Tuesday, 7 February 2012

The obvious solutions nobody dares pronounce

At this time of the year a particular spot at Tal-Qroqq gives one the impression of a third world country.   It is the Accident and Emergency  (A & E) department at Mater Dei Hospital where confusion reigns supreme, as resources are stretched to the limit as demand and supply get hopelessly out of sync.

This does not mean that the situation is much better at other times, only that in this period of cold weather and influenza, a  bad situation turns acute to the point of rupture.

As an economist I would take an economic and logical approach to addressing this situation and then check it with a social thermometer to see whether it passes the social test.    And doing so makes me suggest that at least two things must happen in order to bring the A & E Department to the same high standard of the rest of Mater Dei.

1.   Firstly we need to increase the supply.   Regional Centres must be made to offer non-acute type of interventions to reduce the undue confluence of petty cases at Mater Dei. At least three regional centres operating on a 24 basis must be opened , north , central and south so that in addition with the Gozo Hospital they can take some of the work load off Mater Dei.

2.  Secondly we need to discipline the demand to ensure that only genuine cases seek emergency services both at Mater Dei and at the regional centres.   There is no way this can be implemented unless users of public emergency services are made to pay a token, say ten euro, for  such services.  

Our politicians have been promising that public health services would remain free.  They would immediately shoot down any suggestions, no matter how sensible, that would expose them to criticism of breaking their promises, especially at this time of the political cycle.

But sooner or later someone must bite the bullet if politicians truly see themselves as guardians of the nation's interests and good housekeepers of taxpayers' money.

Would payment of a mere ten euro to eliminate abusive use of emergency service,  ( in many cases to save the fee for a normal visit to the family doctor clinic) be truly a pledge breaker when all the rest of the health services remain free,  from mere hospital stays for observation to the most complicated surgical interventions with outpatients after-care and all?

Not in my dictionary!   By the same reasoning if charging a mere ten euro for access to emergency service is socially offensive to anyone, especially if social korta roza cases are exempted, then we can just as well start having the State paying for our bread, for the roof over our head and for all family doctor visits.

Unfortunately, though solutions are obvious,  our politicians playing for the gallery, have constrained themselves from adopting them even if as a consequence a critical part of our health services remains dogged in third world standards.   Is it not time for our politicians to reach consensus on something which could save a bomb and offer a good service to who truly needs it, at a small fraction of its true cost?

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