News | Sunday, 07 December 2008

‘I fought the law… and I won’

Bridget Giusti spent two years petitioning MPs before taking up the health department to court to be given a medicine for her son that was already being dispensed for free to two patients

If you can’t get what’s yours by right, how long do you have to wait before the favour of politicians is bestowed upon you?
For Bridget Giusti, the mother of diabetic 15-year-old Michael, petitioning the authorities for the medicine her son needed could have taken forever, until she decided to fight the government in court.
For two years, Bridget spoke to MPs, members of the Prime Minister’s secretariat and even the Prime Minister’s wife, in a bid to secure the provision of Lantus, an insulin used by sufferers of Type 1 diabetes.
But as she explains, Bridget was not seeking favour from the authorities for her son, who was diagnosed diabetic at the age of six.
“The fact was that my consultant’s request to government for state-provided Lantus was turned down when it was well known that two people already enjoyed that privilege,” Bridget says.
So three years ago, Bridget began querying politicians over the government’s apparent discrimination on putting Lantus, an insulin recommended by many consultants for Type 1 diabetics, on the national formula.
“We had used various insulin mixes in the past. Type 1 diabetics can have their blood sugar levels go down without even realising how serious the situation could be. And when the blood sugar level is down, a sufferer can lose their ability to think at that point. Once Michael had to be hospitalised after fainting and hitting his head hard against the floor. Type 1 diabetes can be very dangerous for sufferers who need to be administered insulin daily.”
Michael would be hospitalised at least twice a year due to problems associated with dehydration and other complications. “It’s one of the effects when the body succumbs to illness, which means he would have to be fed from a drip to replenish the body.”
What would send Bridget on a mission to assert the rights of diabetics to a state-provided insulin was when two diabetics had earned the free provision of Lantus from the government.
“It’s a small country, and you get to hear about such situations: in one case, a diabetic had been hospitalised for six months before being finally sent over to the UK. There a consultant simply ordered that the patient be given Lantus, which the government complied with, dispensing it free of charge.”
Patients using the Lantus treatment use an average of 20 to 30% less insulin, which is why treatment with Lantus has been highly recommended for patients who experience frequent hypoglycemia (the pathologic state produced by a lower than normal level of glucose – sugar – in the blood) and those who have problems with acute hypoglycemia.
“The guidelines of the National Institute for Clinical Excellence, on which various treatments are made available on the UK national health service, highly recommends treatment with Lantus,” Bridget says.
“However, Maltese consultants were advising patients who were not achieving adequate control on their blood-sugar levels with their current insulin supplied by the Department of Health, to switch to Lantus. Those who could afford the extra expense were able to do so, but the rest had no option but to stick to second-best treatment.”
In 2004, the head of the diabetic clinic advised Bridget to buy the new insulin. “In six months of using the new insulin, Michael was better controlled.. Before he needed to inject four times daily and he still wasn’t stable. And he was only admitted to hospital once due to a chest infection.”
With the new insulin, also came new costs – Lm25.90 (€60) which would last for 50 days.
So her consultant made a request to the authorities for Lantus to be dispensed on the state formula, a request which six months later was denied.
“Personally I thought this was unfair, as many others did, since two patients were already being supplied with the insulin due to recommendations by foreign consultants. And the fact was made clear by the former minister of health Louis Deguara himself, who talked about it on NET TV’s Opinjonisti.”
Bridget started petitioning MPs. She met Kate Gonzi, explaining her situation. She met MPs from both sides. “I found closed doors pretty much everywhere, except from the late Labour MP Karl Chircop, who pursued my case with the authorities and in parliament. Nationalist MPs said that since the government had refused the request, then it was obvious that Michael didn’t need it, which was obviously not the case. But the issue at stake was the discrimination between patients by the government.”
In January 2006, she wrote to the Prime Minister. She got a meeting scheduled with a member of his secretariat. “At the OPM, the secretary told me I was right so he instantly called the director-general of health right in front of me, demanding that I be given the medicine, but I was still refused. At that point there was no option for me but to go to court.”
It would turn out to be a short-term affair. No sooner had she deposited her court fees for the case to be heard, in September 2006 the Department of Health informed her that it would be issuing a protocol for Lantus to be put in the national formula.
“The health department finally decided to provide the insulin for free and my son was one of the first patients to be provided with this insulin,” Bridget says, aware that her victory had earned diabetics all over Malta the right to an insulin that was already being dispensed by the State for free.
“I think people are not bothered to go to court against the government or big businesses, and I can say that the system is simply too cumbersome to overcome. You have expensive court fees to pay, lawyers to pay, and you have to take days off work to attend sittings. That’s why people don’t bother taking on the government,” Bridget says.
“My son Michael today leads a normal life: he plays in the basketball youth national team and in summer he plays waterpolo for Sliema. Diabetics still succeed in leading a normal life, and Michael is very responsible and independent.”
Bridget’s regret in the whole affair seems to have been the way she was treated by the political forces at hand. “At the end of the day, this was a victory for everyone who was being discriminated by the State. This year, right before the election, the Nationalist Party called my friend so that she speaks to me personally and convince me to pick up my voting document… I wonder if in four years’ time, they will be facing me directly and ask me if I have collected my voting document.”


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