The sweet pill

One of the bitter pills that the 1996-98 Alfred Sant government had to swallow concerned, ironically, the social distribution of medicines.

I was a member of the Cabinet that approved a measure that would see a nominal charge of 50c (€1.16) on each prescription when a patient went to collect medicines paid for by the state. I remember the government's sense of purpose that here was a measure that would reduce waste by discouraging unnecessary claims and hoarding of medicines. In cracking down on waste, a social purpose would have been achieved, by freeing up resources for the truly needy.

And indeed, during its short-lived period of implementation, the measure had an unprecedented effect on unnecessary claims for free medicine.

The bitter pill was the fierce opposition which met a measure that the then government believed was transparently well motivated and sensible. The fierce attacks were led by the Nationalist Party, then in opposition. However, resistance also came from nominally "non-political" quarters.

Once the Nationalist Party returned to government, it was electorally committed to remove the charge. And it did.

Therefore, it was very sweet medicine to read the sensible statement this week by Reginald Fava, the main spokesman on healthcare business of the Chamber of Commerce, Enterprise and Industry.

Mr Fava spoke in defence of what Labour had done. He confirmed the charge had acted as deterrent against wastage. He said that the charge should have been retained... and even increased.

Mr Fava is now recommending a different way of implementing the measure. It is a very sensible one, which in general has my support.

Under his proposed scheme, patients would need to pay for the medicines they need, and then be reimbursed by government. An exception would be made for that particular social class of people who is too strapped for cash to be able to pay up-front.

The overall effect would be that medicines would remain, effectively, free. However, the extra effort required to get back one's money would make people think twice about obtaining medicines, if they did not really need them. The system proposed is similar to the one which members of the European Parliament are subject to. Under this system, to be reimbursed an MEP needs to provide a prescription with his or her name clearly written on it, as well as a receipt from a pharmacy.

The documentation is given to a special unit which decides if the medicine bought is eligible for reimbursement. (It is a feature of the system that the list of eligible medicines is not known to MEPs.) Sometimes, a special medical report may be required, for example to confirm a chronic condition.

I hope that Mr Fava's proposal for a new scheme will not fall on deaf ears. I also hope that a more general lesson will be drawn.

For too long, the winner-takes-all mentality of national politics has led to genuinely good schemes and measures to be opposed, just because of who was doing the proposing.

The fault could be distributed between governments and oppositions. The latter would avoid any constructive opposition.

The former would have partly brought this upon itself because of its reluctance to give any credit for constructive approaches.

Things have begun to change but not as fast as could be. Ironically, for things to begin to change with Mr Fava's recommendation, the Labour opposition may have to swallow another bitter pill.

Because Mr Fava is clear that the Nationalist opposition was mistaken to oppose Dr Sant's government's introduction of a charge. It should either have endorsed it or at least opposed constructively by making suggestions for improving the implementation of an idea that was sound in principle.

Twelve years later, it is Labour's turn to crow in the wake of Mr Fava's declaration. Let it have its moment of satisfaction. But, in the social and political interests of the country it wants to serve, especially the needy who would most benefit from Mr Fava's proposal, Labour should remember not to let its proper sense of vindication perpetuate the cycle of what in England is called "yah boo" politics.

The country's senior spokesman for healthcare business has justified Labour's past measure.

Let Labour take the sweet pill in its stride, walk purposefully in the present and urge the government to implement a good idea with all the means available today, so that our healthcare system can have a robust, socially just future.

Dr Attard Montalto is a Labour member of the European Parliament.