Health promotion messages 'not getting through'

Labour health spokesman Michael Farrugia yesterday called for a review of health education "because the message is not getting through."

He said that despite the efforts of the Health Promotion Unit, Malta still had a high number of overweight children, a high percentage of smokers, a high rate of alcohol abuse.

Dr Farrugia said during the budget debate on the health sector that development of the primary health sector in general had stopped and a campaign was needed to educate the people on how to use health services.

Eligibility for free medicines was getting far too bureaucratic, with approval by consultants even required for medicines which were in regular use. Why were important medicines out of stock for weeks on end? Why were new medicines not approved, even for use to hospital patients?

Dr Farrugia said that the Opposition agreed with the registration of medicines and this process had started under the Labour government.

The present government slept on the matter and was now finding it difficult to procure medicines at a good rate. Certain medicines had also disappeared from the shelves of private dispensaries.

The issue of licences for new pharmacies had been left pending for far too long and clearly needed to be settled.

Dr Farrugia asked when was the new Mental Health Bill would be discussed in Parliament.

Turning to hospitals, Dr Farrugia said that there was a brain drain because many doctors were opting to go abroad for specialisation.

The government was contributing to this situation because it felt uncomfortable of enthusiastic people who wanted to modernise the way the health care sector operates. These people then got frustrated and found jobs abroad.

The Prime Minister had spoken of Malta having been recognised as having an excellent medical service.

That was true in many respects, but then public hospitals over the past month had missed basic supplies such as sterilised gloves and bandages. In some instances, patients were made to buy products they needed. More recently, certain bolts and plates in orthopaedic operations were being cut there and then.

At the X-Ray department there was no space for X-Rays and files were lying everywhere.

When it came to hospital cleanliness, there was a lot to be done. There was also a problem in the ambulances sector and ambulances needed to be replaced.

Dr Farrugia criticised the government for not recruiting newly-qualified nurses, despite existing vacancies, because of a shortage of funds.

On what criteria would the Foundation for Medical Services recruit staff for the hospital?

Dr Farrugia also referred to the building of the new hospital, attacking the recent agreement reached with contractor Skanska as well as the "shameful procedures" used when the contract for medical equipment was awarded, when Inso was preferred to German company Hospitalia.

The Foundation for Medical Services had chosen Hospitalia, whose equipment was 90 per cent compliant.

The Contracts Department, however, annulled the award because of conditions which went against the tender document. It embarked on discussions with Inso and gave it the contract even though several clauses of the tender document were breached.

Two protests were then filed, one by Hospitalia and the other by a Dutch company - Seamed and the issue prolonged for a further nine months.

The minister then made use of a clause which gave him the right to decide who to award the contract to and he decided to give it to Inso.

The same contract which had been annulled by the Appeals Board was awarded to Inso by direct order.

On the agreement with Skanska, Dr Farrugia said those responsible for designs, costs and decision-making should shoulder their responsibilities.

Although Lm43.5 million had to be spent on the hospital last year, Lm28.5 million were spent instead. Why did the government ignore the Lm15 million difference when he said that the deficit projections were met. Had projections been met, there would have been an additional Lm15 million deficit.

Concluding, Dr Farrugia said that in 2003, Lm13.2 million were spent on the elderly, the revised amount this year was Lm13.6 million. Could someone explain how Lm12.5 million, Lm1.5 million less, were being voted for next year?

Earlier in the sitting, Silvio Parnis (MLP) observed that suggestions made by NGOs such as the National Pensioners' Association before the budget had been ignored.

He said pensioners in government homes were seeing a higher portion of their pension deducted by the government to the extent that some could not afford to buy Christmas presents. At the same time, the quality of service at the homes left much to be desired, especially where catering was concerned.

Mr Parnis called for a review of the means test (karta roza) for eligibility for free medicines, but said it should also be ensured that medicines were always available in government pharmacies.

There was also need for guidelines on the management of old peoples' homes - whether public, private or church-owned. There was also need for fairness in the provision of the home help service. He knew of a case where a pensioner who had knee problems was refused service because she was perceived to be well off.

Mr Parnis also complained of the hike in the price of kerosene and the water and electricity surcharge.

Adrian Vassallo (MLP) also complained about free medicines from government dispensaries being out of stock. And eligibility for an unnecessary large number of medicines was now possible only after approval by consultants.

The labour MP complained that waiting lists were getting longer at the hospital out patients' department as well as for surgery - patients sometimes had to wait two years for a cataract operations and three to four years for hip replacements. And many operations then had to be postponed because the ITU could not handle the load.

Dr Vassallo called for a review of how the Emergency and Admission Department at St Luke's Hospital worked. Perhaps rather than waiting for many hours for tests, patients should be admitted immediately and subjected to the necessary tests, after which one could decide whether further hospital treatment was needed.

Dr Vassallo said that while abroad operations were made by video connections, in Malta a doctor could not even ask for hospital transport for elderly patients on the phone.

He also complained about the state of the nurses' quarters. The area had been without water for about a month and a nurse just escaped head injury when a piece of concrete fell from the ceiling.

The hospital, he said, was disgracefully overcrowded with patients in corridors, with not even a screen for privacy.