Matthew Vella Over 13,000 patients were on the national health service’s waiting list for operations that mainly include cataract removals and arthroscopies for the examination and treatment of joints.
The statistics were presented by social policy minister John Dalli in parliament.
Over 5,600 patients are waiting to have a cataract removal, while over 3,700 are on the waiting list for a knee arthroscopy.
Another 2,700 are on the waiting list for knee replacements, 700 for hip replacements, and 400 for gall bladder removals.
Mater Dei Hospital has seen a significant increase over the past year in the number of operations and surgical interventions it carried out.
Over 21,000 surgical interventions were carried out this year until June – 1,445 more over the same six-month period in 2008.
But according to parliamentary statistics presented by Dalli, the frequency of operations for hip and knee replacements and arthroscopies seem to have remained constant. Only cataract removals seem to have been increased, with 225 more extractions taking place over last year.
Dr Josie Muscat, the chairman of the St James private hospital group (and leader of the right-wing Azzjoni Nazzjonali), says the country’s limited resources render the free healthcare system unsustainable.
“It’s useless trying to copy other countries larger in size and wealth. Our national and private systems are flagrantly abused. We in the private sector are struggling. Government costs are escalating fast – meaning more taxes and less money in people’s pockets – and the latter believe they are getting all for free,” Muscat says.
While waiting lists are part of the reality of free national healthcare systems, they also reduce people’s quality of life, making a mockery of the free provision of healthcare.
“Instead of arguing over data and statistics, I would rather sit round a table and seek systems and solutions that suit a small island. We must change or else we’ll suffer. How fast we do either, depends solely on us,” Muscat says.
Dr Frank Portelli, chief executive of St Philip’s Hospital, points an accusatory finger at the system that permits doctors to practice privately, in parallel with their job in the NHS. He says it creates the financial incentive for surgeons to maintain a waiting list.
“The Ombudsman is on record stating that consultants ‘keep a stranglehold on waiting lists’,” Portelli says. “I am in favour of engaging full-time doctors dedicated only to the NHS without the need to work in private practice.”
He praises the creation of one common waiting list at Mater Dei as a move in the right direction: “What we need to see to now is ‘updating’ : to clean up the list, remove patients who have died, and patients entered in more than one list.”
But he adds that waiting lists should not be managed by individual doctors, which he says can lead to conflicts of interest.
He also believes targets should be set for maximum waiting times, as in the UK, which has a maximum 18 weeks’ waiting for most surgical procedures. “Cases would be ranked by a priority system based on progress of disease, disability, dependency, age, loss of ability to work, etc,” Portelli said.
Both doctors make little reference to progress on a public-private alliance to cut down on waiting lists. Muscat has gone on record stating that no progress has been registered on getting private hospitals to cut down the NHS waiting lists.
Portelli proposes taking Mater Dei outside the government stream, to turn it into an autonomous institution. “It would reduce the present bureaucracy. A medical czar, appointed from outside the present structure, would bring fresh ideas to tackle old problems which the present management has been unable to solve.”
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