Shortage of doctors in health centres getting worse - opposition

Opposition health spokesman Michael Farrugia said on Wednesday that the government had lost the opportunity presented by the new agreement with doctors to introduce incentives for more doctors to work in health centres.

He said that although the opening hours of a number of health centres were temporarily curtailed seven years ago because of a shortage of doctors, the situation now was actually worse and the government was under pressure to close more health centres during the night.

Dr Farrugia was speaking in Parliament during the budget debate on the Ministry of Health.

He said the vast majority of fifth year medical students were already seeking opportunities to work abroad. What was the government doing to keep them here after having invested in their training and paid them stipends?

Unfortunately, a number of specialists were also considering leaving, not just because of their salary, but because they were disheartened.

Dr Farrugia said the PN government had wasted almost 20 years before coming up with the possibility of offering post-graduate training facilities in Malta.

The area of community nursing had seen some progress in the initial years of this government, but then everything went downwards. Labour was promising to inject new life into this sector. It would cooperate closely with doctors, who would be able to use the facilities of health centres and public hospitals, so that referrals to hospital would only be made when absolutely necessary.

Turning to the government's launching of a breast screening programme, Dr Farrugia said a Labour government had taken initial steps towards this end but the present government had been sceptical. Just a month ago the health minister told a TV programme that Malta lacked the set-up and human resources for a breast screening programme. Yet now such a programme had been announced. But how would this programme succeed when the waiting list for a mammogram was between 18 months and two years long? Labour would give such a programme high priority and would also insist on cervical smear tests.

Turning to the Pharmacy of Your Choice scheme, Dr Farrugia said that in 1998 the Labour government had agreed in principle with the GRTU and the Chamber of Pharmacists on a Pharmacy of Your Choice scheme. The formal launching had been earmarked for after the 1998 election but after the change of government everything was shelved until now. The problem was that doctors and pharmacists were still in the dark on the details.

Dr Farrugia complained that local medicine prices were on average six per cent dearer than in the EU, even though salaries here were just 60 per cent of the EU average. Why had the government waited years before starting to do something?

The Labour MP said it was worrying that the government owed Lm12 million to the medicine importers. It was no wonder that some medicines went out of stock.

He said there was substantial room for improvement in the registration of medicines so as to widen consumer choice and bring in real competition.

On Mater Dei Hospital, Dr Farrugia said its much delayed opening would not mean the solution of the health sector's ills. There was a need for change in management and work procedures unless the problems of St Luke's Hosptial were to migrate to Mater Dei. Waiting lists for operations simply could not be allowed to get any longer. Since 1998 the waiting lists had tripled. This meant that for thousands of people the quality of life had deteriorated. Labour was promising to be innovative and would invest towards a solution to this problem, including setting benchmarks of acceptable waiting times which would be reduced by 15 per cent every year.

The situation at the new hospital was such that although the number of operating theatres would rise, some of the theatres would remain closed because there were insufficient human resources to man them. Surely this situation should have been rectified before the hospital was opened.

The Labour MP observed that the migration process to Mater Dei would peak when Queen Elizabeth II was in Malta. What would happen if there was some incident?

But while the Queen's visit was a one-off, it appeared that water seepage at the new hospital was not. Was this why the hospital was not blessed? The wind had also brought down a fence. All this was unacceptable.

Dr Farrugia also called for better services for the treatment of mental patients, including improved community services.

He said the health service needed to evaluate the medicines it used. Some medicines were not the latest. New medicines, though more expensive, could mean fewer days in hospital and thus greater savings.

Dr Farrugia said smoking, alcohol abuse and obesity remained a problem in Malta and education campaigns needed to be intensified and made more effective.

Concluding, he said that up to some time ago the government boasted that Maltese medical services were ranked fifth by the World Health Organisation. Now Malta was ranked 20th in Europe. This was the result of the shortcomings he had mentioned. He promised that a Labour government would address these problems and also introduce patients' rights in the law.

Silvio Parnis (MLP) complained over the cost of living, saying it hit the elderly especially hard. The elderly, therefore, should always get the cost of living adjustment in full. He said that Labour was ready to keep working on whatever good would have been done by Nationalist administrations. Labour could not be against allowing pensioners to keep working while taking a pension.

On the other hand, it was disappointing that home help had not been accorded to many duly-certified people who really did need help. This was one sector that a new Labour government would be certain to strengthen.

The 80 per cent of pension income currently forfeited by residents at St Vincent de Paul Home would be reduced to 65 per cent by Labour. The new government would set up a committee to oversee the needs of those residents at the home, especially those who did not have families to support them. The refurbishment of parts of the residence was praiseworthy, but Labour was promising to do even more to turn the residence into a villa city with all possible amenities for senior citizens.

The Kartanzjan scheme would be revisited, and systems would be devised for a culture of fostering for senior citizens.

Adrian Vassallo (MLP) also complained over growing waiting lists for operations in state hospitals. Diabetes was the national malady, yet appointments at the diabetes clinic stretched to almost a year. The situation was much the same for other common ailments, with some exceptions. The situation was not made any better by almost half the applicants eventually not keeping their appointments, but this could be partly explained by individuals having had recourse to private treatment because they could not wait so long.

The average waiting time for emergency services was six hours. There were long queues at health clinics, where things were made worse by the fact that they were no longer open around the clock. The average time a health clinic doctor could spend with a patient was four minutes.

With Malta being a world leader in IT, it was a wonder how so many medicines could run out of stock. Buying expensive medicines with limited financial resources was not an option for many. There should be some sort of financial compensation for such cases.

The Pharmacy of Your Choice Scheme sounded good for those with a yellow card, but what about those with the pink card? Would they be served immediately or would they have to wait for urgent medical supplies?