if she really has a shot at beating Donald Trump.

We still have a ways to go, but we keep moving up.

Which all evidence suggests is false. And the second thing that’s happening is that Donald Trump —

And just a little note to Nikki — she’s not going to win.

— is fixated on attacking Nikki Haley and her campaign over and over.

And I said, wow, she’s doing a speech like she won. She didn’t win. She lost. And you know —

Despite the fact that she has no real shot at beating him.

But let’s not have somebody take a victory when she had a very bad night. She had a very bad night. And you —

And you have been studying the Republican presidential race very closely over the past few months. So my question for you is, why are both of these things happening, and what do they tell us about this political moment in the Republican Party?

Yeah. I mean, I think if you see it through the lens of just Donald Trump versus Nikki Haley and two candidates that are vying to get the nomination, then you’re right, it is kind of baffling. You know, Haley has always been a long shot to become the Republican nominee. And that’s even become more clear as voters in Iowa and New Hampshire, and particularly the Republican base, has made it overwhelmingly obvious that their preference is Donald Trump.

But I think if you view it through a different lens, and specifically the kind of broader coalitions that these two candidates represent and the donors that support these campaigns, then I think you understand why they feel so diametrically opposed and why the slices of the Republican Party who are supporting them see themselves as diametrically opposed.

So what I mean by that is the more Nikki Haley stays in the race, the more it fuels the distaste on the Trump MAGA movement side, specifically because they see her as a candidate who represents the interests of an elite donor class, of a moderate Republican wing that’s more lenient on issues of immigration, that is more deferential to the foreign policy establishment and embrace kind of American intervention in wars abroad. And those are such fundamental beliefs, when you think about the kind of Donald Trump wing of the Republican Party, that they see someone like Haley as being offensive to the idea that that’s what the Republican Party in 2024 represents.

And when I was at Donald Trump’s victory party in Nashua, New Hampshire last week, when we see the results rolling in that confirm another victory, it wasn’t just that the supporters in the building were mocking Nikki Haley and kind of gloating on the fact that they were winning. They were also mocking what they call the elite donor Republican class, who they think is funding Nikki Haley. So when we were watching the results on the screen on Tuesday —

First, off reintroduce yourself.

My name is John Fredericks. I’m a TV and radio talk show host.

And more importantly, the Godzilla of the truth.

I am the Godzilla of the truth. I’m on in the morning —

I talk to a conservative radio host named John Fredericks. He’s someone who has aligned himself with Donald Trump and really gives a good articulation of what the MAGA movement represents.

Listen, this is the greatest movement, the populist movement of working people in the history of the Republicans. And these donors on Wall Street don’t get it. They don’t understand the party has changed. This is a working-class party now. White, Black, Asian, Hispanic, it doesn’t matter. If you work for a living and you are punching a clock and you’re not part of the elite, right, you’re getting screwed. And they know it.

Your jobs are going away. Your wages are eroding. Your profit share is going down. Your savings is getting obliterated with inflation. You’re getting wiped out. They don’t care. Illegals are overrunning your country. They’re taking your jobs. They’re shipping them to China. And the elites and the donor class, and the Wall Street gangster banksters who live for open borders and cheap labor just think they can buy this stuff.

Those are the type of messages that the Donald Trump wing of the Republican Party is putting out there about Nikki Haley, kind of framing the efforts as a elite, undemocratic idea that they can talk over what the working-class Republican person wants. And of course, what they’re saying that working-class Republican wants is Donald Trump.

But one of the things that he said that really sticks with me is that they see the MAGA movement as something that is independent from any individual candidate.

It’s our movement. Right now, Donald Trump is the conduit for that. Post-Trump, there’ll be someone else, because the populist movement is on the verge tonight of obliterating the establishment uniparty elite. And we’re weeks away from taking over the whole Republican Party apparatus. If not weeks, a year.

And so in supporting Donald Trump, they’re not only doing that because they want him to be the individual candidate, they’re doing that because they see him as a conduit to be able to root out that slice of the Republican Party, the kind of donor class that supports Haley, which they find kind of detrimental to their overall interests.

Right. They want to reclaim the Republican Party from rich donors and fully ensure that it’s in the hands of the MAGA movement, which, in their minds, is a working-class movement, kind of profoundly and inevitably at odds with a bunch of rich donors.

100 percent. And not just at odds with rich donors — odds with party leadership, at odds with the kind of Washington establishment. They feel that they are distinct from the kind of political institutions and apparatus that keep people in defined lines that they want to bust out of.

And so I think that’s a little bit of a different way to view the different candidacies. I think Nikki Haley has supporters, people who are voting for her because of her stances on particular issues or because their desire to see them as the nominee. Donald Trump runs a group that thinks of themselves as a movement, as more than just supporting a candidate, but is a vehicle to overtake the party itself.

But to the question of why she’s still in the race when all the signs point to that movement you’re describing working and defeating her, what do you say?

I mean, candidates drop out of races not because of their own volition, but mostly because they run out of money and they run out of support and the path to making them president.

And so I think that it is critical to understanding, if you’re asking why is Nikki Haley still in this race, it’s because there are enough Republican donors who are willing to continue to support her to stay in this race. Right? And I think this is unique to this year, partially because some people don’t want to see the primary end so fast, partially because Donald Trump has legal issues hanging over his head.

And so there are some reasons in the air about why that support has continued. But for the kind of Trump wing of the party, what they are saying is that the existence of that support is a kind of anti-democratic perversion of the people’s will.

Hmm. So thinking back to my question about why is Haley staying in the race, why are Trump and his supporters kicking her around so hard, the answers are kind of interrelated. And they’re very much tied to what you just laid out, which is the sense that donors, whose values and visions are very much at odds with the MAGA movement, they’re fueling the Haley movement beyond its expiration date, according to Trump supporters. And that is why Trump and his supporters are so mad at this campaign.

Exactly. And I think it’s important to not just view this in the vacuum of 2024, but this is the entire premise of Donald Trump’s candidacy and his ascension in the Republican Party. He came in as the, quote unquote, “outsider,” as the person who had his own individual money and was therefore unreliant to big donors. There is a sense among his supporters and a sense that he furthers in his own kind of rhetoric that he is the only candidate that is untethered to the political institutions that serve the elites. And that is not only donors, but that is the political establishment in Washington, right? Like, this is the message of Donald Trump.

And so being at that event in Nashua, seeing the open vitriol not only do the Haley campaign, but to the Republican donors who are backing her, made me think about the kind of broader question of the party’s unity going forward.

So the next morning, after the results had come in, I decided to call a Haley donor, a billionaire who was backing her, to see how he saw the race going forward and how he would respond to the argument that, in giving so much money to a candidate who is such a long shot, he is kind of seeking to upend the will of the voters.

After the break, Astead’s conversation with that donor.

We’ll be right back.

Hi, Astead. How are you?

I’m doing well. How are you?

Tim Draper is a venture capitalist who’s invested in companies like Tesla, Skype, Hotmail, Twitch, and Robinhood.

I mean, can you tell me a little bit about yourself? Can you tell me about how — tell me about your business career and how you made money in the first place.

Yeah. So I started out as an entrepreneur. Oh, let me go way back. My grandfather was the first Silicon Valley venture capitalist. My father was a venture capitalist. I had venture capital in my blood. It was —

He’s given more than $1 million to Haley’s campaign and the outside groups that are backing her.

I guess I would start with just saying, like, what caused you to back Nikki Haley, and specifically what caused you to donate your money to Nikki Haley?

Yeah. I have been really impressed with her. I think she has very good character. I think she is kind. She is very thoughtful. She sees all points of view on things like pro-choice versus pro-life. She understands foreign policy, which is — I travel a lot. I go all over the world. And I’ve seen how important our foreign policy is and how we’re represented internationally. And I like her attitude of I support my friends, I support democracies, I don’t support dictatorships.

When I first met her, I just thought, wow, this woman is strong and capable, and she gets things done. And you see that she does it in an effective way, where everybody comes out feeling good. And I think there’s a strong character there. And she’s tough and she’s willing to run for president. I mean, for somebody that amazing to be willing to run for president, I think we were just lucky.

One of the things that we’ve reported on through this show is how Nikki Haley has a difficult path to win the Republican nomination, partially because the ways the party has changed in the Donald Trump era. When you were giving to her, when you were backing her originally, I guess I’m wondering kind of how were you thinking about her path to victory in the primary, considering Donald Trump has changed the party to such a degree.

You know, it’s funny, I miscalculated on one thing. And that was that I didn’t realize that those Trump supporters just want retribution. They’re just angry, and they want retribution. And they stopped listening. And I was thinking, oh my god, a Trump-Biden combination? It would be ridiculous. We’ve got so many great candidates out there. Why would we ever want these two octogenarians to be our two candidates?

You thought everyone was kind of on the same page, that you wouldn’t want the same thing again.

Right. I didn’t think anybody really wanted that. But I think that there is so much animosity built up. And I don’t know which side is right here. I don’t have a really strong feeling about whether the people who are saying he was wronged or the people who are saying he’s a felon are right. I don’t know. That’ll come out in the courts or whatever. But I did think he might have been a good candidate eight years ago. I’m not so sure that makes any sense today. But his supporters are just so much after retribution that I think they stopped listening.

Yeah, I mean, that’s kind of where I wanted to go. I mean, obviously there were high hopes for Nikki Haley in New Hampshire, specifically, because it has so much more of the independent votes, the moderate kind of Republican voter. And I think about the results last night, as I’m sure you watched. Would you say, like, is an 11-point loss there an example of her gaining traction, or should we take the results from Iowa and New Hampshire as evidence that the majority of the Republican base is squarely behind Donald Trump?

No, I think — you know, she had 2 percent of the vote when I started backing her, and she is now at 43 percent of the vote. She had 20 percent in Iowa. The trend is good. He still polls better than she does, but I think that that is changing. And now is the time to support her so she gets into the general election.

So what I hear, you’re saying the trend line is such that you still feel good about that investment in the Haley campaign. And will you give more money going forward? Should she stay in this race? I know that’s an open question that some people are trying to pressure her to get out. What’s your message to that?

No, no. A lot happens in politics, and she’s down to just the two of them. She should definitely stay in. A lot can happen through South Carolina, Super Tuesday. So no, I think she should go, go, go. I’m very happy with the investment I’ve made. And I wrote a song for her.

I mean, I was going to go to the song next, so I’m glad you brought this up because I recently heard —

It’s fantastic.

— the song. It’s a real earworm. I listened to it yesterday, and I have to say, I did wake up today with “we need you, Nikki, right now” still stuck in my head.

Isn’t it cruel?

I was going to ask, can I hear some of the rap? Can you drop a little for us right now?

No, I’m not sure I can because I don’t have it all in my — I know it sticks in your ear.

(SINGING) We need you, Nikki, right now to lead our nation. We need you, Nikki —

There we go.

(SINGING) We need you, Nikki, right now to lead our nation.

We need you, Nikki, no doubt, to lead the conversation.

We need you, Nikki —

And then it’s — oh, I can tell you this part of the rap. It’s —

[CLEARS THROAT]: (RAPPING) Trump, the bully who’s afraid of a fight against five-inch heels with twice his might

(RAPPING) And Biden is dying to drain our reserves. When voters come out, he’ll get his desserts

(SINGING) We need you, Nikki, right now

I mean, that’s a different level of dedication to a candidate than we typically see, right? I guess I’m asking, like, considering the high road she has to climb to become the nominee, what made you say this moment right now is all in? Is that the candidate, or is that the political moment at large?

It’s the candidate. I think it’s Nikki Haley. And we tend to get the candidate we need at the time we need it in America. Nikki Haley gets it.

One of the things that stuck out to me at the Trump victory party last night is that they’re not just mocking or kind of demeaning Nikki Haley, which there was a lot of. There was a lot of mocking and demeaning of the kind of donor class, too. They would say pretty openly that the reason she’s going to stay in this race is because people who are rich Republicans are going to fund her money.

And what they’re trying to do is speak over the will of the voter, who have made clear the kind of working-class Republican voter wants to back Trump. I guess I wanted to hear you respond to that idea. What do you say to the idea that what the donor class is trying to do in terms of keeping Nikki Haley afloat is against the will of the base Republican voter?

Well, I’m rich, but a lot of the donors are not. You know what they’re getting? It’s interesting, the Haley campaign, they’re getting a lot of small donations from women. And they’re getting donations from Democrats. That —

Who aren’t Republicans, you know? Like, that’s not the base of the Republican Party. Is that a problem?

Well, I mean, it depends on what you mean by a base. I think Trump just has a lot of people who they’re just thinking of, hey, he needs retribution. And they’re saying I’m not thinking about anything else. And I hope that they open their minds. And I hope that they start looking at it in a new way. But I can’t see that happening overnight.

Mhm. Well, kind of my last question is to look ahead. I know you’re hosting a fundraiser for Nikki Haley soon. I guess I’m asking —

Two. You’re hosting two. OK.

I guess the question I have is, like, what are the markers that you’re looking for for the campaign to continue the upward trajectory that I think we both know it needs? And then a follow-up question I have is, if it does end up being Biden versus Trump again, do you know what you would do? Would you donate? Would you vote Trump? Would you — do you know?

[SIGHS DEEPLY]

I don’t think that’s going to happen. And I think Nikki Haley will be the president. If it were in that situation, I would kind of desperately look for a third party. And I think a lot of people would, too. I think there’s going to be a very interesting couple of months here. A lot of things happen in politics. And I think a lot of things will happen.

So I hear the first step being look to South Carolina and Super Tuesday, invest more to try to give Haley the bump that she needs and continue to close that gap with Trump. And then maybe a secondary step, if this does get to a thing that you don’t want, being a rematch of 2020, would you invest money in a third — or you’ll just deal with that. We might have to follow up in a couple of months.

I don’t know, the —

— the thing that went off in my head was a — what do you call it? A fight or run?

Yeah. Yeah, the fight or flight.

The fight or flight. [LAUGHS]

You’re saying some instinctual nature would kick in.

I don’t know. I don’t know which way I’m going to go. I’m going to either fight this thing out or I’m going to run.

Astead, ultimately, what do you make of this donor, of Draper? Is he in denial about the state of this race and the reality of the Republican Party in this moment? And how representative is he of donors to Haley, in both senses?

Yeah. I mean, when I talk to him, I definitely hear a person who is disconnected from the Republican base, right?

To say the least.

[LAUGHS]: In Draper’s defense, a lot of people are. You know, his presumption that the Republican base would not come back to Donald Trump considering all the things that have happened in the last couple of years was a widespread belief.

That was not just true among a donor class. I think that was true among a lot of people who have underrated the consistency and cohesion of the MAGA movement. So I would say if he is in delusion, it’s a delusion that’s shared by a lot of people.

Well, looking back, why was there so much delusion, given the steamroller that Trump has always been within the Republican Party?

Well, I mean, I think certainly post midterms, there was a overly presumptuous idea among the party establishment that Donald Trump’s electoral losses would start to weigh on the base and that some people would look for other options because of it. And one thing I think was the biggest part of the shared delusion was the secondary presumption that his indictments would hurt him.

That the candidates themselves did not have to make Donald Trump unpalatable because the legal cases would do the work for them.

Which, as we know —

[INTERPOSING VOICES]

Not only wrong, the opposite of the truth, right?

Like, it was —

It made him more popular —

And so after the midterms, normal political logic would tell you that the electoral results, the legal cases would inherently add up to a universe where Donald Trump could not be the Republican nominee again, and particularly not at this kind of wide of a margin or clarity of result. And that was a presumption that was made without the Republican base input.

But this is why I keep going back to movement politics, is because that’s the answer to why those rules don’t really apply here, is because they are not thinking in the traditional political calculus. And they’ll tell you that. They simply tell you that all the time. I just think it’s an unwillingness to believe them.

So the Drapers of the world are not just trying to make Nikki Haley happen, they are trying to undo reality.

Right. And when we think about Haley’s donors, all of them, I mean, how representative is Draper and his view of the situation? Basically, that if Haley loses, he’s out of the Republican Party?

To the question of how representative is he of the larger donor class, I think we’ve gotten some answers to that in the last couple of days since the New Hampshire primary. Big donors like Reid Hoffman, the founder of Home Depot, who’s a big mover and shaker in Republican politics, announced that he was going to take a pause on supporting Nikki Haley because he sees a hard time seeing the path forward.

At the same time, there’s clearly enough donors still supporting her that the Trump campaign is taking it very seriously. Trump announced that he would try to blacklist donors who continue to support Nikki Haley, a clear attempt to pressure people to kind of abandon her and make the party rally around him as the presumptive nominee.

But the thing that I think is important is when you talk to the Trump movement, they say they don’t care either way. They have multiple goals. And the biggest goal is to return Donald Trump to the White House. So even losing the general election is obviously not what they want. Certainly, the MAGA capture of Republicans has given them problems with independents. And they would need a Nikki Haley base if they want to unite the Republican Party to go against Joe Biden.

But a subset goal, a thing that John Frederick says very explicitly, is to own the Republican Party. That’s why it’s important to see it not as a traditional political campaign that operates in tactics, but to see it as a movement that operates in ideals, right? Because —

— the most important thing is to run a campaign that’s based on those ideals. And they basically think they’ll get with us or they’ll get lost.

There’s an understanding, it sounds like you’re saying, that this effort to obliterate the Haley-style donor class and the establishment of the party, it might mean they lose the election. They understand that Haley has not just donors, but lots of supporters who they may not win over. And because it’s a movement, what you’re suggesting is they may be able to live with that.

Yes. But remember, they already asked Nikki Haley on the stage, would she support Donald Trump in the general election, and she’s already raised her hand. The majority of Republicans are going to vote for Donald Trump no matter how much he mocks, no matter how much he demeans. Right?

You know, Democrats work from a premise of appeasing a kind of liberal or moderate group and expecting progressives to come along. And the Republican base has basically appeased their most conservative sect, and think that middle will come along.

And we’ll find out if they’re right.

Yeah. [MUSIC PLAYING]

I think the specific thing this year is, considering the staleness of the candidates, does that lead people to drop off all together? Does that lead people to vote third-party? How does that fall? I don’t think we know the answer to that.

Hmm. Well, Astead, thank you very much.

Thank you for having me.

Here’s what else you need to know today. On Monday, the most important United Nations relief agency in Gaza, the UNRWA, warned that its funding could dry up by the end of next month after more than a dozen countries suspended their financial support. The collapse of support was the result of Israel’s claim, made on Friday, that 12 of the agency’s workers in Gaza participated in Hamas’s October 7th terror attack on Israel. The United Nations has fired the accused workers, but outrage from Israel’s allies has mounted. Among the countries that have suspended support for the UNWRA are the United States, Canada, Germany, and the UK.

And a former IRS contractor who pleaded guilty to leaking confidential tax records to journalists, including those of former President Trump, was sentenced on Monday to the maximum of five years in jail. The contractor, Charles Littlejohn, admitted that he disclosed Trump’s tax information to The New York Times in 2019 and later leaked tax documents from thousands of wealthy Americans to the news organization ProPublica. Taken together, the documents showed that wealthy Americans like Trump pay little or no federal taxes.

Today’s episode was produced by Caitlin O’Keefe and Mary Wilson, with help from Asthaa Chaturvedi and Clare Toeniskoetter. It was edited by Rachel Dry, Rachel Quester, and Paige Cowett, with help from John Ketchum, contains original music by Dan Powell, and was engineered by Alyssa Moxley. Our theme music is by Jim Brunberg and Ben Landsverk of Wonderly.

That’s it for “The Daily.” I’m Michael Barbaro. See you tomorrow.

The Daily logo

  • January 31, 2024   •   25:06 Is the Future of Medicine Hidden in Ancient DNA?
  • January 30, 2024   •   30:08 Trump’s Voters vs. Haley’s Donors
  • January 29, 2024   •   30:25 The Failed Promise of Police Body Cameras
  • January 28, 2024   •   44:41 The Sunday Read: ‘The Whale Who Went AWOL’
  • January 26, 2024   •   1:00:57 The Mother Who Changed: A Story of Dementia
  • January 25, 2024   •   30:46 The Hybrid Worker Malaise
  • January 24, 2024   •   25:50 Why the G.O.P. Nomination Fight Is Now (All But) Over
  • January 23, 2024   •   21:49 The Shadowy Story of Oppenheimer and Congress
  • January 22, 2024   •   37:27 The Rules of War
  • January 19, 2024   •   26:44 The Fishermen Who Could End Federal Regulation as We Know It
  • January 18, 2024   •   29:16 What the Houthis Really Want
  • January 17, 2024   •   28:39 The Messy Fight Over the SAT

Hosted by Michael Barbaro

Featuring Astead W. Herndon

Produced by Caitlin O’Keefe and Mary Wilson

With Asthaa Chaturvedi and Clare Toeniskoetter

Edited by Rachel Dry ,  Rachel Quester ,  Paige Cowett and John Ketchum

Original music by Dan Powell

Engineered by Alyssa Moxley

Listen and follow The Daily Apple Podcasts | Spotify | Amazon Music

Inside the Republican Party, a class war is playing out between the pro-Trump base, which is ready for the nomination fight to be over, and the anti-Trump donor class, which thinks it’s just getting started.

Astead Herndon, a political correspondent for The Times and the host of “The Run-Up,” explains the clash.

On today’s episode

home visit doctor malta

Astead W. Herndon , a political correspondent and host of The Run-Up for The New York Times.

Buttons with Nikki Haley’s face are displayed next to stickers that read “Trump 2024.”

Listen to “The Run-Up” on tensions between big Republican donors and the party base.

Former President Donald J. Trump said donors to Nikki Haley, his remaining Republican rival, would be “ barred from the MAGA camp .”

There are a lot of ways to listen to The Daily. Here’s how.

We aim to make transcripts available the next workday after an episode’s publication. You can find them at the top of the page.

The Daily is made by Rachel Quester, Lynsea Garrison, Clare Toeniskoetter, Paige Cowett, Michael Simon Johnson, Brad Fisher, Chris Wood, Jessica Cheung, Stella Tan, Alexandra Leigh Young, Lisa Chow, Eric Krupke, Marc Georges, Luke Vander Ploeg, M.J. Davis Lin, Dan Powell, Sydney Harper, Mike Benoist, Liz O. Baylen, Asthaa Chaturvedi, Rachelle Bonja, Diana Nguyen, Marion Lozano, Corey Schreppel, Rob Szypko, Elisheba Ittoop, Mooj Zadie, Patricia Willens, Rowan Niemisto, Jody Becker, Rikki Novetsky, John Ketchum, Nina Feldman, Will Reid, Carlos Prieto, Ben Calhoun, Susan Lee, Lexie Diao, Mary Wilson, Alex Stern, Dan Farrell, Sophia Lanman, Shannon Lin, Diane Wong, Devon Taylor, Alyssa Moxley, Summer Thomad, Olivia Natt, Daniel Ramirez and Brendan Klinkenberg.

Our theme music is by Jim Brunberg and Ben Landsverk of Wonderly. Special thanks to Sam Dolnick, Paula Szuchman, Lisa Tobin, Larissa Anderson, Julia Simon, Sofia Milan, Mahima Chablani, Elizabeth Davis-Moorer, Jeffrey Miranda, Renan Borelli, Maddy Masiello, Isabella Anderson and Nina Lassam.

An earlier version of this episode misstated Reid Hoffman’s title. He is the co-founder of LinkedIn, not the founder of Home Depot.

How we handle corrections

Astead W. Herndon is a national politics reporter and the host of the politics podcast “The Run-Up.” More about Astead W. Herndon

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