The European Health Consumer Index has thumbed down the Maltese health service, largely on the basis of patients not being granted access to their files, high levels of MRSA in hospitals, waiting-lists, no facilities for booking appointments on line, and “the unexplained number of Ceasarean sections” when that method of bringing a baby into the world is the “last resort option in advanced health-care systems”
It is crucial to point out here that this study has no links at all to the European Union/Commission and that it is produced by a private company called Health Consumer Powerhouse, which has links to the pharmaceutical industry. Unfortunately, at least one section of the media reported on it while giving the impression that it was EU-related. It is not.
It has been heavily criticised by several EU member states on the basis of its methodology, and in Malta’s case, it has certainly got the facts wrong on patients and their files: patients can access their files through a designated person, under the Data Protection Act.
The Ministry of Health has criticised the methodology used and has said that figures which it gave were either ignored or wrongly reported. “Malta has been consistently recognised as providing an excellent health service,” the ministry said. “Even in the current scenario, when several countries have reduced their investment in health, Malta has continued to invest so as to strengthen the existing health service and introduce new services.”
But the European Health Consumer Index is correct in saying that MRSA – the notorious super-bacteria, which is virtually ineradicable and which kills the elderly and those who are weakened by surgery – presents a problem in Maltese hospitals. One of my grandmothers contracted it and eventually died of it, and that was 13 years ago. Over the last year alone, the fathers of two of my friends, both in their 70s, went into hospital to be treated for something quite different, became infected with MRSA, and died of that. But we hear nothing about this sort of thing. There is a fine line to be walked between not creating a public panic and keeping information from the public.
MRSA remains a serious problem in British hospitals and was all over the news some years ago. We have headed down the same route but it is a ‘silent’ problem because there isn’t the media attention here that there was in Britain.
I’m also right behind the European Health Consumer Index when it raises the alert about the “unexplained number of Caesarean sections” which take place in Malta. This is not only at the state hospital, but also at private hospitals and clinics. I have written about this matter once or twice; the last time was when statistics were released which showed that around one in three births occurred in Malta in this way. That was around three or four years ago.
This is disproportionately high and points to some form of abuse or mismanagement of births. It’s the ‘let’s play safe’ attitude that never existed before but which has now taken over. To compound the problem, when a first birth takes place by C-section, all subsequent births are C-sections too.
It’s been a long time since I met anyone who gave birth recently by the usual channel. Everyone I meet who has had a baby, or whose daughter has had a baby, has done so by Caesarean section. What’s worse is that they are not emergency interventions when the baby falters badly under a long and arduous labour, for example, but booked weeks or months in advance.
They are Caesarean sections by appointment. I find this appalling. It is third-world behaviour and thinking in an environment of first-world health-care. But these decisions are in the hands of obstetricians and not the state. If it is the state’s responsibility to do anything at all, it is to study the reasons for the high number of C-sections and raise awareness of the fact that this is not a routine solution but truly a last resort.
But I do not agree with the European Health Consumer Index when it points up waiting-lists and lack of facilities for booking appointments on line without putting this into the context of reality: that health-care is, in Malta, 100% free of charge. Malta is the Cockagne of health-care, and in Cockagne, with the mobs and the scrums for free food and snouts in the trough, booking meals and quick access to the trough were not necessarily options.
Many of the people who are the state health-care system’s typical patients would in fact object most heartily and see it as a form of abuse if they were asked to book their appointments on line. They are the sort who I still see queuing up at the post office to pay their water and electricity bills, or at the bank to cash their monthly cheque.
As for the waiting-lists, they are inevitable where everything is free and where demand, precisely because the supply is free, outstrips supply. There is no other country in Europe, except for Britain, where you can walk in brandishing your ID card and come out the other end, after extensive surgery to your broken leg, arm, wrist, head, or whatever, without being given an invoice. And it is no coincidence that Britain has much worse problems with waiting lists. But it also has a higher number of people who are privately insured and who pay for their treatment so as to avoid those waiting-lists and hospitals that are in several cases very much inferior to our general hospital.
The European countries which came top of the list for health-care, in this index, are the Netherlands, Iceland and Luxembourg, countries in which health-care is not completely free of charge as it is in Malta. The argument the Index makes, that Maltese people do not get good value for money from their health service, is beyond ridiculous. Maltese health-care offers excellent value. The people who use it most are in fact those who contribute little or nothing at all towards it. In their case, it is truly absolutely free.
The reality is that the best care you can get in Malta is in the state general hospital, and when the private hospitals are so good, that’s saying something.