No progress registered in primary health reform, EU says

Malta has made no progress in improving its primary and community healthcare in a bid to cut costs in hospital care, the European Commission has said in a report released this week.

Brussels’s country-specific recommendations for Malta – a list of economic and structural reform policies – were published earlier this week, and with it a warning that Malta had to do more to ensure the sustainability of the healthcare system.

“The authorities have made limited progress in ensuring the sustainability of the healthcare system. Even if healthcare expenditure in Malta is currently below the EU average, it has one of the highest projected increases in the EU in the long term,” the EC 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.

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.

However, in its country-specific recommendations, the European Commission says that no progress was registered in raising the cost-effectiveness of the healthcare system.

“The increasing costs have yet to be contained. 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. Overall, the implementation of the healthcare reform has been slow.”

Saving millions in healthcare

• The health ministry is aiming at savings of €7 million in 2020 on healthcare services for self-reported diabetes, hypertension, cholesterol and obesity ailments that could be handled by GPs.

• According to data presented in the country-specific recommendations, the government is aiming at reducing the prevalence of diabetes for those aged over 35 from 11.3% to 10% by 2020 – saving €714,594;

• Reducing prevalence of hypertension in those aged 15 and over from 22.8% to 19.8% by 2020 – savings of €1,425,635;

• Reducing prevalence of obesity to 18.3% and shifting 4% to overweight – savings €2,622,311.69;

• Reducing the proportion of those aged 15+ consuming cholesterol medication to 5.8% from 7.5% - savings of €2,220,443.