A call for tenders is about to be issued for the provision of breast prostheses that will finally be up to the standards demanded by cancer patients who have had a mastectomy.
Maria Cassar, Health Ministry policy coordinator, said the tender specifications were drawn up and even seen and approved by the cancer lobby groups, which have been complaining about the quality of the breast prosthesis the government supplied.
They also wanted to see the tender document again and be represented on the adjudicating committee and Ms Cassar said she would be passing on their request to the relevant authorities.
“The momentum on the issue has been stepped up and the concerned stakeholders have been consulted,” Ms Cassar said, eager to solve the problem breast cancer patients have been facing.
The Action for Breast Cancer Foundation had voiced its concerns to the ministry about the free prostheses, which, it said, were poor in quality, comfort, purpose and function. They believe superior, solid, silicone replacements could be available for practically the same price.
The foundation also felt the monopolistic situation of the prosthesis provider had to be rectified and that patients should be able to use their government voucher at any retail outlet of their choice.
Back in 2009, it had presented a report on the deficiencies of the fake breasts to the ministry, which had said it was in the process of issuing a tender to switch to silicone prostheses.
“Their complaints have been verified and, indeed, they were not receiving the service they should have,” admitted Ms Cassar, who embarked on a fact-finding mission when she was tasked by the Health Minister to look into the matter last August.
“We are, therefore, seeking to rectify the situation by publishing a tender, with specifications that have been endorsed by the cancer lobby groups, breast care nurses and consultants at Mater Dei Hospital.
“We have made an effort to be sure we get it right. Hopefully, the right bidders that can provide the requested service and reach our specifications will now come through. Otherwise, we will be stuck again,” Ms Cassar said.
“Hopefully, there is someone up to scratch that can provide the prosthesis within the stipulated timeframe, agreed to by all stakeholders.”
One avenue being explored was that the fittings and provision of the breast prosthesis, supplied by the private company, would be carried out in-house, within the public service, as is the case with other limbs, to curtail any abuse and ensure a quality service, Ms Cassar said.
As things stand, the foundation said, women who had just had their breast tissue surgically removed and wanted to resume normality had to experience the inconvenience of appointments that were only accepted after 5 p.m. and then finding the house that supplied them in the side streets of Mosta to undergo the delicate ordeal of getting a replacement in an unwelcoming environment that did not offer privacy.
It claimed patients were shown the prosthesis provided by the government for their voucher of €46 but were immediately told that, if they added about €20, the supplier could provide a better one. Most patients opted for the latter but questioned why it could not have been offered by the government in the first place.
Hospital Services director general John Cachia confirmed the Mosta contract has been terminated and an interim call for prosthesis suppliers was issued to cater for patients until the new tender was awarded.
However, a gap remained in the supply of the prostheses, a ministry spokesman said, admitting patients were caught in the middle of the exercise to improve the situation.
Asked if the Mosta supplier would be blacklisted from applying for the tender, Ms Cassar said the issue was a legal matter and any complaints would be passed on to the Contracts Department. “Our priority is to establish a good quality service for the patients,” she insisted.
Foundation co-founder Esther Sant, who had breast cancer herself and has been fighting for the cause, said she was not aware of any developments with regard to stopping the contract. While not wishing to jeopardise anyone’s business, she had pointed out the tender had always gone to the same person.
Ms Sant said the specifications of the new tender were not entirely to their liking, so others were added. “We just want a good prosthesis and a good service,” she said, speaking on behalf of the users, who were fed up of the “hollow and rubbery” replacement.
About 400 women a year require a prosthesis. Apart from psychological implications, an inappropriate and unrealistic breast also has physical repercussions: if they are not the right weight on both sides, the patients can develop problems in their torso, back and shoulders.