Malta has just one palliative care consultant when it should have 12: MAM
Medical Association of Malta says it is pushing for 30 advanced medications to be made available
Malta has just one palliative care consultant when global guidelines suggest it should have 12, the Medical Association of Malta has said.
The doctors’ association said that the “severe shortfall” meant many palliative care services ended up in the hands of hospital doctors and family physicians who lack the necessary training.
“Malta currently has only two officially appointed palliative care specialists, one consultant and one resident specialist. They are supported by a handful of general practitioners with a special interest in the field,” MAM said.
“This is far below what is internationally recommended. According to WHO and European Association for Palliative Care guidelines, a country of Malta’s population (just over half a million) requires a minimum of 12 full-time palliative care consultants to adequately serve hospitals, hospices, community services, and non-oncology patients.”
The association said that it was also in talks with the government to add 30 medications used for advanced palliative care in the UK and EU to the government formulary.
While practically all palliative care medications recommended by the World Health Organisation are available to local patients, doctors say the WHO list represents a minimum standard and that Malta should strive to exceed it.
“Countries like the UK, France, and Germany have expanded palliative care formularies that include over 50 medications to manage complex pain, breathlessness, agitation, seizures, and terminal secretions,” it said. “Malta should strive for similar gold standards in this area, ensuring compassionate, evidence-based care for all terminal patients not just some.”
It also raised another concern about existing palliative care provisions in Malta – that of accessibility. Most palliative care in Malta focused on cancer patients, it said, despite cancer accounting for just 25 per cent of cases requiring palliative care.
Other conditions which sometimes necessitate end-of-life care, including heart failure, respiratory failure, advanced dementia and neurodegenerative conditions such as ALS should also qualify, the MAM said.
Public debate about palliative care in Malta was reignited in recent weeks as a result of a public consultation about euthanasia.
The MAM was among organisations that opposed the euthanasia proposal, saying palliative care services should be improved before any euthanasia proposal is considered. Proponents of euthanasia have countered that one does not exclude the other.
The government, which has pledged to introduce some form of legislation concerning euthanasia, is currently assessing the over 15,000 submissions made as part of the public consultation process.