The Health Ministry has hit out at a report which yesterday gave the Maltese health service a poor bill of health.

The ministry said the Eurohealth Consumer Index 2012, was issued by Health Consumer Powerhouse, a private company commissioned by pharmaceutical companies with no links to the European Union.

The ministry criticised the methodology used in the survey and said that figures submitted by the Maltese authorities were ignored or erroneously reported.

"Malta has been consistently recognised as providing an excellent health service. Even at current times when several countries have reduced their investment in health, Malta continued to invest in order to strengthen health services and introduce new ones, the ministry said.

The ministry also gave the following point by point reaction to the survey report:

"The Eurohealth Consumer Index 2012 was conducted by the Health Consumer Powerhouse (HCP), to provide a comparison of practices and standards for healthcare from a consumer point of view across the 27 EU member states, Norway and Switzerland. In five categories, covering 42 performance indicators, Malta scored 609 points from a potential 1,000. Malta's healthcare was ranked 23rd across Europe.

One should note that this is an independent private healthcare organisation, made up of a small team of individuals which is not, in any way, an official body linked to the European Commission or its entities. Their operation are supported by unrestricted grants from a number of major pharmaceutical companies. It has been heavily criticised over the years by most European member states and stakeholders since the choice and structure of the indicators is clearly influenced by the funders.

The majority of the indicators chosen tend to be improvised and not validated, so their comparability is likely to be limited.

This company usually consults the official governmental bodies on their chosen indicators prior to the release of this publication. Indeed, as customary, it did contact the Ministry for Health, the Elderly and Community Care this time round and corrections have been suggested where erroneous data was reported.

Unfortunately, once again, our advice has been disregarded in a number of areas as detailed below.

In effect, the Ministry for Health, the Elderly and Community Care already submits data on a number of platforms hosted by official organisations, such as WHO, EUROSTAT and OECD, for internationally established, validated and comparable indicators.

Accessibility and waiting time for treatment


The HCP has agreed on the progress registered in this area and are considering our progress in this area as almost at par with the Netherlands and better than most other Western European countries.

Indeed, since the compilation of this report the Ministry has invested heavily in public-private partnerships with the private health sector, in order to further alleviate these waiting times both in relation to surgical operations as well as emergency services.

Prevention/Range and reach of services provided

The HCP report recognises some of the Ministry's efforts for better and more equitable access to health services and prevention. Malta has one of the highest rates of peritoneal dialysis amongst end stage renal failure patients, which enables them to receive their treatment at home thereby disrupting their daily schedules rather than having to attend hospital for haemodialysis.

The investment in longterm care for the elderly is also billed as one of the best in Europe. Unfortunately, HCP decided to disregard the rate of mammography reported by the Ministry, and the extension of the local screening programme to also include women aged 60-69. The Ministry has looked into the coverage
seen at the National Breast Screening programme and in 2010 uptake of breast cancer screening was 61.8% of the eligible population which is on par with most of the high performing countries.

Malta also scores at equal level with top performing countries Sweden, Finland and the Netherlands when it comes to smoking prevention and long term care of the elderly.

Patient rights and Information

This is where the report makes most erroneous conclusions about the Maltese health system.
Indeed, Maltese patients have easy access to medical second opinions, together with public listings of legally registered specialists and doctors, available on the web. It was erroneously reported that patients do not have the legal right to access their own medical file.

Indeed, as per the provisions of the Data Protection Act 2001, each data subject can access his own medical file by contacting a designated person within Mater Dei Hospital – a system that has been in place since 2001 in St
Luke's Hospital as well.

Also the setting up of both the office of the Commissioner for Mental Health and the Office of the Commissioner for Older persons helps promote and safeguard the rights of persons suffering from mental health conditions and their carers as well as safeguarding and promoting the rights and interests of the elderly population and is testimony to the Ministry's commitment to patient rights.

In addition, the summary presented by HCP gives the impression that the agreement with the United Kingdom, whereby Maltese patients may access specialised care in the UK where this is not yet available in Malta, is not in place any longer.

Not only it is in place but it has been strengthened and other similar collaborative agreements are being developed with other countries as well. It is also a well established fact that a number of conditions traditionally requiring treatment in the UK are being managed locally following the development of the expertise and capacity in Malta.

eHealth

Malta has also been heavily penalised on eHealth. Contrary to what has been said, the recent launch of the myHealth system was made possible primarily by the developments in eHealth and electronic hospital records introduced with the advent of Mater Dei Hospital.

The myHealth system is
empowering patients by introducing access to their Mater Dei Case summaries, their Pharmacy of Your Choice entitlement data and enabling one or more doctors to have electronic access to their medical record through myHealth.

Outcomes

HCP's choice to focus on a very limited set of outcome indicators is indeed most unfortunate. In fact, should one consider other more comprehensive and holistic indicators considered by the European Commission, such as healthy life expectancy, one can note that Malta ranks amongst the top in both overall life expectancy and the number of years an individual expects to live in good health.

Consistent progress is also being registered in survival of patients for most of the major cancers that afflict our population, together with childhood cancer.

Nevertheless, the Ministry is also well aware of weak areas within the health system and the health status of the Maltese population and is striving to address them in as efficient and as expedited a way as possible. In fact, it has invested in a number of strategies targeted at addressing these areas.

Each of them includes a monitoring strategy to estimate the effectiveness of the measures being implemented.

Pharmaceuticals

Information on every pharmaceutical product available on the market is publicly available through the Medicines Authority website, including the Summary of Product Characteristics and Patient Information Leaflet.

In addition, the public health system grants free access to a wide range of
medications and the list of eligible conditions and associated medications has been recently doubled.

The Ministry has also engaged in extensive bilateral discussions with the pharmaceutical industry to decrease the pricing of a wide range of medications in the private sector to make sure to make these medications more accessible to the whole population. HCP also highlights our abuse of antibiotics for viral infections, a problem that seems to afflict most European countries. Nevertheless, the Ministry is
aware of this problem and is indeed embarking on initiatives to actively reduce it."

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