The state of health

Malta Independent - - FRONT PAGE - Neil Camil­leri

Health Min­is­ter Chris Fearne yes­ter­day was the main speaker at a Busi­ness Break­fast held at the Hil­ton or­gan­ised by The Malta Busi­ness Weekly in con­junc­tion with the Health Min­istry.

The gov­ern­ment will soon is­sue a ten­der for the for­ma­tion of a com­pany to chase af­ter third coun­try na­tion­als and re­coup money owed for health ser­vices, Health Min­is­ter Chris Fearne said yes­ter­day. He was speak­ing at a Busi­ness Break­fast held at the Hil­ton or­gan­ised by The Malta Busi­ness Weekly in con­junc­tion with the Health Min­istry.

Mr Fearne said third coun­try na­tion­als are not en­ti­tled to free health­care and the gov­ern­ment will fi­nally em­bark on a mis­sion to re­coup money it is owed from such peo­ple. He also ex­plained how EU na­tion­als are not charged for health ser­vices re­ceived in Malta but the Mal­tese au­thor­i­ties then bill their re­spec­tive gov­ern­ments.

The Health Min­is­ter said Malta wants to at­tract more for­eign pa­tients to its shores, adding that this was the only way in which a qual­ity health­care sys­tem – that re­mains free for Mal­tese peo­ple – can be sus­tained.

This was why the gov­ern­ment had at­tracted for­eign in­vestors to Malta. He was re­fer­ring to Vi­tals Global Health­care, which now runs St Luke’s, Karin Grech and the Gozo Gen­eral Hospi­tal. These will of­fer free NHS ser­vices for the Mal­tese and pri­vate ser­vices for their own pri­vate cus­tomers.

“The new hos­pi­tals will be bet­ter than Mater Dei,” Mr Fearne said, adding that the state hospi­tal would later be made to catch up. “The pri­vate hos­pi­tals will up­hold the best US stan­dards and they will be work­ing with us. All ser­vices will re­main free for Mal­tese peo­ple.”

Mr Fearne spoke about the time when he worked at Great Or­mond Street Hospi­tal in the UK – con­sid­ered to be one of the best chil­dren’s hos­pi­tals in Europe. “What made it so great was not the build­ing or the equip­ment but the peo­ple who worked there – the hospi­tal at­tracts the best peo­ple in the busi­ness. That is what we want to do here.”

Malta was also mak­ing great strides in re­search but the coun­try needs to at­tract more fa­cil­i­ties of this sort. This is what is hap­pen­ing in Gozo. An­other tar­get was for the coun­try to be­come a cen­tre for med­i­cal teach­ing. The na­tional health sys­tem al­ready guar­an­tees a num­ber of place­ments for univer­sity stu­dents at Mater Dei but we need other in­sti­tu­tions to do the same, Mr Fearne said.

“At the same time we have to keep our feet on the ground and deal with the prob­lems that come our way. One of these prob­lems was the is­sue of out-of-stock medicines. This prob­lem has been largely dealt with and nowa­days only a cou­ple of prod­ucts would be out of stock, if any. The same could be said for pa­tients in hospi­tal cor­ri­dors. To­day this is the ex­cep­tion.”

The min­is­ter said wait­ing lists have also been de­creased be­cause the health au­thor­i­ties are manag­ing to give more in the face of an in­creas­ing de­mand. “There is still work to do at the out­pa­tients de­part­ment. We have to de­crease de­mand by preven­tion,” he said, not­ing that obe­sity costs the coun­try be­tween €45 and €50 mil­lion a year. The open­ing of a new health cen­tre in Kirkop, a re­gional cen­tre in Paola and sev­eral new clin­ics would also lighten the load on Mater Dei. This has to be com­ple­mented with a boost in hu­man re­sources.

Af­ter the min­is­ter’s open­ing speech a team of pan­els was in­cluded in the de­bate. The panel as made up of MAM Pres­i­dent Gor­don Caru­ana Dingli, Mary Ann Sant Fournier, the Pres­i­dent of the Cham­ber of Phar­ma­cists, Engi­neer Karl Far­ru­gia, the head of the Cen­tral Pro­cure­ment and Sup­plies Unit and Mater Dei Hospi­tal CEO Ivan Fal­zon. The de­bate was mod­er­ated by Stan­dard Pub­li­ca­tions Ltd Con­tent Di­rec­tor Pierre Portelli.

Dr Caru­ana Dingli said the coun­try had lost the per­son­alised link be­tween the in­di­vid­ual, the fam­ily and the doc­tor. He stressed

on the need for in­creased ed­u­ca­tion and in­vest­ment in pri­mary health­care. Asked if the new hos­pi­tals were a pos­i­tive devel­op­ment and would lead to a higher level of care, Dr Caru­ana Dingli sad “these are the ques­tions we are ask­ing our­selves,” adding that what MAM wanted was trans­parency.

Ivan Fal­zon said one had to make a dis­tinc­tion be­tween a state hospi­tal, with the huge load that it faced, and the more con­ve­nient pri­vate sec­tor but said Mater Dei “meets and ex­ceeds ex­pec­ta­tions” ev­ery day. He said there needs to be greater in­vest­ment in com­mu­nity-based ser­vices.

Mary Anne Sant Fournier said phar­ma­cists wanted to see less waste and more ad­her­ence by pa­tients.

Dr Stephen Zam­mit, CEO of Karin Grech and St Luke’s, who spoke in his ca­pac­ity as a con­sul­tant, said Malta has long been yearn­ing for a proper re­ha­bil­i­ta­tion hospi­tal. This is now hap­pen­ing at St Luke’s hospi­tal thanks to the agree­ment with Vi­tals Global Health­care.

Field­ing ques­tions from the floor, Mr Fearne said the Mal­tese health sys­tem is geared to­wards cur­ing sick­ness but the time has come for us to start fo­cus­ing on preven­tion. Asked if the time had come to in­tro­duce a sugar tax, the min­is­ter said he be­lieved in ed­u­ca­tion, not im­po­si­tion.

He spoke on the need for in­creased ef­fi­ciency in the pro­cure­ment of medicines and said that these should, ide­ally, be taken di­rectly to phar­ma­cies or pa­tients at home. These would save up on stor­age and trans­port costs.

MAM Sec­re­tary Gen­eral Martin Balzan, speak­ing as a pa­tient, said the choles­terol pills he is given on the NHS sim­ply do not work. “It is good to fol­low pro­cure­ment rules but we have to en­sure that we are buy­ing good qual­ity stuff.”

He also al­leged that nurses were de­mo­ti­vated be­cause un­qual­i­fied per­sons had been cho­sen to ap­prove pro­mo­tions. The best peo­ple were not cho­sen for the job, he said.

The Health Min­is­ter re­jected these claims, say­ing that the roles were cho­sen ac­cord­ing to es­tab­lished pro­ce­dure and by com­pe­tent per­sons.

Turn­ing to the medicines is­sue, Mr Fearne said all generic medicines im­ported to Malta are au­tho­rised by the com­pe­tent Euro­pean au­thor­i­ties. “If any­one has any ev­i­dence of unau­tho­rised medicine or drugs that don’t work they should re­port it to the medicines au­thor­ity.”

“If we were to buy brand medicines only our bud­get would more than dou­ble,” he ex­plained. “In gen­uine cases where gener­ics are less ef­fec­tive than branded medicine there are pro­to­cols for the pro­cure­ment of the lat­ter. These pro­to­cols are be­ing re­vised, mak­ing ac­cess eas­ier.”

The CPSU head ac­knowl­edged that there were re­ports of ad­verse ef­fects from a par­tic­u­lar brand of eye drops but said the is­sue had been ad­dressed.

He also noted that the gov­ern­ment had al­lo­cated an ex­tra €3 mil­lion for the pro­cure­ment of cancer medicine, which would save peo­ple the trou­ble of go­ing to the Malta Com­mu­nity Chest Fund.

Clos­ing the de­bate, the Health Min­is­ter an­nounced that health­care pro­fes­sion­als will be taught “soft skills” as from next year, and this would im­prove the over­all pa­tient ex­pe­ri­ence. “This will cost us around €3 mil­lion but it will be to­tally worth it.”

He also an­nounced up­grades to the IT sys­tem as the health au­thor­i­ties move closer to a sys­tem where all med­i­cal records are kept on file. And the new myHealth sys­tem will be launched in April. This will be more user­friendly and pro­vide more fa­cil­i­ties for pa­tients and com­mu­nity doc­tors.

Pho­tos: Michael Camil­leri

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