Editorial

The case of a foreign detainee who repeatedly complained to the Ombudsman about waiting years for a knee operation has triggered off a chain reaction of accusations regarding the intolerable excessive waiting time to have operations done.

The Ombudsman castigated the health authorities for being incapable of exercising control over consultants "who keep a stranglehold on current waiting lists in their departments" and obstruct an independent check on how these active lists are compiled and managed.

The Medical Association of Malta reacted strongly to the Ombudsman's scathing report claiming justified delays because work at the new hospital was bedevilled by a shortage of beds and qualified staff.

However, Social Policy Minister John Dalli, who months back had not minced his words by labelling Mater Dei as a part-time hospital, again criticised the prevailing state of affairs and pledged a "revolution" at Mater Dei Hospital to tackle this mounting problem.

Mr Dalli has a reputation for tackling unsavoury tasks head on and, being armed with pragmatic professional accountancy skills, he is very able to ferret out waste and mismanagement.

Yet, with an aging population, neglected primary care, a free-medicine policy and ever increasing advances in medicine, it takes wizardry to meet all demands and expectations.

A confrontational approach would bode no good, yet, as Mr Dalli insisted, old work practices must change if we want to ensure a sustainable health care system. The Ombudsman's demand that the authorities conduct an urgent and detailed review of waiting list management so as to ensure a system based on transparency, accountability and best practice is justified and deserves immediate implementation by the health authorities.

This is not an intrusion into the judgment of consultants who ultimately have to prioritise the urgency of the cases before them. On the contrary, it is a necessary and overdue requirement to identify shortcomings and even unfairness that must be rooted out. It is an unfortunate reality that, with most consultants combining public and private work, there is too easily a conflict of interest.

The medical profession would be foolish to defend the indefensible. Besides, it is unfair on other members of the profession who work with dedication and integrity. However, if it is still unable to meet the demand, the government has to consider other options that might include farming out work to private hospitals and employing foreign medical staff. Both options would have to be handled very carefully and with rigorous controls.

Besides, prevention and primary health care must be given the funding and resources they need to promote the people's health and reduce the uncontrolled growth of avoidable treatment needs.

Above all, the people cannot expect that because they pay taxes any government can provide unlimited services at all and every level. As Mr Dalli himself admits, there is waste and mismanagement that siphons off resources from meeting so many essential and dire needs. Unfortunately, both political parties have allowed partisanship to poison any measured and positive debate on ensuring a sustainable health service.

The time for talk is over. It is in our country's interest that the authorities take the bull by the horns. The sick and ailing should be spared any more undue hardship. After all, an efficient and readily available health service is the cornerstone of a compassionate and civilised society.