Judging by what the man at the helm of the island’s health service has written about the need to get the best of the system, he appears to have all his bearings right. He has no easy job, as all his predecessors had found out for themselves.
Far too often, the health service is in the news for the wrong reasons with the good that is done overshadowed by complaints over staff problems, shortage of medicine and, worse, degrading treatment when patients are left waiting in corridors.
Few, if any, complain about the quality of the care given by healthcare professionals but there are problems that have yet to be tackled with greater energy if the overall standard is to improve.
Unfortunately, Malta’s health service did not get a clean bill of health last year. In fact, a European health consumer index reported that the island’s public healthcare system had deteriorated significantly. In the words of the index’s main researcher, Malta had performed worse than the year before in terms of patient rights and information; accessibility and waiting times; outcomes and results of service; and the provision of pharmaceuticals.
When Malta used to pride itself so much on its health service, the report must have come as a shock to many but not to those who work in the service or who are familiar with the way it operates.
Again, like all his predecessors, the parliamentary secretary, Chris Fearne, well recognises the fact that the health service faces “significant challenges”.
He says that, as a clinician, he is used to taking decisions based on evidence and good practice. So, to help him set about tackling the challenges in the right way, his secretariat has appointed a working group to develop and implement a health system performance assessment.
According to Mr Fearne, this is the first time Malta is to have a formal model for performance measurement at a national level.
What makes the system important is that the hospital services will be monitored and measured regularly, not when part of the service fails.
It will take into account the efficiency of the health service; its level of quality and accessibility to timely and adequate healthcare; its financial status and affordability; user experience and patient satisfaction, as well as health status indicators, such as life expectancy, mortality, risk factors, premature mortality and cancer survival rates.
It may well be argued that the problems in the health service are already well known to all and that the exercise that has been taken in hand will not be of any particular benefit if, as in the case of so many reports in the past, it is left to gather dust on a shelf rather than acted upon with a kind of determination that will really help bring about tangible improvement.
As the cost of the health service keeps rising, the country can hardly afford not to take all the necessary steps to make the management of the hospital more efficient than it is today.
This is needed not only to bring the cost down but also to further improve the standard of the service.
Another stiff challenge is to eliminate all traces of patronage in the provision of services. This is a hard nut to crack in an island where patronage overrides fairness in so many instances of daily life.
Concurrently with the new monitoring system, there is therefore also need to look into this and other matters that will also ensure fairness all round.