- Malta seeking ISO classification prior to health tourism push
- More streamlined registration process for third-country health professionals
- Obesity: Malta Presidency to push EU-wide food procurement guidelines for schools
- Malta to be promoted as hub for clinical trials, detailed genetic profile of Maltese population in the pipeline
- Robotic operation for Mater-Dei hospital pharmacy
As Malta starts to successfully address longstanding issues in the health sector including waiting lists for operations and out-of-stock medicines the country is now ready to take the next step in turning the sector around. Infrastructure projects and joint ventures with private companies are opening new avenues including health tourism that coupled with a good dose of research and innovation can turn the NHS from a contentious policy issue to a poster boy for Malta’s new economic age. This is the background to MaltaProfile's discussion with the countries Health Minister, Mr Chris Fearne.
What were Government's achievements in this sector since the start of this legislature to date?
The plan was to tackle the major issues faced by the sector and starting to build on our vision of positioning Malta as a centre of medical excellence.
One of the major problems that we had was a lack of supply; out of stock medicines, long waiting lists, lack of medical space in our hospitals, long waiting times at the emergency department. We started off by tackling all of these.
Out of stocks medicines are now a thing of the past. We've increased the number of acute beds on the island, and we now look after our patients in high quality and high standard beds. We have drastically decreased waiting lists for cataract, orthopaedic and vascular surgery and regular interventions like MRI’s and CT scans.
We have also decreased the average waiting at the Accident and Emergency department from an average of 13 hours to less than 4 hours, 90% of our patients are served within less than 4 hours. Decreasing appointment times for our patients is one of our targets for 2017.
CO-ORDINATION: Accident and Emergency department waiting time decreased from an average of 13 hours to less than 4 hours
Apart from these accomplishments, the main news in the sector has also been the Private-Public-Partnership deal on the running of three major hospitals. Can you give us some insight into the project?
Four years ago, we had one or two good hospitals. We had three or four other hospitals which were of a much lesser standard.
So, we embarked on refurbishment and rebuilding of three of our main hospitals: the Gozo General hospital, St Luke’s hospital and Karin Grech hospital. This is an ongoing project with our partners Vitals Global Healthcare (VGH). Partners Healthcare International (PHI) who run the Harvard medical hospitals in Boston are also on board with us.
The project shall enable us to offer high-quality free service across the board for all our Maltese patients. Sustainability is one of our key priorities. This is where the concept of medical tourism comes in play. Private entities through their capital expenditure would have acquired increased capacity that can service both our citizens but also paying foreign patients. We are currently looking at obtaining ISO classification, which is central in having foreign insurance companies covering our services. The plan is to have this within the next few years.
on Health Tourism
"We are currently looking at obtaining ISO classification, which is central in having foreign insurance companies covering our services."
A health tourism industry will also need more nurses and doctors. What's the status at the moment in terms of attracting more foreign doctors or carers?
Our job vacancies are advertised across the whole of the European Union, and European candidates go through the same selection process as Maltese applicants. As we are expanding our services so rapidly and because like other countries we had a chronic lack of nursing staff, we are also looking for third-country applicants.
In 2018, we plan to open our new nursing school. We want foreign students to come to Malta, learn the system in Malta and then provide their services here which is way easier than attracting a working professional to relocate.
We are also in discussions with the Malta Medical Council in order to implement a more streamlined registration process for third-country nationals.
Is the involvement of the private sector in Malta’s health sector limited to the partnership on the three hospitals? Is there room for more substantial investment?
There are several other private hospitals opening up. The St James Hospital Group has just opened a new eye clinic in Birkirkara, St Thomas Hospital opened in Qormi and other hospitals are in the pipeline. We are also working closely with private GPs, dentists and pharmacists.
For instance, the Health Ministry is buying services from doctors to look after some of our mental health patients or to provide follow-ups to our cancer patients. Such patients would see a private doctor but the services are paid for by the government. In the case of dentistry, people can have fillings, of course, booked through the health service and that service is paid for by the government.
This means that we are utilising all the country’s resources. We are giving a better service, and we are bringing service closer to the community.
The philosophy is that of having the private sector invest in the capital expenditure and Government buying the services. This is already the modus operandi for orthopaedic surgery, ENT surgery and other interventions.
We're also collaborating with NGOs. Case in point is the project we launched together with the Richmond Foundation, for a hostel that can be used by mental health patients who can live within a community but need accommodation.
Preventing diseases and promoting a healthy lifestyle are important to achieve good standards of health within a population. What is your assessment of Malta’s situation?
We are very conscious that we have to up the game when it comes to prevention. We have a high level of obesity in Malta, which is a precursor for other non-communicable diseases like diabetes, heart disease and cancer.
We are actively looking at improving our people’s lifestyles. For instance, 90 new lifestyle clinics have been opened across all of Malta and Gozo where individuals can go to receive professional advice on how to eat and what to eat. About 1,500 clients have applied for these sessions over the course of a few months.
on Obesity in Malta
"90 new lifestyle clinics opened across all of Malta and Gozo with 1,500 clients applying for these sessions"
We're also collaborating with industry to reformulate food in order to decrease high levels of salt, sugars and fatty acids. We think this should be a voluntary process rather than imposed by governments. For instance, last year one of the major bakeries decreased the salt content in their Maltese bread by 35%. This will have a significant impact on reducing the levels of hypertension in our population when considering that 22% of Maltese are affected by this condition that increases the risk of stroke and heart disease.
PERCEPTION TURNAROUND: Malta hasn't shied away from admitting its problem with child obesity. On the contrary, the Ministry is using Malta's EU Presidency to showcase new national policies which can be replicated across Europe.
Furthermore, childhood obesity is one of our priorities for the European presidency. We are working on a set of voluntary food procurement guidelines for schools. This shall be presented during our Presidency and will have a European-wide distribution. In Malta soft drinks, sugary and high-fat content and high salt content foods are banned from schools.
In relation to screening, we've expanded both breast, colon and rectal screening while also introducing cervical screening in 2015.
Health centres remain the first health touch point in the majority of our communities. What’s the vision here?
Over the years, a lot of these health centres have been neglected. We are now working closely with local councils to refurbish these buildings while rolling out health clinics in more villages. Opening times have been extended, amenities have increased, while more services, such as immunisation, have been added.
PRIMARY HEALTHCARE: Community healthcare needs a shake-up. The new Paola health centre shall act as a small hospital and ease the pressures experienced at the national hospitals.
By the end of 2017, we'll have a new functioning health centre in Kirkop which will cater for another 25,000 people. We're also working on plans to have a large regional centre in Paola, which will cover the southern part of the island. The Paola facility will be bigger than today's health centre but still not as large as a hospital. It will have speciality clinics, an ambulance bay and an operating theatre.
Moving onto life sciences. It seems that while we do have a life sciences park, this sector is not reaching its full potential. Do you agree?
We need to increase drastically the amount of medical research conducted in Malta. In fact, we believe that Malta can be a centre for clinical trials as we have very good data collection and a small population, but a population which is served centrally. These conditions are ideal.
There are two methods by which this can be accomplished. We can either use our existing facilities or have purpose built facilities which will cater for the research community. There is a strong base at the Malta Lab Sciences Co-op which we intend to continue developing together with Malta Enterprise. There is scope for pharmaceutical companies and investors as well as clinical institutions to invest in Malta.
We are also looking at the very strong possibility of having a cyclotron in Malta, which would allow research on cancer drugs and dermatology drugs to happen here. Not to mention that we will also give our all to try and relocate the European Medicine Agency (EMA) to Malta. The giant EU agency is currently looking for a new home as it must move out of London upon Brexit.
We are also exploiting scientific advancements to provide better care here at home. Going forward, we will see further developments in the realm of personalised medicine. Instead of treating diseases, we will be treating patients with diseases, and every individual patient with the same disease will be treated differently. Therefore, we are working with the University of Malta to create a detailed genetic profile of the Maltese population. With the new generation of sequencing, it will become easier to tailor treatment for each individual patient.
on a post-Brexit scenario
"We will also give our all to try and relocate the European Medicine Agency to Malta"
What are your plans in relation to e-Health?
We already have a series of electronic records for our patients; from entitlements to blood results, x-ray results and medical summaries. These are centralised, and each and every patient has a unique identifying number, which is their ID card number. These records can be accessed at any point within the health service. We're now working to have a more detailed electronic patient's record available.
We've also launched the first version of our e-prescribing mechanism, which will decrease not just the amount of time that doctors spend writing prescriptions but also waste as patients will be getting the exact medicine and dose that they need.
We're also implementing a robotic system at the main hospital’s pharmacy. Instead of having pharmacists put medicine into packets and trays, this will now be packed by a robot. This system will also decrease waste and errors.
What are your main targets now that we're nearing the latter end of the legislature?
Our plan was to start by addressing problems we have inherited, which we now have successfully managed, and then focus on new projects. However, our next target would be to improve our mental health services. Our mental health hospital is now too old, and we need to come into the 21st century with regard to mental health. Therefore, we need to increase and strengthen community mental health services, but we are also planning for a new acute mental health hospital.