The doctors’ association said today it was expressing its disagreement and drawing a clear red line against the 'privatisation' of the public health service in Gozo, Karin Grech Hospital, and other future facilities that provide free services for the National Health Service.
In a statement, the Medical Association of Malta said there must be a clear demarcation between public and private providers, as the motives of the two were completely different.
"The public service must provide an efficient and sustainable service to all, especially those at or below the poverty line, while a private enterprise ‐ which must generate a profit ‐ tends to cater for the profit making activities and limits social support to the disadvantaged and avoids complex and expensive medical treatments which only state run facilities can afford," it said.
MAM said that although it might appear attractive for the government to entrust a private investor to build new hospital facilities as there was no immediate capital expenditure, the long term rental payments to use these facilities might not be cost effective and could seriously cripple the long term sustainability of the government health service, as has happened in other countries.
The association said it acknowledged the positive intentions of the Health Ministry and called for more in depth professional analysis of health policy objectives and financial viability studies before taking long term and far reaching decisions which would be impossible to reverse.
MAM reaction to recent announcements in healthcare
1. Health policy: The proposed developments are not in line with the published government health policy sent to the European Union. Private investment needs to be carefully considered only within the long term vision expressed in this policy, together with careful calculations of the costs and the long term sustainability.
2. The confirmation of the addition of at least 200 beds to Mater Dei hospital is most welcome, and likely to meet the needs of the population in the immediate future.
3. Priority needs to be given to other health sectors, namely primary health care and GP practice, development of services for the elderly and palliative care. Primary health care is essential to maintain a healthy population, and cost‐effectively limit hospital outpatient visits and referrals to the emergency department. There are on average 100 patients at Mater Dei awaiting transfer
to geriatric services leading to another 100 acutely ill patients treated in corridors in medically unacceptable conditions.
4. The opening of the new Oncology centre will represent a significant leap forward in the treatment of cancer patients, however palliative care services have to develop in parallel. The future development of Boffa hospital into a hospice would be a welcome development.
5. The opening of a second medical school in Gozo may be feasible, however the medical services at Mater Dei which support the training of local students must be ring fenced to maintain the current quality standards.
6. The investment in two privately owned hospital hospitals each with 250 beds will present new opportunities for local doctors, however past experience has shown that the local market was unable to support two local hospitals with a combined number of 120 beds. Previous attempts at Medical Tourism were unsuccessful in the past making the long term viability of these investments questionable.
Health Ministry replies
In a reaction, the Ministry of Health said it welcomed the positive comments presented by the MAM regarding developments at Mater Dei and Sir Anthony Mamo hospitals, specifically the recognition and endorsement by MAM of the government’s efforts to increase the number of beds at Mater Dei. The ministry also agreed with MAM that the opening of Sir Anthony Mamo Oncology Centre “represents a significant leap forward in the treatment of cancer patients”. In fact the present administration has installed the latest linear accelerators, which will provide the most advanced radiotherapy treatments available.
Likewise the Health Ministry agreed with MAM that the development of primary healthcare was a priority with the active involvement of family doctors. Indeed this was in line with Health Department’s direction.
On the opening of the second medical school, in Gozo, the ministry said the involvement of the prestigious Barts London School of Medicine and Dentistry in Gozo is an important development in the field of medical education which will lead to increased post-graduate opportunities for local doctors as well as give a much needed economic boost to Gozo.
"The investment from the private sector coupled with the Barts’ project will lead to a significant and game changing improvement in the services available free-of-charge to Maltese and Gozitan patients. Government can assure MAM that services for Maltese and Gozitan services will remain free-of-charge. The exciting vision of the introduction of medical tourism into the healthcare equation will ensure a further source of revenue which will continue to encourage further investment by the private sector. This vision is already being validated by the recent arrival of Johnson and Johnson Medical and La Sapienza at the new private orthopaedic hospital at Smart City."