The Mater Dei Hospital has now been handed over to the government and the migration process should be in full swing so that the hospital can receive its first patients later on this year.
This hospital has been long in coming. Today's finished product is not what was planned out 15 years ago, because of the different views adopted by successive governments. It cost more than it was projected; but, the general view is that we have a modern, well-equipped hospital that should suit our needs. We have always tended to look at the new hospital and the health care system in general from a social perspective, rather than an economic perspective.
We wanted to ensure that health care was available to all for free, even if we have private hospitals and clinics for those who wish to pay for their health care. There are also some categories of people who benefit from free medicines. This gave us a health system that we are generally proud of and the public feels that from a health care point of view, its needs are being catered for.
Moreover, it has left the desired results. Life expectancy has edged up gradually and operations that were previously not done in Malta are now being carried out. There is probably room for improvement but the health service is definitely of no concern to the Maltese, both from a national and individual perspective.
It is only now that questions related to the economics of health care are being raised. People have questioned whether the cost of the Mater Dei Hospital is justified or not. Others have doubted whether its running costs can be sustained in the long term. Some have proposed the introduction of hospital fees and to move away from the concept of a free health service for all. Since Mater Dei Hospital has less beds than St Luke's, there were those who asked whether we would need to keep both hospitals open to cater for all possible demand.
Others focused on the management processes and work practices and have maintained that unless these change in line with current trends in health care and in line with the amenities available at Mater Dei Hospital, running costs may be too high. In the meantime, we are also introducing the Pharmacy of Your Choice initiative, and some have raised questions about the sustainability of this scheme. And what would be the role of the health centres within this new scenario? Probably all these questions are justified and they have one common denominator - the economic sustainability of our health care system.
The issue may be new to us, but it is not new to other countries. In other countries it is normal practice that public health officials make decisions on whether to make some type of treatment available to some patients if there is little chance for them to be cured.
They look constantly at costs and benefits, as if human life has a value that can be put on a profit and loss account. This may come as a shock to us, but the minute we start questioning the economic sustainability of our health care system, we have started on a path that could eventually lead us to having to take awkward decisions of the type I have just referred to.
Maybe it is understandable that one wonders whether the cost of Mater Dei Hospital is over the top or not. One needs to remember that that is the first hospital of this size we have built in Malta. St Luke's Hospital was built under a colonial administration, with all that this implied in terms of funding of public expenditure. Up to a certain extent, we cannot be faulted if we thought that St Luke's Hospital came for free, and so the cost of a new hospital would always be seen as being too high, no matter what that cost really is.
Maybe, even more surprising, is the amount of money that is spent on health care in this country. The estimates of public expenditure for the current year show a figure of around Lm90 million. Recurrent expenditure is at Lm84 million. Private consumption expenditure by households on health care is estimated at around Lm40 million annually.
This makes a total of Lm124 million and represents Lm310 per head of population. Thus the economic sustainability of health care, even if it needs to take second priority to the social needs of the country, must start to be considered.
However, the economics of health care must also take into account the benefits of a well-run health service. What is spent on health care, in its widest definition possible, is eventually recovered through a more productive population. It is this awareness of what the real benefits of our health care system are that will guarantee its sustainability in future.