7 - 13 September 2000

Revising medical tariffs 'not a solution' - health minister Louis Deguara

by David Kelleher

Revising the medical tariffs is not a solution to solve the issue of medical professions charging different prices for their services, the Minister of Health, Dr Louis Deguara, has said.

In an interview with Insurance Quarterly magazine, which is being published today with The Malta Business Weekly, Dr Deguara said that everyone is aware that the tariffs stipulated in legal notice 1 of 1960 are fictitious.

"Today everyone is conscious that the tariffs are fictitious. The legal notice says that a normal house visits costs around five shillings, which is certainly not the case today," Dr Deguara said.

He added: "Different ministers were faced with the same problem over the years. Revising the tariffs is not a solution. One of the concepts of competition is that you have different prices. If a doctor charges Lm5 for a visit and another charges Lm2, no one will go to the former."

Despite numerous complaints from the public, very few formal complaints have been lodged with the Medical Association of Malta, he said.

"The MAM cannot act on its own initiative but must receive a formal complaint. But no one does. The problem will not be solved by introducing tariffs," Dr Deguara said.

With regards to private health insurance policies, he said the government, as stated in its electoral programme, believes in the private sector giving a service that complements that given by the government.

"The advantages of a private health scheme is that it increases the availability of hotel

services in our hospitals. No one criticises the level of health available but the lack of privacy, that catering is not up to standard, and there aren't flexible visiting hours," Dr Deguara said.

"The infrastructure of St Luke's does not allow this concept to be introduced, however we have tried to address these problems. Certain wards and sections have been redesigned bearing in mind these needs. We have single rooms with private bathrooms, nursing quarters, and so on. People go to a private hospital because they have a better chance of getting this service.

"The government is studying how it can encourage people to take up private policies and the removal of the 10 per cent tax on private policies was one way," he added.

Asked what major problems were facing the local health sector, the minister said: "It is no use beating about the bush. One of the major problems facing health systems the worldover is sustainability of health expenditure. To give an example, if in the past 100 heart operations were performed for free, and this has gone up to 300 today, costs have gone up as well. In 1995, Lm6m were allocated for medicinals. This year it is estimated to go up to Lm17m."

He stressed however that increasing or introducing new taxes was not a solution. However streamlining the service and cutting down on waste was necessary.

"Everyone is aware of the fact that there is too much waste. The government's plan is to introduce management systems that cut down on waste and make people accountable and responsible in what they do. When we introduced a similar system at the laundry we immediately had a positive result.

"Without anyone losing their job, we set up a cooperative and reduced the workforce by half. However, efficiency went up by 300 per cent, the workers were much happier and took more pay home.

"We received no more complaints. All in all, the laundry started saving up to Lm400,000 a year. If this was possible in the laundry, it should be possible in other areas too," Dr Deguara said.