The controversy surrounding the health service was touched upon once again by the Health Minister in an interview in another section of the media earlier this week. The Minister, egged on by the interviewing journalist, reiterated what his leader, Prime Minister Joseph Muscat, had pledged in his party’s election manifesto, that this is a no-go area and that no fees in this sector would be introduced.

This position is no different than that adopted by the previous administration and pledged by the Nationalist Party for this legislature – a stand by which it has abided throughout all its years in government.

Yes – this may politically satisfy Joe Public, who had reason to grin with glee at the confirmation of this position. The issue, however, transcends such a superficial political stand of convenience adopted by our governments of the last legislatures.

History shows us that turning matters into a political football does no good either to the matter, or to the method of determining it. If my memory serves me well, this matter had been partly addressed by the Sant government, which had wanted to introduce a nominal fee on prescriptions for free medicines, a proposal that was massacred by the Opposition. The proposal was subsequently withdrawn and the issue has become a no-go area.

The Health budget is one of the largest, if not the largest, budgets provided for by government. Both local and international experience has shown that it has to increase every year and that raising the standards of primary health care has resulted in more citizens accessing it, more personnel and medication, among other things, required and, naturally, a larger financial budget.

While applauding our politicians for their social conscience, Joe Public keeps on slapping himself even harder in his pocket as he is the ultimate sponsor of this massive expense.

The issue here is, and I say this before a swarm of communists and free health care exponents take pen to paper, not of whether to have free health care or not, but, realistically speaking, it is a question of what services should be free and to whom it should be given for free.  It is to ensure the elimination of abuse of the free health care system and to ensure the proper use of this essential service.

This in itself would ensure that we still provide health care services free of charge, but we would – to some extent – be controlling the cost while relieving the service from a lot of pressure, which in turn would offer Joe Public an even better service in return.

Basically, the issue requires a rethinking of the way we bring forward election pledges, the consequences of which outweigh political gain. The health sector election promise does not make financial or medical service sense. Politicians may not have the gall to admit this in public, but it remains logical to those who want to reason things out.

Discussing reforms of financing the health sector should not be a taboo. The Health Minister rightly complained that his predecessor left his Ministry with a massive debt which he now has to attend to. When asked about this debt earlier this week, in a television programme, the new Leader of the Opposition answered (and correctly so) that the previous Health Minister had chosen to give citizens a service, rather than let them out in the cold in pain and potentially to die as a result of financial budget constraints.

The way forward is an analysis of the sector by a non-bureaucratic working group, sensitive to the needs of Joe Public and capable of finding a balance between all the considerations of the sector leading to a reform of the policy of free healthcare currently in force.

The introduction of a fairer system, where basic fees could be introduced and – by way of example – citizens could be incentivised to visit regional health centres instead of Mater Dei would automatically spread the services requested over the various health centres and lead to less waiting time and possibly also to other benefits.

There are, I am sure, numerous considerations that may lead to an overhaul of costs that will not reduce accessibility to the service for Joe Public, but do our politicians have the courage to act?