The provision of health services has always been a political bone of contention worldwide and more so in Malta. Butit seems to peak whenever an election date is looming.
The much talked about need to change our work practices in order to absorb the bed shortage problem can partly alleviate but definitely not solve the problem- Franco Mercieca
Recently the problems of overcrowding and long waiting times at the Accident and Emergency Department coupled with the acute chronic bed shortage have been topping the agenda. Unfortunately, the Nationalist Party cannot fathom that most of the problems people are facing in order to access health services is their own doing.
The health service has long been managed by crisis and has lacked long-term planning. Two shortcomings stand out. Firstly, the importance and investment on primary healthcare has been ignored. Secondly, the number of hospital beds has been drastically reduced.
If the current administration does not accept there is a problem, the chances of resolving these issues are very slim indeed. Having insight into the reasons as to why we are in this mess is essential to plan restructuring policies.
It must be just over a decade ago that the government had systematically shrunk the services offered at the level of the polyclinics around Malta. This decision had sent a clear message to the people that these health centres, most of which were opened in late 1970s in midst of the doctors’ strike, may not be here to stay.
This led to an increased number of people seeking primary healthcare either privately or at the main hospital. Recently, with the credit crunch, more pressure was placed on Mater Dei, which although dubbed by many as a state-of-the-art hospital, is definitely not in a position to cater for such numbers.
Therefore, some €500,000 worth of refurbishment at the Mosta health centre with the promise of augmenting the services came as a pleasant surprise. This is most definitely a step in the right direction and is in stark contrast with the recent past policies of GonziPN. In fact, this is a complete U-turn from the previous clear intent to scale down the polyclinics.
The downsizing of polyclinics’ role was further compounded by the problem that the much- acclaimed electoral promise of the primary healthcare reform has never left the drawing board due to customary internal squabbles within GonziPN, that will go down in history books as the main characteristic of this legislature.
On the other hand, the €500,000 investment in primary healthcare comes only a few days after the announcement of the austerity measures of the €40m cut from the 2012 Budget, which included a €300,000 reduction in allocation towards primary healthcare.
Who should we believe?
To add insult to injury, with the migration to Mater Dei the bed complement was reduced from a potential of 1,600 to 900 beds. So it is no surprise that after waiting long hours for a bed, many patients needing hospital admission end up being transferred to various makeshift wards or even corridors.
The need for more beds at Mater Dei is not only backed by current needs but also by easily foreseeable increasing future demand.
This demand for more beds will be partly due to reorganisation of services and also the direct result of the research and development centres worldwide that are actively seeking new innovative treatment, that once proven will be instituted with the standard practices.
I can vouch for this, as during my relatively short career in medicine I have witnessed the setting up of an endoscopy unit, a cardio thoracic/surgical unit, a burns unit, an infectious disease ward and a high-dependency unit, just to mention a few. The number of new treatments in my field of ophthalmology alone are innumerable, just imagine in all specialities.
The much talked about need to change our work practices in order to absorb the bed shortage problem can partly alleviate but definitely not solve the problem. One can send a patient home on the day of his hernia repair or cataract surgery but one cannot hasten the recovery from coronary bypass surgery or speed up recovery from pneumonia, heart attack or leukaemia.
Who is accountable for such a short-sighted decision to reduce bed capacity in our only public general hospital?
Labour’s health policies have been clear since the late 1970s – and that is to strengthen primary healthcare with special emphasis on health centres in order to provide a more accessible service while alleviating the burden from the main hospital, be it emergency or outpatient services.
Also, to compensate for bad planning, further public-private partnerships have to be established to cater for the slow and untimely service. The number of hospital beds has to increase in order to cater for the current and predictable ever-increasing future demand.
The provision of health services should be a common front and not a battlefield between political parties.
franco@francomercieca.com
Franco Mercieca is an ophthalmic surgeon and prospective Labour Party candidate.