We have been told, in no uncertain terms, by the parliamentary secretary for health that the state’s coffers are not bottomless, and that the state could not afford to pay for everything.
These were Joe Cassar’s comments to criticism made against the government on refusing the cancer treatment drug Herceptin to treat a woman’s relapse. She will now have to find about €70,000 to pay for the medicine, possibly having to sell her house.
Breast cancer victims who cannot pay the average €54,000 a year for a full course of Herceptin, have no option but to give up on the vital treatment. The drug is prescribed to around 35% of breast cancer victims who have tumours that are Herceptin receptive, meaning that the tumours respond positively to the drug. Around 245 women a year are diagnosed with breast cancer in Malta, meaning that Herceptin could save the lives of around 85 of them.
Cassar says there are some €3 million allocated for new medicines, of which not all can go towards medicines demanded by the slick lobbying of the breast cancer lobby. Cassar said it’s a matter of priorities: not all medicines can come for free.
Is the government justified in its reasoning? To cancer sufferers and their families, it’s a logic that does little to assuage the pain of illness, and the uncertain fate of those who have to endure yet again, the devastating effects of cancer treatment.
But it’s also a logic that also opens the government to accusations of the way it deals with the way it handles such healthcare concerns. When the Prime Minister first announced the call for tenders for the supply of the medicine Herceptin, it had already taken six months after first deciding, back in April 2008, to finally provide this expensive drug on the national health service’s medicine list.
Take for example the government’s procrastination when it came to the introduction of a breast-screening programme. The Prime Minister had declared in 2007’s budget speech that a national breast-screening programme would be introduced in 2008 – only to be outed, the next day, by the head of the oncology department that he had not been consulted, and that the resources for the launching of a national breast-screening programme were not available.
Then it was revealed that the government would not be introducing a national cervical cancer screening programme, before the commencement of its breast cancer screening programme, which leaves Malta as one of just two EU member states to lack a screening programme for cervical cancer, along with Cyprus, and with no plans for one either.
In the past, this newspaper has refused to beat about the bush. The reason why such programmes are not available is because of money – money, however, that we know was spent elsewhere and is not available for a life-saving intervention that should be the norm for any EU member state. This newspaper has chronicled a litany of abusive procurement contracts, some for the supply of services to Mater Dei itself, that pay witness to the incredible wastage of resources and money within the health system. The cash is there, but not for interventions that save peoples’ lives. It’s stories like these that bring up the issue of whether it is government’s priorities in the way its finances are managed, that are wrong.
Tied to this is the question of who deserves to make use of the wide array of services our health system offers: we know of patients who get compensated by private insurance firms who take up a bed at Mater Dei Hospital instead of claiming the same service in a private hospital. Will politicians get to grips with investing real ownership of the NHS in citizens? Like Alfred Sant’s much demonised 50c charge on prescriptions for government medicines, will every suggestion to charge a cost for health services fall foul of the malaise that grips Maltese politics? With the Prime Minister going on record he would resign if his government introduces any health costs, one still asks whether the taboo of charging certain health services is still considered taboo in Malta is sustinable in this day and age? The cost of Malta’s healthcare is real, and users must understand the value of the NHS healthcare before availing of the service.
While Cassar defends the government’s decision not to provide Herceptin to relapsing cancer sufferers by saying that the public coffers are not bottomless, one asks where is the justice in the way funds were squandered on direct contracts within Mater Dei. Now that the government has taken the first step in encouraging people to use the primary healthcare network of GPs, it should look into a means testing system for certain basic services to cut down in unnecessary usage and encourage more responsibility in people who do not want to see their money wasted.
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