A pay-on-collection system should be introduced for free medicine picked up from pharmacies, the Chamber of Commerce, Enterprise and Industry is proposing.

Patients will then be reimbursed by the State according to a pre-established tariff benchmark.

This and other proposals, first made four years ago, were resubmitted for consideration by the chamber in response to the government’s White Paper on the pharmacy-of-your-choice scheme.

Reginald Fava, a pharmacist and chamber representative, said yesterday the proposals would discourage waste.

Health Minister Godfrey Farrugia was quick to distance himself from the pay-on-collection proposal saying it was one of many suggestions the government had received.

“I am personally against it but the consultation process is still open and the government has no official position yet.”

Speaking at a seminar on healthcare organised by the chamber, Mr Fava said that under the system in place patients collected medicine they were entitled to even if they did not need it.

As things stand, patients collect the free medicine provided by the State from the pharmacy of their choice. Pharmacies are then paid an administrative fee per patient by the State.

The system had to be changed, Mr Fava added.

“It is not the first time we heard stories of people who come to us with a bag full of ‘free’ medicine they did not use to be exchanged for perfume or a toy.”

For the patients who cannot afford to pay on collection, the chamber is proposing that the price be deducted from a pre-charged e-health card topped up by the State.

The chamber wants the government medicine system to be outsourced to the private sector, relieving the State of distribution and stock costs.

Mr Fava criticised the reluctance to review the State formulary periodically and replace certain medicinals with newer, more expensive ones that were needed to treat diseases like cancer.

“The current system denies the patient his dignity,” he insisted, adding that the more important medicinal products were not on the formulary and this constrained people “to beg for money” to finance the cost of treatment.

In one diatribe after another, Mr Fava hit out at politicians, accusing them of failing to face reality that medicine could not continue to be given out free to everyone.

But while Dr Farrugia and his counterpart, Nationalist Party health spokesman Claudio Grech, acknowledged the difficulty in maintaining a sustainable free health service, they steered clear of proposing any fee structure.

Dr Farrugia said sustainability could be achieved through better management and “cost savings” as opposed to cost-cutting.

Mr Grech said that ensuring “value for money” was essential for sustainability.

The minister said the government was assessing the possibility of having public hospitals run autonomously and adopting a approach that also tackled the availability of space at homes for the elderly. This would free up beds at hospital occupied by people who had no one or nowhere to go to when discharged.

Continuing the conciliatory approach he has adopted since he started shadowing the sector, Mr Grech said politicians should abandon populist health policies and confront each other on ideas.

Bishop: don’t forget the health poor

Poor people are not taking their medication because it is too expensive to buy, Gozo Bishop Mario Grech has warned.

A speaker at the health seminar, Mgr Grech used the platform to focus on what he termed as the new health poor.

“Reforms to the health sector should not include measures that can crush those who are already downtrodden,” he said.

Mgr Grech quoted the example of a Gozitan single mother who thought twice of visiting a gynaecologist after she was charged double the fee when the doctor realised she was having twins.

ksansone@timesofmalta.com