Health services far from "free"
Video: Mark Zammit Cordina
Beds in Mater Dei Hospital do not come cheap, with those in a surgery ward costing the State €180 a day, about €147 in orthopaedics and a whopping €1,038 in the intensive therapy unit.
Surgical operations are not cheap either: an operation to remove an appendix costs about €1,503, a cataract operation about €705 and a hip replacement could cost as much as €4,800, figures seen by The Times show.
Thousands of tests are carried out every day at hospital; nearly five million were carried out last year, a daily average of over 13,000. Tests for cholesterol or sugar levels in blood topped the list with almost 2.9 million ordered last year.
Tests also cost money: one histology test (analysis of tissues taken during surgical procedures) costs about €9.88. With 71,487 histology tests done in 2008, this added up to about €706,291 of taxpayers' money.
Similarly, about €818,130 was spent on the 67,951 virology tests (for viral infections) carried out last year. Each test costs €12.04.
People had to understand that the health services were not actually "free" because everything was paid for by the taxpayers, Health Parliamentary Secretary Joe Cassar said.
Everything in hospital cost money, including the ward beds, the medical tests and the operations, some of which ran into thousands of euros, Dr Cassar said.
Plans are underway to give patients discharged from Mater Dei a full breakdown of how much their stay cost the taxpayers.
The measure will only be launched once the results of the government-launched costing exercise of the whole system are studied.
Similarly, the hotly-discussed waiting lists are also being placed under scrutiny.
Dr Cassar explained that part of the exercise involved sending letters to each patient on the lists, which was sometimes followed up by a phone call.
The painstakingly long exercise has started on the list for the orthopaedic operations, which was one of the longest. Although the scrutinising of the list was not yet complete, it had already been cut by 30 per cent, Dr Cassar said.
He pointed out that this was not just a matter of numbers. Behind each number was a patient with his suffering and problems, he said.
Figures tabled in Parliament recently reveal that the number of ophthalmic patients waiting for surgery, including for cataracts, fell by just over 300 - from 6,157 to 5,847 - between January and June. The vast majority of them - 5,628 - were waiting for cataract surgery.
The waiting lists were evaluated between January and February and again between June and July.
Even though progress was registered in certain areas, the waiting list for orthopaedic operations rose by more than 460, with 10,660 waiting for different operations, including knee and hip replacements. These included 1,559 patients who were on the list of a retired orthopaedic consultant. In next year's Budget, the government has allocated €4 million to reduce waiting lists for operations within three years.
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maria aquilina
Nov 14th 2009, 06:58
Is Dr.Cassar conscious of what is going on at the Gynae andObstetric wards at the moment? There is such a big deand for beds that gynae patients are being transferred to other wards to make space for newborns and their mothers.So in the gynae ward there is a mixture of patients.In this ward one finds moribund patients and newborns.Do you think this is right? We are all the time boasting of a state of the art hospital.Patiets do not like it when they are transferred from one ward to another during their stay ,the reason being to make space for other patients.Dr Cassar and Mr.Dalli please note that neither the patients nor the staff are being amused.
DVella
Nov 13th 2009, 17:54
@ P Cassar ...the heaviest taxed in the EU? Are we REALLY? I think you need to get out a little more often friend!!!!
E. Azzopardi
Nov 13th 2009, 17:52
I have been suggesting for ages that those who have a Private Health Insurance Policy are given a tax rebate. I suggested this again before this Budget but it was not to be. If it is worked out, the amount of money the government saves would be far superior than the tax rebates because those with the policy will obviously go to a private hospital and not Mater Dei. The above rates surely confirm this.
P.Cassar
Nov 13th 2009, 16:22
OF COURSE IT'S NOT FREE
WE ARE PAYING NATIONAL INSURANCE EVERY DAY OF THE YEAR AND VAT INCREASE FROM 15% TO 18% IS MEANT FOR THE HEALTH SERVICES. IF IT'S BAD FINANCIAL MANAGEMENT THEN SAY SO.
MR MINISTER PLEASE GIVE US THE RESPECT ARE DUE, DO NOT TRY TO MAKE FUN OF US AND STOP REPEATING THIS ABOUT THINGS BEING FREE WHEN EUROSTSAT SHOWS THAT WE ARE THE HEAVIEST TAXED IN THE EU!!!!
N.Calleja
Nov 13th 2009, 16:01
Most of the criticism hereunder is a load of rubbish! The government is studying the cost and exposing it to the general public that make use of the Mater Dei services just to prove that, out of our taxes, people are getting the best of services at the hospital. Those who had the unfortunate experience to be in hospital know what great service is given in all aspects to the patient. Nothing is left out, no matter how much it costs. Although it is all coming from our taxes, the Maltese people should be grateful for all that is done in the patient's interest. Waiting lists are found in every corner of the world. Nowadays the services at Mater Dei are so excellent that private hospitals are 'selling' operations at a cheaper rates because most patients are prefering Mater Dei to them.
Claire Busuttil
Nov 13th 2009, 15:36
@Dr.Cassar,nahseb li kwasi kulhadd jaf li s servizzi li nircievu fil qasam tas sahha, huma imhallsa, u imhallsa minna stess( ok forsi hemm xi nies li ghadhom ma jafux insomma)
imma li tigi tasal biex taghti kont lil pazjent li ghadu kemm hareg mil isptar, biex turieh kemm sewa lil pajjiz, hi haga ridikola ghal ahhar.....flok tahli il flus taghna f din il haga(ghax ovvja dis sistema ukoll se issir bil flus ghal gvern) mhux ahjar timpjega il hin tieghek, f affarijiet aktar konkreti u ta gid ghal poplu???? Taf bizzejjed li hemm hafna x ghad isir f dan il qasam, ghalkemm mhux kollox iswed ta, imma still ghad hemm hafna u hafna x isir.....u kull min juza regolarment is servizzi tas sahha, jaf sew x jiena nighd.
G.Debono
Nov 13th 2009, 14:49
Church schools get government funding, but send letters for donations to cover expenses that are over and above.
Why does not the same happen (for once ! in agreement from the opposition) to send a donation letter to people having made use of hospital for more than 0.5 day stating what the government funds directly from our taxes and the difference for the procedure the patient would have had. If the patient wants s/he can contribute via a donation.
Eg. Appedix fee 1503
Direct taxes say cover 1000 of it with the rest being covered by indirect taxes/other.
A donation letter could be sent to the person who had the procedure explaining the 503 + other costs are not covered by direct taxes and a donation (of any amount) to the hospital services would be appreciated.
Fejn naf forsi jibghat nofshom almenu.
Paul Barrett
Nov 13th 2009, 13:44
Unfortunately at the quoted prices, 4 million would only be enough to clear those needing cataract operations, never mind any of the others.
g.Sinagra
Nov 13th 2009, 12:50
Would it not this 'cost exercise ' add more cost to the taxpayer? Is it not enough having the NP media dishing out day in day out propaganda .Is the Gov. expecting tipping before leaving hospital ?
laurence schembri
Nov 13th 2009, 12:47
That is why we pay into the NHS.
Joe Grima
Nov 13th 2009, 11:53
This is how government employees' time is wasted to satisfy the whims of politicians. Soon after a stay in Hospital the patient will soon start receiving a letter telling him how much the stay cost the taxpayer. This will be a futile exercise that no one needs, only intended to make patients grateful for the attention received in hospital. I suggest that patients who receive these letters should send a letter in return to Dr Cassar , informing him of how much they will have paid, over the years, in deductions from their salaries to fill the kitty from which these hospital expenses are paid . Dr Cassar then can write back to tell the patient how those millions that have been collected each year from us taxpayers have been used in the last 20 years. We pay for the whole of all our working lives for the privilege of free health care and so, getting medical attention at Mater Dei when we need it, is no favour. It is a service for which we will have prepaid many many times over.
Julian Borg
Nov 13th 2009, 11:50
Healthcare in no way is FREE, but it is a moral responsibility of the government and the tax payer to bare the brunt of this responsibility. It would be an excellent idea to show people how much these things cost us as tax payers, as most of us seem to think that it costs nothing since the government does it.
I would like to bring to the attention of the public healthcare system, my wife did her blood tests at St. James where she sees her OBGYN, when we went to register at the hospital, we were made to take these tests again. Is this a bureaucratic screwup? or is it easier for the doctor to just order up all the tests without thought of workload or costs to the taxpayer?
Regardless of my previous statement... congratulations to the health department and whoever else was responsible; we have a beautiful, well deserved hospital that we can all be proud of, regardless of these bits and bobs.
Mike Farrugia
Nov 13th 2009, 11:48
Why doesn't the minister publish the full costings including the variable and fixed costs of every medical service (or department) provided? Some services might be much cheaper if out-sourced to a reliable provider.
Adrian Cachia
Nov 13th 2009, 11:40
" Plans are underway to give patients discharged from Mater Dei a full breakdown of how much their stay cost the taxpayers. " - a first step in getting people used to pay for healthcare.
The same thing will probably happen with the free medicines.
I Abela
Nov 13th 2009, 11:31
@ Joe Cassar - While it would be interesting knowing what each and everyone is costing, it is ultimately irrelevant. I am more than happy to contribute (with my taxes and NI) to help people in need of medical care, because one day i might need medical care myself and it will be others who will contribute to it. If you want to speak about numbers, why not tell us how much your mobile phone and bill is costing the tax payer ? How much you car and driver is costing the tax payer ? How much your brand new office furniture and A/C and Heating Bill is costing the Tax Payer. The majority of us tax payers don't care what medical treatment is costing because that is a necessity. But we do actually care about ministers using Ferrari Laptops which cost more than double the same laptop without the Ferrari Badge. We do care about ministers using Armani mobile phones which cost more than double the same phone without the Armani Logo. Why not publish a detailed costings excercise for each ministry instead of Mater Dei?
r ferriggi
Nov 13th 2009, 11:21
i am not a consultant tothe health services :)
but unless a system is introduced where EVERY person who steps into the General Hospital is made to pay a minimal amount ( i mean very minimal,,, ) the general hospital problem will continue to grow.
it is useless for govt to pretend that the problem will be solved or will go away.
likewise,,,, government should make an option for ANYONE to opt out of the National Heath system and of course that person will not be able to make use of the service for free. but that person can make his own arangements, insurances etc.
how is it possible that it i not eclared and understood that the system as it is ,,,,, is not viable, not sustainable, not giving the right service,,, and worst of all,,,,, we all know that there is abude in the waiting list system.
stop burying your heads in the sand.