Towards a healthier future

Our health care system has served us well during the 20th century. It has developed concurrently with Malta's development as a nation. The question is what is the kind of health system that we require in order to meet our needs for the 21st century in an economically-viable and socially-acceptable manner given the current challenges.

These include an aging population, demands by increasingly-informed patients, costly medicines and technology and, more recently, the impact of the internal market rules on health systems in the European Union.

Together, the public and the private sector expenditure in health accounts for almost nine per cent of GDP. The public health care system is funded through the consolidated budget, which means that health has to compete with other sectors of government for funding its resources. The budget for health care has been increasingly consistently over the past decade, yet further increases are doubtless necessary to allow us to cater for the rising demand and the costs of innovation.

Satisfaction with medical care in Malta is about 84 per cent (compared with average 70 per cent for the EU 27) and this is, no doubt, partly due to the comprehensive services we provide. We are however finding it increasingly difficult to keep up with service innovation both in terms of new medicines and in terms of new diagnostic and treatment modalities.

Our flagship project for the last decade has been the construction and commissioning of the 825-bedded acute specialist hospital, Mater Dei Hospital. This hospital has been equipped with state-of-the-art functionality, especially in areas such as cardiac services and the radiology department, which is a fully digital setup with a nation-wide Picture Archiving and Communicating System (PACS) and Radiology Information System (RIS). We also have a dedicated oncology hospital which we are planning to relocate to a modern facility complete with new investment in equipment including replacement of linear accelerators and investment in a PET scanning service. We will also be investing more in prevention such as through the development of breast cancer screening.

The developments made at Mater Dei have only served to demonstrate what is possible for health care delivery in the future.

We must continue to build on what has been developed but we must also be able to continue to roll out development in health ICT to other parts of the health care system. Our ambitious project is the development of a national electronic patient record, which will serve to better interface hospital with community care as well as bridging the information gap between the public and private health systems.

Our main attention now needs to be focused towards primary care. The current situation where services are fragmented and duplicated between the public and private sectors is untenable. We have to see how our health centres can evolve to cater for specialised services in an ambulatory setting. We need to urgently introduce a system of patient registration that strongly involves the private primary care sector. These are not easy solutions but are the mechanisms we need to have in place to build a robust health system. That continues to meet our needs in the coming years.

The government's vision is to achieve excellence in the health sector in its national plan for 2015.

All the ingredients are in place: investment, infrastructure, a capable and competent workforce.

We need more will to change practices and the will to work together as a team.

I have no doubt that, although the trek will be long and arduous, we will get there and we will be able to look back with a sense of satisfaction having introduced the necessary reforms that allow the Maltese health care system to thrive in a sustainable manner at European level.

Dr Cassar is Parliamentary Secretary for Health.