Deal over use of PET scanner

Cancer patients in need of a special scan can start having it done in a private hospital at the government's expense through an agreement signed yesterday.

The health authorities signed an agreement with Saint James Hospital to start using the private clinic's Positron Emission Tomography/Computed Tomography, which it acquired last year.

Described as a "historic chapter" in Malta's health service, Health Minister Joe Cassar said the agreement paved the way for future collaboration between the government and the private sector.

The €2 million PET scanner shows how tissues are functioning, proving invaluable in cancer patients since it allows doctors to see whether there are still live cancer cells. It can help doctors in deciding which treatment to go for.

Saint James Hospital head Josie Muscat said 112 patients had already undergone the scan in Malta and a change of treatment was needed in almost a third of cases.

"It has served to save the lives of some and improve those of others," Dr Muscat said, adding that needless surgery was also avoided when the cancer was seen to have spread beyond control or when other modes of treatment were deemed necessary.

Despite the agreement, there was an obvious divergence of opinion about the acquisition of a second PET scan by the government. While Dr Cassar said the government was committed to honour its electoral promise and install a PET scan at Mater Dei Hospital, Dr Muscat said it did not make sense for a small country with limited resources to double such big investments.

"There are several other areas where we can work together with the government and perhaps overcome the problems we both face," he said during a press conference.

He later told The Times that one PET scan was more than enough for Malta. "Getting another one would be a waste of resources," he said.

Apart from the major investment in the scanner, the hospital has to fly in a special chemical, called a tracer, every time a patient is undergoing a scan.

Tracers, which are injected into the patient, have a shelf life of just a few hours and start deteriorating very quickly. Since there is no producing plant in Malta, the chemical has to be flown in from Italy just before the patient is due to undergo a scan.

Dr Cassar insisted on patients turning up for their appointments considering the expense and coordination required to bring the tracers to Malta.

He said not all cancer patients would need such a scan, and it was up to the treating oncologist to decide who needed one. Patients with breast, lung or intestine cancers, as well as lymphomas, melanoma and skin cancer could benefit from the scan.

Last October, Dr Muscat said there had been "very initial communication" with the government about the possibility of using the private hospital's scanner.

The Nationalist Party had pledged to install a PET scan in its electoral manifesto and, in November, a ministry spokesman said the authorities were working towards procuring it.

A scan costs almost €1,700 per patient. However, it is not clear how much the government will be forking out, with Dr Muscat saying the cost of each scan depended on the number carried out.