Editorial

The findings of our latest opinion survey, whose conclusions are carried elsewhere in this issue, bear out the well-deserved reputation which Malta enjoys for its generally good health service, including hospital treatment (state and private) and highly qualified doctors.

The provision of free medical treatment and free medicine represents an ever-growing slice of government expenditure, which is set to rise further with the opening of the new Mater Dei Hospital and its upkeep; yet even here, the vast majority of our respondents (84.7 per cent) think the expenditure is justified, since the present general hospital, which is over 70 years old, has clearly become inadequate for present-day needs.

This does not mean that there are no complaints. Indeed, our survey found that the most common, as regards state hospital services, is that waiting to be seen is too long, and in fact the whole system of appointments is unsatisfactory to most.

On the other hand, many feel that the cost of private medical treatment and of medicines is too expensive, particularly as this affects mostly old age pensioners enjoying only a modest income. Yet two-thirds of respondents prefer a private medical service. No wonder that a large majority (82 per cent) would like spending on private medicine and treatment to be tax-exempt.

In this connection, given the increasing popularity of private medical insurance, it is felt that the cost of this should be at least partly tax-exempt.

The use of government health centres is more widespread than perhaps thought. Again, the major complaint seems to be long waiting times; also the fact that some doctors do not turn up, and staff shortages.

So it is natural that while believing the huge expense for the new general hospital and its upkeep is justified, people expect, in return, a number of improvements in the health service, namely a general improvement in quality, the elimination of waiting times, greater staff discipline, and that doctors and even specialists work full-time. One could say that from what has been publicly revealed so far, expectations regarding the new hospital and its services are quite high.

On the other hand, one has to realise that there is no such thing as a free lunch, and that hospital and medical services are becoming increasingly expensive. Malta boasts of one of the most comprehensive free health services in the world, yet one has to ask whether society as a whole can be expected to continue to bear the rising costs of such services, particularly when it comes to elective surgery, without at least a partial contribution by those benefiting from them.

Smoking ban just on paper

And while on the subject of health, it is a sad indictment of one of our most negative characteristics - lack of enforcement of rules and regulations, a failing of successive administrations - that almost two years after regulations prohibiting smoking in public places came into force, these are widely flouted.

This is particularly true of discos, night clubs and bars which are frequented mostly by young people, who are thus exposed to second-hand smoke at very close quarters. After a couple of hours their clothes reek of tobacco smoke (just imagine what their lungs look like!), their eyes water and they feel sick. This was the experience of patrons at one large party in a Paceville disco club last Thursday attended by hundreds of young people, forcing many of the non-smokers among them to leave early. Needless to say, the police do not seem to have taken any action.

Why aren't these establishments regularly visited by police officers to see that the no smoking regulation is observed, and offenders brought to book? And indeed, why are there so few prosecutions for this offence? It seems the no-smoking regulations (which, despite initial opposition, are being strictly observed in other countries like Ireland) are destined to remain on paper, as with so many other regulations in Malta! The penalties - a minimum Lm100 fine for the first offence, and Lm10 a day for as long as the offence persists, and up to three months' jai and the withdrawal of the premises' licence - look fine on paper, but that's as far as it goes!

When will our "authorities" realise that in this area, at least, the price of inaction is much higher than that of enforcement?