NEWS | Wednesday, 21 January 2009

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Mater Dei Security contract to be revised

James Debono
Private medical insurance schemes were described as a farce by Social Policy Minister John Dalli in a business breakfast held yesterday by GO and di-ve.com.
Dalli also announced that the controversial €1.5 million security contract for Mater Dei is being revised.
He also revealed that the government intends to remove non-essential items like cloths and aspirins from the list of free medicines in the forthcoming reform of the sector.
Speaking on private insurance, Dalli described the practice of compensating patients for taking up a bed at Mater Dei instead of claiming the same service in a private hospital as “daylight robbery”.
“They push you to a bed in Mater Dei and pay you €40. Whisking people into Mater Dei is daylight robbery… we are being taken for a ride.”
His comments were not taken lightly by Catherine Calleja, chairperson of the health section of the Malta Insurance Association.
“Dismissing our industry as a farce is unfair,” she said, claiming the cash benefit for people staying in public hospitals represented less than 1% of insurance claims. “We agree that this is a white elephant [sic] which should not be there.”
But according to Calleja, the insurance industry is not to blame for the inclusion of such claims in schemes offered in certain job contracts. She said insurance companies have been taking the burden of providing essential medicines like Herceptin, despite their unavailability from the national health scheme.
“We have been paying claims for medicines like Herceptin for five years,” she said about the life-saving cancer drug which government only put on the national health service late December.
Dalli also announced the introduction of a new system regulating entitlement to free medicines. “We have to get rid of all those multicoloured cards which determine which people should be given free medicines.”
According to Dalli the government intends to focus on which medicines should be given for free. “I would concentrate on the expensive medicines people cannot afford, not the wool cloth or panadol. I do not have a blank chequebook. I would give Herceptin but not cotton wool. I hope I will not be criticised for denying poor people free cotton wool.”
Dalli also announced the setting up of a negotiating team responsible for ordering medicines. “The crazy thing that we are doing is that we tender for medicines on a three-year basis.”
Since medicine prices tend to go down when research costs are paid by companies, it does not make sense to order them at a fixed price for a long time.
Dalli passed the buck onto the finance ministry for the government’s failure to pay back €30 million to medicine importers. “I do not have a mint... the gatekeeper is the finance ministry… we have an arrangement to pay after 150 days. And we should honour it,” Dalli said.
But medicine importer Reggie Fava insisted his category was promised by the Prime Minister that payments will be made in 120 days. “150 days is an eternity in the business world. Our original demand was that payments are made in 90 days and even 120 days is a long time.”
Fava defended medicine importers from the charge that they are putting up prices. “We are not philanthropists and we employ 1,000 persons who have to be paid by the end of each month.”
But Dalli begged to differ insisting that a rethink is needed in the sector. “In some cases medicines are more costly than abroad,” he said.

Contracts and waiting lists
Dalli also said that many contracts awarded at Mater Dei had to be revised when questioned by Alternattiva Demokratika chairperson Arnold Cassola whether it made sense to award a security contract of €1.5 million to a private company when government employees were not doing anything in St Luke’s Hospital.
“On security you are correct. There are lots of contracts in Mater Dei which need a revision. But this is not easy, as in some of these contracts there is no leeway to move.”
But Dalli precised that 47 watchmen at St Luke’s are being utilised in other parts of the public sector.
On waiting lists, Dalli proposed opening the 13 operating theatres in Mater Dei to ensure that any type of intervention is made within a timeframe of six months.
Only last week the Ombudsman lambasted hospital waiting lists as being “shrouded by a thick veil of unaccountable criteria.”
“I am focusing on determining the number of operations we can do on a weekly basis. I have the theatres, why am I not using them?” Dalli said.
But reacting to Dalli’s cautious remarks, St Philip’s Hospital director Frank Portelli compared the current regime which puts waiting lists in the hands of consultants to “a fox who is put in charge of the hen house… They have a conflict of interest because of their private practice. Some of them have a double conflict of interest because they also own shares in private clinics,” Portelli said.
Dalli also hinted at a radical change in the financing of Malta’s health system. “We should have a National Health Insurance scheme with private insurances to top it up. But to get there politicians have to bite the bullet in the interest of future generations.”
Malta lacks a health fund and National Insurance money is used to finance both the health and the pension system.
But Dalli refrained from answering a question by GRTU director general Vince Farrugia, who asked him whether the government was thinking of introducing a new type of health insurance.
According to Dalli, the government’s ultimate aim is to turn Mater Dei in a revenue-generating instrument by offering services to foreigners. He claimed the government’s cost-cutting measures, as well as revenue generated by the hospital, would be enough to offer more generous pay packages to consultants in a bid to dissuade them from private practice.
But Dalli admitted that only two consultants had accepted a higher wage in return for giving up private practice last October.
He said the government intends to have more flexibility in its recruitment by divorcing Mater Dei from the civil service.
Dalli expressed his disappointment that the government does not even know how much every service at Mater Dei is costing the country. “My final objective is to ensure sustainable health in Malta and to achieve this we need to know the cost of health care.”

jdebono@mediatoday.com.mt

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