European countries like the UK, France, Malta and Cyprus that provide public medical services that are free at the point of delivery are under constant pressure to ensure that their healthcare system is financially viable. This often means tough choices: either ration services or increase taxes.
Distressed countries like Cyprus are told what to do by the European Commission or by the IMF which see financially unviable health services as one of the causes of sick public finances.
One can understand that when most EU countries are under pressure to sanitise their public finances, long-term health services issues are put on the back burner until, hopefully, the economic climate improves and the next election is a long way away. The UK’s National Health Service is a model that many countries envy. But it seems that not all is well with the NHS with many health care professionals, as well as ordinary people, feeling that it needs fixing.
Kailash Chand, the deputy chair of the council at the British Medical Association who was honoured by the Queen for his services to the NHS, makes a very honest assessment of Britain public health service: “There have been increasing demands to look at alternative ways of funding the NHS such as charging drunks for A&E attendance, income generation through private patients treated in NHS hospitals, increasing prescription charges and charging for GP attendance.
“These ‘cosmetic’ measures will do nothing to save the NHS as it faces major challenges: rising demand due to complex medical problems and chronic illnesses, emerging problems of lack of doctors and nurses in some specialities, overburdened general practices and scores of hospitals gasping for oxygen.”
Speaking privately to local health professionals, a similar assessment is often made by medical practitioners about our public health system. Improving the management of our hospitals will always be a top priority for our health services policy makers, but these improvements will only have a ‘cosmetic effect’ on the financing of the service.
Our political leaders have two options: postpone a root and branch reform of public health with the risk of having to ration services; or undertake reforms that will make the service financially viable in the long term.
The latter option is not as scary as some politicians may think, at least if one were to assume that the Maltese public may be changing its perception on what needs to be done to keep our public health service free at the point of delivery.
When most EU countries are under pressure to sanitise their public finances, long-term health services are put on the backburne
A poll conducted by polling firm ComRes about the NHS services in the UK found that almost half of those surveyed would be prepared to pay more tax to help fund the health service.
The public’s willingness to pay extra taxes to help the NHS has reached its highest level in over a decade. This is not surprising as people see “hospitals slip in the red, waiting lists lengthening and service becoming unsustainable”.
Chris Ham, chief executive of the King’s Fund, a health think-tank, said: “The results of the survey are a wake-up call to politicians to be willing to debate the funding of the NHS and to avoid colluding with each other in saying spending can’t be raised until deficit reduction has been completed.”
Our public health services, just like education, should continue to be free at the point of delivery. These services are achievements of our welfare state that need to be preserved. But we have to realise that our free public services must remain viable through proper funding. Many argue that both our health and educational system call for some radically fresh thinking to ensure that our people continue to enjoy free health and education services.
Cyprus is adopting a national insurance approach to ensure that its public health services are financially viable. They have had to accept this imposition by the troika that saved them from bankruptcy last year. The secret of success for such a system is to ensure that the most vulnerable in society are not overburdened by having to pay additional taxes to get health insurance cover.
Our own policymakers have some very good ideas on how to address the threats of mushrooming health services costs. Giving our hospitals autonomy in the way they run their operations is one good starting point. If professional management is followed by the adoption of a sound financing model, then our free public health service will have a brighter and guaranteed future.
johncassarewhite@yahoo.com