The arrangement for patients receiving treatment that is not available in Malta to start being sent to Italy, besides the UK, following an agreement signed with Italian Health Minister Ferrucio Fazio on December 23 is great news, considering the proximity geographically as well as the fact that we can communicate so easily in Italian. John Dalli is on record to have pointed out that Italy had advanced tremendously in the medical field.

Hence, I now demand that government change track about the European Commission proposal for a directive on the application of patients' rights in cross-border healthcare concerning treatment for pre-existing conditions not covered by the E-111 European Health Insurance Card Entitlement Unit.

The July 2008 proposal states that: "The right to reimbursement of the costs of healthcare provided in another member state from the statutory social security scheme of patients as insured persons was recognised by the Court of Justice in several judgments.

"The Court has held that the freedom to provide services includes the freedom for the recipients of services, including persons in need of medical treatment, to go to another member state in order to receive those services there. It has to be remembered that all the case-law of the Court of Justice in this matter are based on referrals initiated by single citizens trying to exercise individual rights stemming from the EC Treaty itself.

"As the Court has also held, the fact that the legislation of the member state of affiliation does not guarantee a patient covered by that legislation a level of reimbursement equivalent to that to which he would have been entitled if he had received healthcare in the member state of affiliation is a restriction of the freedom to provide services within the meaning of Article 49 EC ...Patients should be guaranteed assumption of the costs of that healthcare at least at the level provided for the same or similar healthcare had they been provided in the member state of affiliation."

Earlier on last year, in the Scrutiny Committee's Working Group 3, one of the structures adopted by the Maltese Parliament to examine European Union documents and the government's position on the matter, the Ministry of Social Policy kept contesting the proposal arguing that, if anything, waiting lists could be better addressed by local private hospitals, rather than conceding to my argument that this proposal would have hospitals in nearby Italy competing with private local ones, thus lowering prices and relieving the pressure on our state hospitals.

I would just like to mention an example to clarify matters but in no way wanting to single out the Ophthalmology Department where one must concede there is an ongoing effort to ameliorate the situation for the over 5000 cases still awaiting cataract removal at Mater Dei.

Waiting time in Italy for cataract removal in state hospitals is generally only about three months while prices for this procedure in private clinics here in Malta can be as high as in the US.

At the end of the day, equity is better served when people who can afford it make way. The government must realise that incentives in this direction especially where the passage of time can only make matters worse, already implemented in other sectors like education and care for the aging, are long overdue in health. I am tired of proposing such reforms for years on end now. The least one expects is to avoid hindering EU membership from addressing our limitations exacerbated by cartels and undeclared conflicts of interest.