A few days ago, I experienced a uniquely incredible occasion. After a busy shift handling various kinds of emergencies at the emergency department, when our medical staff were approaching the end of their night duties, a female patient entered the waiting area complaining of abdominal pains.
On examination, she informed our team she was pregnant, although unsure of her due date, and that she had visited our ER only to identify the cause of the pain.
It was quickly established that her pregnancy was more advanced than she believed and she was already in labour, about to deliver her third child. Given the urgency and the patient’s financial constraints we offered to waive any charges for this unusual case but patient asked to be transferred to Mater Dei Hospital.
We informed Mater Dei about the case, however it was decided it would be unsafe to transfer the patient and risk delivery in the ambulance so, on arrival from Mater Dei, the senior midwife together with the Saint James Hospital team and on-call gynaecologist, assisted the patient who delivered a perfectly healthy baby boy just an hour later.
This was indeed a public-private partnership by chance, where in an unplanned manner we worked seamlessly together in the best interests of the patient. This episode exemplifies how healthcare should operate in Malta.
I joined the private healthcare industry more than 32 years ago and throughout this time I have seen it evolve and grow. But the industry I entered into then has changed remarkably.
Today it has completely different service standards, client experience expectations, and the necessity of constant investment in cutting-edge technological opportunities.
The cost to deliver quality healthcare is huge and while medical technology and equipment continue to advance at an extremely fast pace coupled with an increased limitation of access to the supply of local nursing and medical staff, this leaves the local healthcare sector struggling in many ways.
It is a fact that national healthcare systems have always experienced a considerable strain to remain sustainable and effective. I am concerned that as technology and healthcare advances continue to progress at such a phenomenally fast pace, the sustainability of the Maltese healthcare system is going to risk an implosion that will be difficult to repair in the short term.
This is why, I strongly maintain that new models of collaboration with government need to be created, which after all is the whole logic behind the notion of public-private partnerships.
However, the approach needs to focus on the total overhaul of current public-private initiatives that all too often have tended to be somewhat of a ‘patchwork’ approach to a long-term sustainable collaboration, whereby healthcare delivery is provided by fully accredited facilities in a safe and sustainable manner and accessible to all.
These new models should encourage and foster greater collaboration between the private healthcare sector and the State to offer specialised services that support each other.
Rather than duplicating work and resources, private healthcare should be leveraged as a complementary force to the public system where together the public and the private sectors, can work in tandem to raise the bar. Healthcare facilities need to be graded to reflect the quality and range of services available, including medical staff and equipment.
National healthcare systems have always experienced a considerable strain to remain sustainable and effective- Jean Claude Muscat
While I acknowledge the significant efforts made by the government to provide comprehensive healthcare services, I believe our current approach faces several challenges which need to be imminently addressed to ensure long-term viability.
It is very clear to me that rather than having a system completely dependent on government service provision, there needs to be a well-thought-out and meaningful shift to a more integrated approach in which private healthcare plays an essential and important role within our national healthcare framework.
By encouraging and facilitating the involvement of private healthcare providers, we can drive much-needed investment from private healthcare groups significantly reducing the healthcare expenditure of the State and enabling it to invest in other emerging sectors such as infrastructure and the environment.
Countries such as Germany, the Netherlands, Switzerland, Italy, Luxembourg and France, embrace healthcare systems that include a mix of public and private healthcare providers.
Some of the most successful among them combine universal coverage with the option for private healthcare, ensuring citizens have access to essential services while also offering alternatives for those who can afford and choose to use private services.
These systems are successful because they strike a balance between providing universal access to healthcare while leveraging private sector innovation and efficiency, with the government’s role being mainly to regulate the whole health sector. This means that the health ministry will oversee both the State and private sectors giving each equal emphasis and importance.
This is crucial to ensure that the benefits of private healthcare do not come at the expense of equity or access.
Incorporating private hospitals and healthcare facilities into the broader healthcare system would also allow private hospitals to operate more cost-effectively, ultimately preventing price increases and making private healthcare more accessible to a larger segment of the population.
Other initiatives which encourage further investment in private facilities and services, promote new tangible initiatives aimed at encouraging more to take up private health plans and reward those who use private healthcare services, are long overdue.
By involving private facilities in the national healthcare management ecosystem, the government would gain clearer financial visibility, enabling better planning and allocation of funding requirements, reducing the constant ‘unknown’ and element of surprise in planning and forecasting budgets and resources to sustain the system.
In transitioning towards a healthcare model that positions private providers as key stakeholders, we can create a far more efficient system that contains costs, improves accessibility for all citizens and significantly reduces waiting lists.
This change in strategy would also allow the government to focus on essential services, while allowing the private sector to handle specialised care.
Jean Claude MuscatJean Claude Muscat is CEO of Saint James Hospital.