28 June 2006

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Business Today

Maltese health system ranks 13 in consumer index

Matthew Vella

Malta achieved a mid-table ranking in a consumer index of Europe’s best healthcare systems, a controversial readjustment of its status as the world’s fifth best health service according to the World Health Organisation.
On Monday, Swedish think-tank Health Consumer Powerhouse said Malta’s healthcare performance was “technically… not too bad”, after it placed thirteenth among Europe’s 25 members, saying the island’s healthcare was found lacking in consumer rights and access to communication with authorities.
HCP added that consumers in Malta lacked access to new medicines, and were very prone to MRSA infections at hospitals. The think-tank recommended that Malta ensure that everyone had access to life-saving medicines, adopt a law on patients’ rights, and curb the “rather bad situation on MRSA”.
The Euro Health Consumer Index (ECHI) was based on five indicators, namely patient rights and information, waiting times, mortality rates, the “generosity” of healthcare systems, and pharmaceuticals.
Malta scored particularly low in patient rights for lacking a patients’ rights law, fault malpractice insurance, a patient ombudsman, and access to one’s own medical record. On the upside, Maltese consumers had round-the-clock information dealing with medical questions.
Malta gained positive points on having same day service from family doctors, direct access to specialist care, and treatment of 90 per cent of its cancer patients within 21 days. Only six EU countries, Belgium, France, Germany, Lithuania, Luxembourg, and Switzerland, managed to provide the same service.
Knee/hip joints and heart bypass operations took longer, with 50 per cent of patients being treated after 90 days.
A remarkable susceptibility to MRSA infection of over 20 per cent, sourced from the European Antimicrobial Resistance Surveillance System, also confirmed Malta’s high incidence of MRSA.
Malta scored high points for its provision of cataract operations, infant polio vaccination, and dental care as part of its public service.
It scored lower points on pharmaceuticals, claiming the speed of deployment of novel cancer drugs was slower than the EU average, and access to new drugs took over 300 days, referring to the time taken between registration of the drugs and an inclusion in the subsidy system.
According to the report, the national scores reflect “national and organisational cultures and attitudes”, rather than how much is spent on healthcare.
The Maltese healthcare system remains commended for its comprehensive coverage for all citizens, offering innovative services free of charge to all those who require them, despite its small size. The major challenges facing healthcare in Malta are ensuring sustainability, developing micro-efficiency but also building mechanisms to measure
quality and outcome.
In a statement, HCP project manager Arne Björnberg said the EU’s public healthcare systems were poor at measuring what they do and how well. “Their measuring capacities are very weak, especially compared to the United States,” Björnberg said.
The 2006 index, drawn together from publicly available statistics and from interviews carried out by the private Swedish company, lists France’s public healthcare system as the most user-friendly, “with a technically efficient and generously providing healthcare system”. France scored 576 out of 750 maximum points.
The Dutch, German and Swedish systems closely follow the French one. Estonia and Slovakia gets the highest ranking in the category “value for money”.
HCP president Johan Hjetqvist said there was room for large improvements in every healthcare system. According to the index, only four EU countries out of 25 offer some kind of provider catalogue and three out of four national systems cannot treat your cancer within three weeks.
Every second country blocks the patient’s access to her own medical record and two out of three governments delays the introduction of new pharmaceuticals into the reimbursement system.


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