So much has been written about this hospital (One year old, Editorial, TMID, 4 December), both before completion through the transfer process from St Luke’s, to today.
As everything else, Mater Dei became a political football with one side trying to deliver the best while the other criticised every step of the way. What is clear today is the overwhelming praise of both the hospital in terms of bricks and mortar, the high quality of service and the excellent delivery of the service by first class surgeons, doctors, nurses, down to cleaning staff.
It is quite a temptation for me to make comparisons from my own experiences where I live to what I read about Mater Dei. The city where I live has a population of close to 400,000, almost identical to Malta’s population. It boasts of three teaching hospitals each specialising in a particular area of medicine. Each hospital is given a budget and invariably, each hospital runs a deficit almost each year. How is this remedied? The provincial government orders beds to be closed in order to make up for the previous year’s deficit. The waiting lists grow longer, A&E departments are plugged up with patients waiting in corridors for hours before being attended to. A triage nurse makes decisions and prioritises the cases at hand. Yet the government claims that each year each hospital budget is increased.
Therefore when one complains that Mater Dei is not utilising all operating theatres, it reflects the realities of the day. These realities are basically two: 1. The expense; and 2. the manpower shortage. You cannot rectify two without a serious impact on one. And there lies the problem – it becomes dog chasing own tail syndrome.
Change is difficult, promises sometimes are very difficult to deliver; therefore the whole system of health care delivery in Malta should be re-examined. Yes, the public has been enjoying free this and free that and moreover, an election promise was the delivery of a vast array of health services to continue to be free of charge.
Therefore, in this day and age, to ask for more, becomes an invitation for a quicker move to bring Malta in line with other countries. In Ontario, as an example, a monthly premium for OHIP (Ontario Health Insurance Plan) is shared between employer and employee, and even with huge contributions, health care here is no better than what is provided ‘for free’ in Malta. Patients frequently cross the border for quicker service, however OHIP will only reimburse OHIP rates. So, if in the US the service costs much more and in American dollars, the patient ends up paying the several thousand dollar difference from his own pocket.
I hesitate to go into the medicine issue but it is good to mention that here, medicines are not covered by government schemes. In addition GST (VAT) is payable on medicines as well. Once one becomes a senior citizen (65) one pays the first $100 each year for medicine starting on his or her birthday! Some birthday gift!
Health is more important than anything else and if one values good health then he (or she) must realise that taking care of it through prevention is vital but should a problem crop up, then expecting excellent service means paying for it. How often, when some relative lies seriously ill you hear next of kin say ‘if money is the solution, somehow we will find it’.
If ‘finding money’ for an even better health service is a solution, the earlier it starts, the better. Leaving everything as is, is no longer sustainable, not in Malta and not elsewhere. The new ‘designer’ medicines cost billions to develop as well as new sophisticated diagnostic equipment. If one expects the best, then it would be irrational not to expect to pay more.
It’s like choosing between a Lada and a Ferrari.
J Martinelli
London, Ontario
Canada