Sociologist from Malta

Tuesday, November 06, 2018

Patient-centred health - Michael Briguglio

Times of Malta, 5 November 2018

A couple of years ago the Labour government introduced the National Patient’s Charter of rights and responsibilities. Undoubtedly this was a step forward in Maltese policymaking, but perhaps the time has come to verify shortcomings and possible improvements.
The charter says it covers “people receiving care within the Maltese healthcare system and provides information to underpin the provision of safe and high-quality care, and to support a shared understanding of the rights and responsibilities of people receiving care”.
It is structured around eight principles, namely health protection, access, information, participation and informed consent, privacy and confidentiality, dignity and respect, safe healthcare, and comments and complaint. The principles are all noble: indeed, it should be verified whether they are always being put into place.
I am saying this because it seems to be the case that there is a lack of proper institutional backing and authority to implement them. Two years down the line, Malta should have a process which ensures that there are proper checks and balances to implement the policy.
Besides, the charter should be extended to public and private health centres and clinics, thus ensuring that patients, professionals and practitioners have their rights and responsibilities protected and in place.
The spirit of the charter should also be extended to other sectors of policymaking in Malta, whether generic or specifically related to heath.
For example, it would be a big step forward if health aspects are mainstreamed in different sectors such as those related to development projects. In this regard, proper consultation should be carried out with health authorities and civil society representatives, for example on infrastructural projects and other Planning Authority applications.
Malta has a good precedent with respect to access for persons with disability. One question comes to mind in this regard: are stakeholders such as the Environment Health Directorate being consulted by the Planning Authority?
The spirit of the charter referred to above should also be applied with respect to Malta’s Council for Health. This body is established by law, but its functions are unclear to the public. It should also include a patients’ representative. Is civil society being consulted on whom to appoint?
I also believe that more importance should also be given to patients’ needs by authorities when applying for EU funds. Areas such as non-discrimination, empowerment and access to digital health could be delved into, together with more standard and equally important applications in areas such as research and evidence-based policymaking.
Some everyday examples come to mind in this regard. Are we sure that EU citizens, third-country nationals, socially excluded persons and ‘invisible’ minorities are adequately informed about their rights and responsibilities? Is digital health accessible to different social groups in terms of internet literacy?
Can the erstwhile positive MyHealth digital system, which gives access to one’s public health data to private family doctors be extended to other areas? For example, why is it that expectant mothers must rely on a manual blue card during and following their pregnancy without having a digital counterpart?
The mainstreaming of patients’ rights should also be ensured in Malta’s upcoming strategic plan for healthcare 2020-30.  This strategy was mentioned in Budget 2019 and is said to also include sectors such as mental healthcare and genetics.
I hope that the current lack of information in this regard is due to government plans to consult thoroughly. It is positive that the government is stating that it values evidence-based policymaking.
I therefore augur that a wide range of experts from the medical, natural and social sciences are consulted together with the various representatives of civil society, governance structures and public and private sectors. Access, sustainability, equity, efficiency, transparency, rights, responsibilities and other values should be taken into consideration accordingly. There should also be a proper audit trail of public consultation.
Finally, I also believe that Maltese society deserves a proper dialogue on what ‘patient’ refers to. For example, are patients just the persons using a hospital, or are there many ‘invisible’ or latent patients who are not so visible in the public sphere? The European Charter for Patients’ Rights published by the Malta Health Network and the Active Citizenship Network is a very important point of reference.

1 comment:

Jon Camilleri said...

my vision for healthcare is that it needs to focus on medical research possibly with artificial support so it manages to extend the quality of life where quality of life in my opinion has a wider definition in terms of social well-being and poverty issues, a global problem.