Ian C. Ellul

I f one examines the budget document presented earlier on this month, one can observe various interesting proposals aimed to invigorate our healthcare system. The following is a summary:

• A patients’ charter will be introduced

• The Government will be issuing a White Paper on medicine management and the implementation of the Pharmacy Of Your Choice (POYC) scheme

• “This year, Government will be allocating funding for the purchase of new medicines that are not available at present for dealing with conditions such as Multiple Sclerosis, ADHD amongst children and widening the choice available of medicines including the treatment of diabetes” – Currently paediatric patients are already being given free methylphenidate for ADHD thru’ Schedule V since ADHD is currently classified under ‘Chronic Psychiatric Disorders starting in Childhood’ (as per Act No. I of 2012, amending the Social Security Act)

•68 new beds will be added to the 925 beds currently found at Mater Dei hospital by 2015 • New services from Mater Dei hospital will be launched. An example is IVF, which will be partly subsidized by the government

• Specialised clinics will be opened, example, eating disorders clinic and lifestyle clinic

• A chemotherapy service is going to be introduced in Gozo – finally

• New services will be launched in Gozo, example, a day care ward and a pain clinic. The Government will also be opening of an eight-bed orthopaedic ward • New equipment to freeze blood will be purchased

• The administration of health clinics is going to be devolved to local councils

• The opening times of health centres are going to be extended

• The expenses of the second parent who accompanies minors for an operation abroad will start to be paid by the government as well

• Income assessment of claims from separated persons for noncontributory medical assistance will not include the share of maintenance given to spouse If these initiatives are implemented in an accountable and timely manner, one cannot but commend them.

Interestingly, the POYC scheme is going to be reformed. This has been heralded by the continuous out of stock scenarios which have plagued the scheme since inception. To compound matters, in 2012, the NAO performance audit of the scheme had concluded that there has been a 313% increase in costs incurred over the former health centre-based system. Notwithstanding this, the government has taken the audacious step to announce that it will offer a wider choice of medicines for specific medical conditions, as well as including multiple sclerosis in Schedule V (Yellow card). We will have to wait and see how this evolves.

The government has also reiterated its commitment to work with the private sector. This can be quite challenging since only last April a collaboration on the provision of free emergency service with a private chain of hospitals has been axed. Nonetheless, this publicprivate partnership will now include the movement of patients from social beds to residential homes in order to maximize the utilization of capacities in both the private and public sectors. This is aimed at reducing the overcrowding currently present in Mater Dei hospital. In addition to this there is going to be a projected 7% increase in new beds by 2015. However one has to wait and see whether these actions will effectively improve the bed management, since apart from an ever-growing elderly population, the prevalence proportion of noncommunicable diseases is also set to increase in the future.

In my opinion, tackling the above scenarios will prove to be quite a thorny affair. Let us not forget that the government also intends to publish the report spearheaded by Mr John Dalli on the Mater Dei hospital practices, which will include revelations which as stated by the Hon Prof Edward Scicluna “should shock the tax payer”.

So I guess that John Francis Bongiovi (alias Jon Bon Jovi) would excuse me for using the name of his song for this editorial…