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I refer to the article "Bad Medicine" as published in the
MaltaToday (19 December).
It is of course the primary duty of every trade union to safeguard the professional interests of its members. It is therefore licit that the secretary general of the Medical Association of Malta dwells in a drastic way on some points, which affect the medical profession in Malta.
Within the framework of a short newspaper article, it could not have been possible for Dr Martin Balzan to go into all details, which influence and regulate a health service.
However, in the report written by Malta Today's correspondent Matthew Vella, I personally missed a number of important aspects.
It should be indisputable that there is need of a reform of the health and hospital service in Malta, if one strives for a state of the art service, which includes the medical service as well as ancillary hotel services.
In Malta, one regularly avails one's self of a classification published by the World Health Organisation, to demonstrate how efficient the incumbent system is in Malta. The lay public is not aware of the criteria, which are used as parameters for this WHO classification, which is quite ambiguous, and which is negatively criticised by some authorities, which incidentally include Dr Balzan's professional friends at the Bundesaerztekammer in Germany.
The Medical Association of Malta also has a public obligation in national terms. In other words, it should be appropriate that the MAM aligns its policies to a framework of national economy and national needs.
I more than agree with Dr Balzan that there should be a nucleus of full time consultants, who would enjoy a remuneration in the region of Lm 45000, while more or less forfeiting the rights to extensive private practice.
On the other hand, Dr. Balzan should be aware of the fact, that it is difficult to explain to the lay public, why an esteemed consultant would prefer a Lm 8000 post, which would enable extensive private practice, were it not because of the possibility of tax evasion, especially when Dr. Balzan wishes to simultaneously criticise the goals of the Tax Compliance Unit.
In Matthew Vella's article one did not find any reference to the exact terms of employment of staff at the new Mater Dei hospital, which, as we all know, will be "autonomous". Now, in an autonomous hospital, personnel management should be a matter for the hospital's CEO and for the hospital's Board of Directors. One cannot have civil servants, as Dr. Balzan himself is, as employees of an autonomous hospital.
It was somewhat ludicrous to read calculations with reference to what a surgeon would earn per operation. Dr. Balzan should be aware of medical economics and he should refrain from making such statements and such comparisons, as was to be read in Matthew Vella's article. Allow me to remind Dr. Balzan of, for example, the so called Diagnosis Related Groups in conjunction with remuneration of hospital services
There are many other points, which can be debated and discussed with reference to a health and hospital service system, to which I shall not refer here.
On a closing note, Dr. Balzan made no reference to the number of practising doctors, which Malta essentially needs. With so many doctors qualifying in Malta, a small enclosed island, it is a natural selection process, that many colleagues will be forced to emigrate and seek employment as specialists abroad.
Dr. Leo Said
Kleve
Germany
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