The European Commission’s annual report on the state of health in the different member states is a necessary assessment that identifies the strengths and weakness of each country. This report goes beyond the key indicators that denote progress or regression in the provision of health services to the public. It also makes an essential assessment of political developments in the health sector of each country.

As far as health services are concerned, this year’s report concludes that the Maltese enjoyed the longest lifespan spent in good health of all EU countries – a significant achievement for the country’s free health system. The increase in the incidence of obesity and increasing consumption of alcohol are realities that need to be addressed by policymakers to ensure that the long-term health of present and future generations is safeguarded.

The European Commission also issued some critical advice on the privatisation process of certain parts of the public health service. It referred in particular to the 30-year partnership with Vitals Global Healthcare. The Commission advised the government to ‘monitor closely’ the implementation of this agreement. The ‘heavily redacted’ version of the contract made available to the public raised some concerns with the Commission.

These concerns are justified because to judge the success or failure of the privatisation process one needs to understand how this will affect both the fiscal sustainability of the healthcare system as well as its equitable merits from a social perspective. Some economists have for a long time questioned the viability of free public services like health, education and pensions.

Different political administrations have committed themselves to long-term provision of free healthcare even if the costs of such commitments come with a vast and spiralling cost. An ageing population, need for capital investment in medical equipment, and increasing expectations of excellence in healthcare from the public can only be addressed if budget allocations for this sector grow significantly every year.

This may not be so much of a problem when the economy is performing well, and government income is improving. It becomes an entirely different matter when an economic downturn sets in as typically happens in an open economy.

In the past, cost pressures on the public healthcare sector were addressed by rationing of services, even if policymakers will deny this unflattering reality. Long waiting lists, scarcity of hospital beds and shortages of ‘free’ medicine could be the result of poor healthcare operational management. But they are more likely a symptom of lack of investment and long-term planning by the political administration. The government should ensure that the privatisation of the operations of public healthcare should never lead to limitations of access to services for those who need such services most.

The government’s record on the privatisation of social and economic infrastructure services is not brilliant. The privatisation of the electricity supply services that saw Electrogas becoming the private energy supplier in place of Enemalta was sugar-coated by the government granting a sovereign guarantee to a consortium of banks that financed the project.

The failure to reveal all relevant details of a contract for the privatisation of an essential public service, be it in health or energy supply, is a weakness that could raise doubts on whether the public interest was indeed the primary motivator for such privatisation.

This is a Times of Malta print editorial

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