Malta has excellent health services. Private practice is solid, starting with very dedicated and able doctors. Public provision is probably second to only a few advanced countries in terms of quality. And it’s free for all, as the International Monetary Fund keeps observing critically in its annual reports. The political parties are committed to the free welfare state. The question is how much longer we will be able to afford it.
These [improvements] will not come about because the Health Minister has set up an office at Mater Dei
The answer lies quite a way down the road and, though one should plan early, there is clearly no political desire to do so. Meanwhile, the free health service, underpinned by massive current and capital expenditure, continues to create problems. They mainly consist of insufficient beds at Mater Dei general hospital, relative to demand; queues for day appointments; and waiting time for operations.
Just how acute this latter problem is was made clear in an update given by the Health Minister in Parliament on Wednesday. Godfrey Farrugia was replying to Labour MP Chris Agius.
The minister gave the following breakdown of operations still to be held: Ophthalmology – 3,409; Orthopaedic – 5,293; General surgery – 2,218; Plastic surgery – 199 (up to October 2012); Urology – 646 (up to May); ENT – 525 (up to Octobe); Gynaecology – 510; Cardiology – 830; Dentistry – 582; Child surgery – nil.
Unless otherwise stated the position given by the minister was that prevailing on March 11, showing roughly what the new Government had inherited. I do not know why the totals are not all up-to-date. Nor can I tell to what extent they will be disputed by specialists, and by the outgoing government.
Whatever adjustments are proposed the problem remains very, very big. That is not news. Waiting lists have been high for a long time. The question is what is to be done about them.
The answer now lies with the new Government. It would be stupid to expect short-term solutions. But solutions must be found. Each unit of each total represents a human person in need of treatment and without the means to get it privately.
It’s no use saying we have a magnificent welfare state when there so many net patients on the waiting lists. In this regard, therefore, it will be interesting to learn from the Government not just how big the problem is, but how it will be tackled.
The parliamentary question did not go into the number of people waiting for beds on any given day. But it is widely accepted that Mater Dei does not have enough. Late in the day, the Nationalist Government had come up with a partial solution, involving St Philip’s Hospital. It did not go through, nor was it explained to what extent that would have solved the problem.
It is up to the Labour Government to indicate its plans. One should presume that it has by now identified the size of the problem. It should therefore be working on reasonably doable ways forward. It would be unreasonable and politically cynical to expect improvements overnight. These will not come about because the Health Minister has set up an office at Mater Dei.
His task is not to micro-manage. He has inherited a massive structural problem. With the aid of experts drawn from within and outside the public health service he has to come up with structural solutions. He also has to set milestones for their execution, first of all for the sake of those who have yet to be given the care they require, and also to permit public scrutiny of the progress made.
The problems involve medical care and those who are employed to give it. It seems to me, as a frequent user of the public health services, that there are also problems of an administrative nature.
For instance, recently I had to go to the Day Centre at Mater Dei. The queue waiting to be served was daunting. To deal with it, meaning checking every appointment against her records and computer, there was a single receptionist.
It becomes immediately obvious that, efficient and hard working though she was, that was not enough. Cannot one or two more receptionists be deployed during key morning hours?
Other factors verge on the incomprehensible. The wife of a friend of mine underwent a test. (I will deliberately leave out what for.) Some two months later she received notice of another appointment at Mater Dei. It was set for February 2014. The appointment, the notice said, was for her to be given the result of her test.
That meant the lady was to live on tenterhooks for another nine months. Could not the result have been sent by mail?
Other examples of the need for better administrative organisation can be given and that is often done in the letters to the editors of our various newspapers.
The point is not simply to criticise. It is to try to point out where improvements can be made while structural solutions are worked out.