Government defensive after EU report on primary health

The parliamentary secretariat for health has played down a report by the European Commission on Malta’s primary health reform, insisting that initiatives embarked upon by the government will “provide the necessary setting” for a push in primary health services.

A spokesperson for parliamentary secretary Chris Fearne said the government has already implemented a number of measures aimed at improving the cost-effectiveness.

According to the EU report, Malta has made no progress in improving its primary and community healthcare.

In its country specific recommendations, Brussels warned Malta it had to do more to ensure the sustainability of the healthcare system. According to the Commission staff working document, the authorities have made “limited progress” in ensuring the sustainability of the healthcare system.

It is also pointed out that “no progress” was registered in raising the cost-effectiveness of the healthcare system and the increasing costs have yet to be contained.

Brussels did welcome a number of measures to rationalise the procurement of pharmaceuticals and medical supplies and to improve the management at Mater Dei Hospital. It also acknowledged some investment made in primary and community healthcare, following a number of reports and recommendations calling for efficiency improvements.

“Although the government has published a document proposing a health strategy, which addresses many of the major challenges that the Maltese health system faces, there are no clear timeframes and financial estimates of the potential savings they might generate,” the Commission said.

“Overall, the implementation of the healthcare reform has been slow.”

In reply to questions raised by MaltaToday, the parliamentary secretariat for health insisted that the reference to primary healthcare was just “an example” where more focus is desirable.

“The government is adamant not to compromise on what has been achieved in the health sector. A principle of paramount importance is that any action to enhance long-term sustainability should in no way compromise quality of care and accessibility,” the spokesperson said.

In 2009, the Nationalist government issued a consultation document for a primary healthcare scheme that would serve as a ‘gatekeeper tier’ for GPs and GP practices to contain minor health problems, and allow the Mater Dei general hospital to be used for more serious medical referrals.
The reform also involved the digitisation of patients’ medical histories across a network of registered GPs for ease of communication between hospitals and family doctors.

The investment that the government is making in the health services is intended to shift the current number of patients who seek secondary care instead of using the services offered in the community through primary care.

According to an economic model presented by the Maltese government, 25% of cases seen in accident and emergency at Mater Dei, “are cases which should be seen in primary care”.
The government says that should 25% of cases seen at A&E be shifted to primary care, estimated annual savings would be in the region of €2.5 million.

The health ministry believes that through the modernisation and refurbishment of health centres, the opening of a new health centre in Kirkop and the opening of a new point of care testing system at the Rabat Health Centre will “provide the necessary setting to achieve the maximum potential shift from the secondary services to the primary health services”.

A new point of care testing system at the Rabat Health Centre, where patients can avail themselves of the services of an Anti-Coagulation Clinic to carry out their blood tests without having to go to Mater Dei, has been opened. This service will be progressively rolled out to various health centres by the end of 2015.