“The Sunday Times editorial blamed Joseph Muscat for being politically irresponsible. I am sorry. But that is what any political leader would do, given such a report, and if that is the definition of
political irresponsibility than all politicians are irresponsible”
I was at the annual Dean’s reception at the, what for me was newly-discovered, Herbert Ganado Gardens. There was the President’s car. I did not see the President, but I did see the Parliamentary Secretary for Health and the Education Minister on their way out when I was on my way in. I do not believe my wife and I went that late; but we do have to settle the kids. Anyway, everyone seemed to be talking about how we cannot continue to pay for the health care in the way we are doing.
Perhaps it was only what my ears were catching but at least three groups I met in my hoofing around touched upon the subject. No matter where I went, it was that people should pay for their health! I said to myself, ‘am I, indeed, am I, missing the point, here, or what?’
This week I belatedly read an editorial of The Times and there it was again. Among the otherwise interesting reading, it said, “Away from the heat of the election campaign, and however much the two political parties insist, purely for their own political ends, that health services will remain free under their administration, does it not make sense for the country to seriously look into the sustainability or otherwise of the health services? Are the political parties, saying that, whatever the costs involved in running the system, all health services will remain free of charge to all for good? Would this be socially and financially wise? With health already taking a huge chunk of the government’s budget, would it not be wiser to see what savings can be made, in any way, hitting those who cannot afford to pay for medical care at all levels of the system?”
And I asked myself, ‘what the h... was the Task Force for’ if not to answer these questions? If it failed, it was either because of being given a lack of direction or because at most, it was given a hazy one. Certainly, knowing most of the people on the committee, one can rest assured they put their laurels to it. The people on the committee chosen by the minister or parliamentary secretary are all respectable persons and they have done their best; but they cannot do this on their own. Neither can the government, nor should it, accept as given what is said in the report. We are all in this together and we have to work together. Up till now we have not had a good start and it is not the minister’s fault. It is the lack of vision they were given.
Politics is not only about balancing the books. The Sunday Times editorial blamed Joseph Muscat for being politically irresponsible. I am sorry. But that is what any political leader would do, given such a report, and if that is the definition of political irresponsibility than all politicians are irresponsible. It would be irresponsible indeed, conversely, if one were to go back on one’s electoral promise.
So what went wrong? First of all the choice of people on the committee did not reflect all positions. The people there were very loyal but were only giving their opinions and reflections, as evidenced by the ample references they made to their own contributions on the subject. What they did need, for example, was a lay person to have a bird’s eye view on where it is going and represent people and patients. What they did need was a political strategist which keeps them in line with government policy? What they did need was someone with a vision – I would certainly have put someone in tune with the party-in-power lines.
And this brings us to the main point. Is there a vision? How can you start driving with having only a hazy idea where you want to go? It reminds me of my wife and I who take the children out without preparing in advance where we wish to go. When we do take the time to plan a goal, both the kids and we enjoy it – and we do not end up grumbling that we were conned e50 for a few burgers or a nasty combo plate of that mixed Chinese food.
Where is the vision? Where do we want to go? Do we want to maintain the present dual system of health centres and private practice? Do we want to make it insurance-based or private-based? I am sorry. But these decisions should never have been within the remit of the task force, which, I repeat, did more than their best (for free and out of their personal time). What are advisors to the minister and parliamentary secretaries there for? Having said that, we do (or did) have some form of vision. We know for example that the present system is not working. We know, or we should know, that we want to maintain a free health service for all. Or do we? Sometimes I get the impression that we have simply decided to do away with the health centres but do not even have a vague idea of where we are going. We say, ‘no problem, let us set up a task force’. Task forces are not there to give you answers. They can give you ideas and options. But politicians are elected by people to be leaders and a leader without a vision is much like me who ends up eating burgers and thinking about the insulin dose he has just taken.
For crying out load, the government has difficult choices. Like the General at war who has to sacrifice the frontline in order to save an army and indeed perhaps have a chance at winning the war, we cannot speak only about sustainable health care, win a battle perhaps and then lose the war. Is it only me, the stupid one, who is seeing the big picture here? Am I the only fool who realised that the past 20 years have flown by making me a grandpa to the students who just days ago looked like my peers? Do we really think that four years is a long time? The election will come and it will come with a vengeance. For those who have not taken the hint from Joseph Muscat, let me put it clear: the next election will be about health care.
For all the bad rhetoric that Eddie Fenech Adami got for accepting the role of President of our beloved Republic, he had visions. Perhaps at those times the visions were much clearer than they are today: water, power stations, airports, etc. But they were all necessary for a sustainable future. He did not worry about deficits that kept his predecessors from doing what was necessary. And that is what won him the election, my friends. You can keep people from giving their contribution on committees. But you cannot keep everyone. It is not only your trusted friends and the yes-men that give you answers. If ‘keep your enemies even closer’ ever had a meaning, it is here. Employ on these committees even people from the Opposition or those who may be blunter to one’s tastes. We all have a word or two to say, and no, it is not my pleasure spreading it out here on the media.
To come back to Fenech Adami, when he took office, he sent for the engineers and asked, ‘Well now, are we going to have water this summer or not?’ And water we did have. What do we care that he was called the money-no-problem chap. He solved our water problem. I remember what it was like to wait for a bowser every Wednesday and let the bathtub fill up with a trickle coming down from the tap, taking it more than a day to fill half of it – and with it you had to survive the next few days.
We needed a power station and no matter how many demonstrations we had, a power station we had. I remember a party dinner when Ninu Zammit explained the advantages of having the power station by the sea and how much per year we were to save on trucks driving to and fro. We needed an airport and we made national debt that sent Sant complaining of pot holes. But it served our economy well. If anything, Fenech Adami can be credited with the cunning, if not the wisdom, of handing him over pot-holes. But he will be remembered for what he created and not for the deficit. And yet, his faith in the people filled our pockets. We never had an unemployment rate as the couple of preceding decades. The point: they had the vision.
Lawrence Gonzi has a vision too. It is in his electoral programme. No, Muscat was not politically irresponsible. He played a card at the right moment. And suddenly the report of the task force all went down the drain. Mary had a little lamb – that turned into a wolf. Suddenly the people on the task force became, for all their energies, our enemies. The result of their report was simply because the Chair, and I know him personally, and have a high regard for him, seemed not to have been given a clear goal – that we want a free health care and see how we can make it sustainable. The final report shows that there was not a vision to keep them on track. Not having that goal is political suicide.
Forget the 15-year-plans, which have become the buzzwords of many a politician today. Those are good for countries that are larger and more stable. Put in the goals you want to achieve in five years’ time and the rest will come. You will steer yourself in the right direction. When we took the children out to see the dolphins, we found the road blocked. But we took another path and still got there. We did not spend money on hamburgers but I still had a deficit in my pockets. The difference is that we had spent it well. The experience will be remembered by the kids for a life-time. The hamburger? Well, it may be remembered for how boring we often were. For what is the present administration going to be remembered: for the dolphins or for the hamburgers? If GonziPN is worth anything, it should be worth Gonzi’s word. This administration has to prove Muscat’s word wrong, not doing so at its own peril.
Pierre Mallia is Associate Professor in Family Medicine, Patients’ Rights and Bioethics at the University of Malta; he is also Ethics Advisor to the Medical Council of Malta. He is also former president of the Malta College of Family Doctors.
