The Parliamentary Secretary for Health has been stirred into action by the inadequacies and inefficient services facing the public on a daily basis. And a commission has been called to look into the faltering system. It is time to remind ourselves of the past to avoid repeating previous errors.
About 20 years ago, the government of the day decided, tentatively, to consider a reform of the health services by looking into the vote-catching plan of the Family Doctor Scheme.
This type of health care system would have involved the enrolling of Maltese citizens to a family doctor of their choice and have all their primary health care needs provided by the family doctor. The doctors were to be paid by the size of the patient roster attached to their clinic. The planners of the scheme looked at similar plans in other countries and picked up the best features that suited the local market.
At the time the government was considering building a new hospital, St Raffaele. The government, the Cabinet and their consultants decided that it would be wiser to spend the taxpayers' money on the new hospital and the idea of the Family Doctor Scheme was dropped.
Thus Mater Dei Hospital came into being.
What about the reform to the health care system? Apparently the budget could not be stretched to cover the funds for the needed reforms.
The hardware of the system, the hospital and equipment, has been given "state of the art" designation but the software, the management and the providers of services, has been neglected.
Primary health care is the basis of any health care services system. It consists of the combined services of family doctors, medical practitioners, pharmacists, nurses, physiotherapists and allied health care workers.
The family doctors would act as the gate-keepers of the system, as advisers, brokers, consultants to the patients and health educators. Without a developed PHC system, the patients are on their own floundering in a complex private health care market, confused about how the HCS operates.
If they insist on individual attention they have to pay through the teeth. Such a helter skelter system that we have promotes dissatisfaction with the service, inefficiencies and long waiting lists.
Health care education the public is needed to make efficient use of the system. Health promotion and disease prevention should be an essential part of the package provided by a HCS. Incentives to medical practitioners to participate in continuing medical education should be built into the system of remuneration.
Health care delivery would be immensely facilitated by the availability and maintenance of digital medical records on the whole population.
We have been dreaming of this ideal for several years; nowadays we have technology capable of securing confidentiality, providing availability of health data to entrusted medical practitioners at a reasonable cost. The only thing lacking is vision and determination to go ahead.
The small size of the Maltese nation has advantages that bigger countries do not have; it is more governable, distances are not a problem, the community is more homogeneous and integrated. If it were not for the daily bickering, polarised political opinions and self-interest groups, Malta could have been the closest thing to "heaven on earth".
The Malta environs form an ideal laboratory for studying small populations; the WHO recognises these opportunities and has shown interest and encouragement to carry out studies on health care in our midst. I am sure, now that we belong to the European Union, we could obtain funds to support a project on the health care delivery system.
We have missed the bus on several occasions to improve the HCS to our citizens. Health is an essential part of the quality of life that we have a right to, when we are thrown down to earth. Let the governments that we elect show respect to the people of the nation and to their families by planning the best HCS that we can afford. Let us get it right this time.