Interview | Sunday, 02 August 2009
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The doctor’s prescription

Nationalist MP Jean-Pierre Farrugia says the PN has to consolidate its ideological bearings before taking an unfortunate turn to the right

Is Jean Pierre Farrugia, long-standing Nationalist backbencher and doctor, one of the party’s last ideologues? He is concerned about how the global recession has exposed growing social inequalities, and that this is the wake-up call for the Nationalist Party to rediscover its Christian-democratic roots. But he says he fears his party is losing its ideological bearings: namely, by clinging to moral conservatism and pandering to anti-immigrant sentiment. That’s a bold description of the state of the PN, once the preserve of centrist democrats inspired by their Italian counterparts; now seemingly veering towards a dangerous, centre-right territory. Farrugia says it’s time for the PN to stop and think of its identity, after so many years in government.
“Unfortunately this soul searching isn’t going on,” he says, saying this exercise has even been made more urgent by the global economic downturn “because it is in moments like these that the people can really judge the party’s social credentials.”
But is soul searching compatible with governing a country during the worst recession?
“It is not easy… it is like servicing a car and driving at the same time,” Farrugia says, conscious of the fact that the PN has come in for some serious political battering since clinching its re-election in 2008 by the skin of its teeth. Case in point is the scale of its defeat in the European elections with Labour taking 55% of the vote. “It is very clear that whereas five years ago people who wanted to check the king voted Alternattiva, this time they voted Labour.”
He attributes this turn of events to the fact that people are becoming less patient with the government, “five years after having been already impatient” he points out.
And he finds the party’s reaction to the defeat as not entirely satisfactory. “The reaction of the parliamentary group was very strong. But at the executive level, where a large number of Cabinet ministers were present and only two backbenchers including myself attended, there was no such reaction…”
Farrugia, who has chaired the party’s executive in the past, recalls that this body was always valuable in times of crisis. “The party executive is hardly ever of import when everything is plain sailing, but it has a crucial role when the party faces a crisis. But in this case the attendance was nothing to write home about. And more so I cannot say that the reaction of the members of the executive was of so much concern considering the scale of the defeat.”
Clearly befuddled by the apparent lack of interest in the party’s electoral defeat, he says that the party’s statute does not foresee the holding of a general council after MEP elections, since such elections are not considered as important as general elections. “As long as a general council is held twice a year as required that should be enough.”
But he welcomes the fact that the Prime Minister is meeting all the sectional committees of the party. Just like other MPs from his district Farrugia did not attend the meeting involving the sectional committee representing his district “to let the grassroots free to say what they are feeling.”
But he is aware of what people are telling the Prime Minister. “In most districts party activists have expressed a lot of concern on the fact that the government is not delivering in the way they expect it to deliver. The main point is that a smaller and leaner Cabinet has not delivered a better performance.”
So what led to the defeat? According to Farrugia the government has a very plausible explanation: that of facing an international recession just a year after being re-elected to power. Recalling Alfred Sant’s defeat after 22 months in power in 1998 he notes that “in the first two years no government can be expected to be in a position to deliver the goods.”
But Farrugia argues that the public has become used to making sacrifices in the early parts of the legislature and are increasingly sceptical of pre-electoral bonanzas. “I think that the electorate has noticed that all Maltese governments have been working in this way for the past decades and it is about time that we face this recession in a way that if there are hardships, these are spread out throughout the legislature and not concentrated in the first few years.”
Neither does Farrugia think that the party should become more populist by pandering to rampant anti immigrant sentiment. He says he was irked by the way the issue of illegal immigration was tackled in the campaign. “Immigrants were the scapegoat of both main political parties in the last electoral campaign.”
But he disagrees that the perception of the PN being too soft on this issue contributed to its defeat. “Polls showed that people who had decided not to vote several weeks before the election did not turn up on polling day. By just taking it out on the immigrants both parties failed to convince people to vote.”
Farrugia says he was even irked by the PN government’s tacit agreement with the Italian government’s decision to repatriate immigrants to Libya. “Internally I criticised this position heavily because I feel that Maroni and Berlusconi are much to the right-wing on this issue. I believe that UN and other international conventions should always be respected and I was definitely against Italy sending immigrants back without profiling each case. In this way one could be sending back people who possibly qualified to become refugees”.
Nor does he feel comfortable with the PN’s association with right-wing elements in the European People’s Party like Silvio Berlusconi’s Popolo della Liberta. “Recently Prof. Serracino Inglott spelt out very clearly saying that the EPP is now more right than centre right.”
And he criticises those who define their allegiance to the Nationalist Party simply by affirming their moral conservatism. He makes a marked distinction between moral conservatives and Christian Democrats. “I am a Christian Democrat and a Catholic. But I am not a Christian Democrat because I am a Catholic. I am a Christian Democrat because I believe that through politics one should give equal opportunities to all… adhering to moral conservatism does not make the Nationalist Party a Christian-democratic party. ”
He adamantly refutes the conservative label. “I believe that you should not boast about being a moral conservative to convince people that you are a Christian politician. These are two different matters. You can be a moral conservative and not care a hoot about vulnerable people. On the other hand one can be a true Christian without being a moral conservative. ”
Has the party become less of a Christian-democratic party under Lawrence Gonzi? Farrugia argues that Lawrence Gonzi’s political aspirations have always been inspired by left-of-centre Christian-democratic values.
“One can recall his commitment on disability and mental health issues. However I must say that he is the third consecutive Prime Minister to have moved to the right.”
The first to move to the right according to Farrugia was Alfred Sant during his brief tenure in office between 1996 and 1998. Even Fenech Adami, who hailed from the centre-left, had to move to the right in his bid to control government costs.
“And now unfortunately the recession is accentuating this drift to the right,” Farrugia says, adding that while he understands the need for reforms to ensure sustainability both in the social and environmental spheres, he is wary of shock therapy.
Farrugia recognises that for environmental reasons it makes sense to disincentivise polluting fuels and to promote alternative sources of energy. He recalls that together with other PN officials he had always urged the government to invest in alternative energy. “But back then the government used to say that alternative energy was more expensive than conventional energy and therefore it was not worthwhile to invest in it.”
Now he criticises the government for trying to make this positive leap “in too much of a sudden way… in a way that people could not understand why bills were becoming more expensive when the international cost of fuel was going down.”
One major issue which is denting the government’s social credentials according to Farugia is health. “The government says that 250 more operations are being performed monthly in Mater Dei today than there had been at St Luke’s. It is true that there was an enormous improvement in cataract operations, but waiting lists for procedures like knee arthroscopy and laparoscopic cholecystectomy are increasing.”
He also expressed his disappointment that six months down the line the committee appointed by the government to deal with the waiting lists’ problem (following a damning Ombudsman report) has not come up with any recommendations.
And he criticises the government for boasting that there are 1,000 visits to the Mater Dei outpatients daily. “How many of these have health insurance? How many of these have been to the consultant privately before?”
Farrugia recommends tax rebates to encourage people with health insurance not to use Mater Dei, citing a similar measure introduced in Australia. He says this measure would counterbalance the insurance companies’ incentives to encourage their customers to receive their treatment in Mater Dei at the taxpayer’s expense. “And the money lost from tax revenue could well be counterbalanced by savings from the money forked out for investigations for insured private patients, who can also be admitted to Mater Dei to jump the queue to conduct free tests immediately, as inpatients always take priority over outpatients.”
Farrugia has already warned that the downsizing of the state’s primary health sector will lead to an increase in the fees charged by private doctors. “If family doctors who generally charge modest fees do not have a free of charge public service competing with them, they are likely to raise these fees.”
Farrugia sees more costs than benefits for the primary health sector if recommendations made in a report discussed by the Cabinet and published by Opposition Leader Joseph Muscat during the electoral campaign, are enacted. “Although it is not yet finalised that report goes in the direction of shifting patients from government health centres and dispensaries to private general practitioners, with the proviso that whoever has a pink card will get a certain amount of visits free of charge.”
Farrugia disagrees with the implementation of this measure especially during a recession. But the downsizing of the public primary health care is already happening. “The government has reduced the number of days in which these dispensaries are open. Until a year ago Valletta had two dispensaries which opened everyday. Now you have only one opening on alternate days. In Hamrun and Santa Venera they open four times a week, but only for a couple of hours each day.
“But there is also shortage of family doctors in the private sector. With less competition, because we are having fewer family doctors; and less competition from the free-of-charge public sector, we are bound to expect further inflation in primary health.”
He also reprimands the government for “being so strong with doctors and nurses who work with the government at the primary health level and so weak with consultants.” He contrasts the government’s increased scrutiny of doctors working in health centres with the “laissez-faire” attitude towards consultants.
Surely for the backbencher the Cabinet report represented an ideological shift from the party’s 1987 pledge to introduce “a free doctor of your choice” system through which patients would choose a private doctor while the state paid the cost. “The report is a far cry from our proposals in 1988. Back then, one was considering a service in which doctors would be paid by the state whereas now one is thinking of a system in which doctors are paid by the patient.”
But is the Maltese health system sustainable? “In a downturn one understands that a government should watch out for the costs as must be done anywhere, even in health and social policy. But here again the government must decide who needs the state’s help most.”
Farrugia agrees with the means-testing of certain medicines, although he insists any reform should only apply to newly diagnosed patients and should not disrupt the life of those already used to receiving free medicines. “If the cost of a medicinal product is negligible as compared to the declared income of the person involved, one can start thinking about not providing that particular product for free.”
On the other hand he thinks that the government should still offer expensive medicines, some of which are not presently available on the government’s list of free medicines, free of charge.
He also expresses his concern that the government is not standing firm against medicine importers as it owes them a lot of money. “Drug importers are owed lots of money by the state. So there is also a great laissez-faire attitude by the state towards these importers. How is it possible that Malta is one of the few countries where a highly effective drug against Ischaemic heart disease is no longer found on the market? Is this because this drug is very cheap?”
In this particular case one can still find two other products which are seven times more expensive because they were developed recently. “Is this a cartel? Have the importers of the more expensive drugs bought out the importer of the much cheaper drug?”

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