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Table 3 Health system transformation and adaptation (Malta 2004–2014)

From: Europeanisation of health systems: a qualitative study of domestic actors in a small state

Health system change
Description Europeanisation Mechanisms Analysis
Public health policies and strategies Transformation Non-binding EU communications, strategies, reportsParticipation in EU working groups Domestic health policy-making process underwent significant change and a number of important health strategies were developed
Cancer Transformation Non-binding EU Council Recommendation on Cancer Screening EU Funds for hospital, equipment and capacity building Participation in EU Joint Actions and networks Submission of health information statistics Services in the area of cancer have been transformed through the development of a national plan, cancer screening services, training of health professionals and the constructions of a new oncology hospital
Development of specialist training programmes for doctors Transformation Directive
EU funds for capacity building
Transposition of legislation and establishment of medical specialist registers as well as structured post graduate training programmes
Regulation of quality, safety and efficacy of medicines Transformation Directives EU funds for capacity building Participation in networks and working groups Transposition of legislation and setting up of the competent authority to regulate the placing of medicines on the market
Establishment of regulatory institutions with separation of regulatory and provider roles Adaptation Directives Participation in networks and working groups Transposition of legislation and setting up of competent authorities for licensing providers and regulating public health standards
Health statistics Adaptation Participation in networks and working groups Benchmarking (EUROSTAT regulations recently entered into force) A good health information system was already in place prior to accession but EU legislation, policy and networking helped to strengthen it