In defence of the national health service

The health minister said recently he planned to submit to the cabinet proposals for a heavy overhaul of the national health service. For the minister, now is the right time to introduce drastic measures designed to curb public expenditure on health care which is said to have reached "unsustainable" proportions.

While arguing that Malta is the only country in the world where the primary, secondary and tertiary health services are entirely offered free of charge to all and sundry irrespective of the individual's financial means, the minister intimated that means tests may be introduced and/or revised in regard to the pink and yellow cards.

But before embarking on a dangerous plan to cut down on the provision of national health services and free medicine, the authorities would need to think twice.

The negative social cost should not be sacrificed on the altar of monetary and financial dictates. To be sure, abuses of the system should be checked and a better deployment of the army of staff complement at the various state hospitals must be carried out.

The government should also assume responsibility for the fact that, many a time, the financial costs of the new hospital at Tal-Qroqq have gone well beyond budget estimates.

The government must also ensure that the collection of fees paid by foreigners treated at our national hospital is as efficient as possible.

The axiom "prevention is better than cure" needs to be inculcated in the psyche of the people more effectively. In this regard, while commending the work done by the Health Promotion Department, the health centres and other national agencies, I would suggest that the services and resources of these institutions be reformed and upgraded. This will enable these institutions to be in a better position to drive their message home across Maltese men and women with improved results.

Health authorities need to keep in mind that severe cuts in the state provision of health care are likely to deal a heavy blow to the living standards of families which have member/s suffering chronic diseases. The disposable income of these families will be eroded if they are required to pay for their health needs and medicines. This will continue to raise the extent of social inequality which brings with it serious implications for the legitimation of the state.

The establishment of the national health service was one of the major achievements in the 20th century. Our forefathers had to fight against strong resistance in order to establish the principle of free health care for all.

The growing contemporary families of hard-working people, who are already burdened with heavy taxation, must ensure that the provision of health care continues to be given on the basis of need and not on the basis of the purchasing power of the individual.

It is unfair for working people suffering from chronic diseases to have a setback in their standard of living by a means test that will penalise them for the simple reason that they were responsible enough to keep their jobs and earn their salary even when their health situation proved to be difficult. The national health service is one of the basic rights of all those who paid their national insurance contribution throughout their working lives.

Proposals for the further privatisation of health provision continue to threaten the core values of the welfare state which regard health care as a social service rather than a market commodity. Social conscience calls for an unrelenting defence of the integrity of the national health system.