A medical time-bomb? | Martin Balzan

Can Malta afford to maintain a costly free health service of population growth and ageing demographics? Yes, argues Malta Medical Association secretary Martin Balzan … but not with current policies

raphael_vassallo
Raphael Vassallo
15 November 2015, 1:38pm
Malta Medical Association secretary Martin Balzan • Photo: Ray Attard
Malta Medical Association secretary Martin Balzan • Photo: Ray Attard
It is perhaps ironic, but ‘health’ has traditionally always been a major headache for Maltese governments.

Back in the 1990s, Prime Minister Eddie Fenech Adami famously had ‘nightmares’ about the endlessly growing national health bill. The same bill sky-rocketed with the long-drawn out construction of Mater Dei Hospital… and all the while, medical expenses (the cost of medicines, hospital equipment, etc.) continued to rise exponentially.

With both parties agreeing on a basic model of ‘free healthcare for all, from the cradle to the grave’, questions inevitably arise concerning the affordability of such a service in practice.

The present government’s strategy is to invest in ‘medical tourism’ – providing local services for free, but charging foreign patients (from non-EU countries) for the same services to recoup costs.

On paper, the maths seem to make sense. But inevitably, the co-existence of two vastly different models within the same regime – public and private health services – may give rise to problems.

Ever since the announcement of a 200 million euro investment drive for a public-private partnership to construct two new hospitals, MAM secretary Dr Martin Balzan has voiced his association’s concerns with the arrangement: arguing that the private sector model is incompatible with a ‘free-for-all’ model.

But first, let’s talk about the existing infrastructure, and its ability to cope with what looks like a demographics time-bomb.

It is a known fact that people in the 60+ age-group will outnumber the 30- bracket five to one by 2050. Even today, many of the waiting lists involve primarily third-age ailments (such as hip replacement operations, etc.). The strains of population growth can already be felt on the system today. How much more will they become an issue in a few decades’ time?

“The demand will continue to rise, not only through demographic shift, but also by real estate developers attracting elderly EU citizens to retire in Malta,” Balzan begins. “Young working migrants might also opt to continue living in Malta and eventually retire here, adding to the demographic imbalance…”

So is Malta’s health infrastructure, in its present form, sufficient to cope with the increase in demand for services projected over the next 20 years?

“No,” he replies, with some emphasis. “Malta’s infrastructure is insufficient. Services for the elderly, acute medical beds and palliative care services for terminal cancer patients… all are at present in short supply. This will only get worse in future.”

It is debatable also whether public expenditure on health is sufficient, nightmare or no nightmare.

“Malta currently spends around 7% of its GDP on health, of which 1.2% concerns private practice,” Balzan points out. “Most other EU countries spend around 10%...”

Read the full interview in today’s edition of MaltaToday