Case Study: Lack of entitlement to medical treatment as the medical condition was not listed in the Social Security Act

Case Study: Lack of entitlement to medical treatment as the medical condition was not listed in the Social Security Act

Published August 17, 2026

The Complaint

The complainants were several parents whose children suffered from a rare, severe and progressive genetic muscle-wasting disease.  When their consultant applied for a specific medication for this condition, they were informed by the Ministry for Health and Active Ageing that their request could not be acceded to since this specific condition was not listed on the official Schedule V entitlement.  Schedule V refers to the entitlement of free medicinal treatment by virtue of the Social Security Act (Cap. 318, Article 23), its subsequent amendments (Act No. I of 2012), and the Fifth Schedule of the same Act.

The Investigation

The Ministry for Health and Active Ageing was informed of this case and a request for further information was made.  The Ministry confirmed that this condition was not listed in the Social Security Act (Part II of the Schedule V) list of medical conditions. Consequently, patients suffering from this condition were not entitled to state-funded medicines for its treatment.

Considerations

This Office pointed out that the fact that these children were not entitled to the specific treatment for their severe medical condition just because this condition was not one of the medical conditions listed in the Social Security Act (Part II of the Schedule V) list was in fact discriminatory in their regards and should be rectified as soon as possible.

Including a new medical condition in the Schedule V list entails a complex process involving a substantial number of entities and Ministries.  Notwithstanding these challenges, the process was successfully resolved and a Legal Notice was published.

Recommendations

No further recommendation was deemed necessary, as the problem was adequately resolved by the Ministry and a solution was fully implemented.