Patients before profits

Our health system is in need of innovation but transparent, robust public funding and a better use of resources are the answer and not privatisation

24 May 2017, 7:52am
Cartoon by Mikiel Galea
Cartoon by Mikiel Galea
The major issue in this electoral campaign has been corruption but all parties have published and presented countless proposals, including their plans for the health system. 

One announcement which might have gone under the radar was Prime Minister Joseph Muscat’s claim that the Gozo hospital would no longer be viable unless it is partly privatised. 

Speaking in Gozo last week, Muscat said that without the investment of Vitals Global Healthcare, the Gozo hospital would no longer be viable – especially since the building was literally falling apart – leading to job losses and a greater economic loss for the whole island.

“If the project and the investment is not allowed to continue as planned, patients will be going to Malta for treatment and staff will be downsized,” he warned. 

On the other hand, the PN has pledged to return the privatised Gozo general hospital to the public sector, with opposition leader Simon Busuttil firmly stating that public services should not have profit as their aim.

 “I’m all for private sector involvement in healthcare, but public hospitals should in principle never be privatised,” Busuttil said. However, in the same breath, Busuttil said the PN was not seeking to seize back Karin Grech or St Luke’s hospitals, which were also privatised as part of the government’s deal with Vitals Global Healthcare.

Surprisingly, it is the Nationalist Party – a party that has in the past privatised various state-owned companies – which is opposing the privatisation of healthcare services while Muscat’s party has followed in the footsteps of the Alfred Sant short-lived administration in the nineties which departed from Labour’s ideological stance against privatisation.

To date, healthcare, together with education and financial services, has drawn wide consensus from the mainstream parties. However, from time to time, the sustainability of a system which costs the taxpayer over €1 million a day is questioned. 

Some argue that the sustainability of the healthcare system is nothing but a fairy tale while others hold that universal access to free public health care is an essential part of the social contract. 

However, the answer cannot only be privatisation because while this has driven the quality of healthcare in other countries into the wall, there are other alternatives such as introducing fees or creating a separate national insurance scheme to finance the national health care system. 

Currently, our taxes fund a health system that is free at the point of use, accessible to all those who need it regardless of their income, social class, and lifestyle. 

In June 2016, Vitals Global Healthcare (VGH) was granted a lease of 30 years to run three state-funded hospitals: St Luke’s Hospital, Karen Grech Hospital and the Gozo General Hospital but the details of the contracts remain shrouded in secrecy and are still not available for public scrutiny. 

Serious concerns have been raised by unions, doctors, healthcare professionals and students, who are calling for full transparency and taking a clear anti-privatisation stance. 

As shown from the experiences of other countries, especially the UK, public-private partnerships do not have a good track record. Profit and public healthcare do not go hand in hand. Offloading public healthcare responsibility onto the private sector is a way to avoid political responsibility and a way to conceal government borrowing since any guarantees undertaken by the State do not show up on public accounts.

Our health system is in need of innovation but transparent, robust public funding and a better use of resources are the answer and not privatisation. Health care services should remain free for everyone, but in view of the demographic changes leading to an ageing population, sustainability must be guaranteed. But privatisation not only sustains inequalities but also undermines the value of inclusiveness. 

There are a number of measures which can be taken, including curbing the practice sustained by insurance companies which encourage patients to use public, rather than private services. Another solution – albeit a controversial one – lies in the creation of a separate national insurance scheme to finance the national health care system.