Since any nation is made up of a group of people sharing the same government in a given jurisdiction it follows that its very performance is determined to a large extent by the state of health of its citizens. In an individual’s life all else pales into insignificance when disease of any form takes over.

The contagious de-motivation that has plagued our staff as they played witness or suffered blatant discrimination on political or other grounds will be eradicated

It is therefore a common ambition of modern governments to create adequate healthcare systems to meet their citizens’ health needs in a comprehensive, efficient and sustainable way.

Our country has a substantial history of several attempts to address the health requirements of its people. By the middle of the 14th century, hospital services existed in Malta and progressed rapidly during and under the duration of the Knights Hospitaliers of St John, often in congruence with philanthropists who chose to contribute in this sector.

The advent of British rule in 1800 saw our hospital management strategy converging to fall under a single authority, while the then already more than 100-year-old medical school (in existence since 1676) contributed by producing excellent medical professionals to sustain the growing health services.

However, the landmark achievement in this sector came in 1980, when the Labour Government of that time decreed all hospital admissions and treatment free of charge for all Maltese citizens.

This significant development came in the wake and in spite of the medico-legal dispute of 1977, during which Malta suffered a brain drain, and health care services had to be sustained by a number of foreign health care professionals mostly from Eastern and Central Europe.

The reverberations of the blow that our healthcare system sustained in those times can still be felt today, made worse by the eventual closure of private hospitals that were functional at the time.

The passage of time has seen our healthcare and public health scenario evolve into a relatively efficient service backed by mostly adequate buildings and equipment. However, social reality is changing at a rate much faster than the healthcare system.

Nowadays, citizens live much longer and expect a much better quality of life. This can become the very cause of the system’s demise if urgent attention isn’t given to the sustainability of the service.

In recent years the symptoms of the ensuing disease gradually incapacitating our system have mainly manifested themselves in George Orwell scenario of “all animals are equal, but some animals are more equal than others” whereby long waiting lists for operations and bed availability created room for manipulation of allocation of services to patients.

Such a situation remitted on disgruntled and demotivated employees of healthcare professionals at all levels. To compound the situation of the health services, we inherited hundreds of workers, mainly women, whose working conditions shame us and our country.

In a nutshell this legislature is going to be crucial for the restoration of a solid, sustainable foundation. The right impetus will be given to the poorly exploited, albeit so important primary care sector, re-establishment of personalised, connected and effective community health centres as well as community care, so as to alleviate pressure on acute hospital facilities, and give more prompt service to the patient.

Our acute specialised hospital beds have to be put to optimal use, with lengths of stay commensurate with what absolute neccesity demands. The same applies to our rehabilitation facilities which have more often than not become parking bays for those unfortunate rejected by relatives and society.

This government is committed to give all its citizens dignified life till the very end, but not at the cost of having to withhold specialised care to the more needy patients for want of beds.

My ministry is working hand in hand with other ministries to establish the best practices for the most effective use of our hospital beds and other resources. But more than that, our intention is to harness the full potential of our excellent private health care providers to create the synergy required to ensure sustainable effective growth in the health sector.

Furthermore, the priceless contribution of the highly motivated NGOs will not just be lauded but will be encouraged, and interwoven with existing and new services to reap maximum benefit from all possible sources.

To achieve all this we will work with all trade unions as long as they genuinely speak out for workers’ rights, as rights emanating from the responsibilities which, properly shouldered by the workers, will ultimately deliver the best healthcare possible.

Sustainability cannot be ensured unless we develop micro-efficiency at each level of operation.

Micro-efficiency and good practice management that respects clinical judgement in turn can only be achieved if we instill a sense of ‘ownership’ in our multi-talented, very professional staff, from the lower to the higher echelons of duty.

Staff incentives linked to performance, and ability to create and sustain teamwork, must be introduced.

Simultaneously the contagious de-motivation that has plagued our staff as they played witness or suffered blatant discrimination on political or other grounds will be eradicated by fair and equitable management.

To quote the wise Herophilus who has inadvertently articulated the raison d’etre of healthcare: “When health is absent, wisdom cannot reveal itself, art cannot manifest, strength cannot fight, wealth becomes useless, and intelligence cannot be applied.”

I humbly invite readers to reflect and act on that statement.

Godfrey Farrugia is Health Minister.