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maltatoday | TUESDAY • 15 OCTOBER 2019 17 maltatoday MaltaToday, MediaToday Co. Ltd, Vjal ir-Rihan, San Gwann SGN 9016 MANAGING EDITOR: SAVIOUR BALZAN EXECUTIVE EDITOR: MATTHEW VELLA DEPUTY EDITOR: PAUL COCKS Tel: (356) 21 382741-3, 21 382745-6 Website: www.maltatoday.com.mt E-mail: dailynews@mediatoday.com.mt EDITORIAL maltatoday | TUESDAY • 15 OCTOBER 2019 17 14 October 2009 Cataracts, knee repair top waiting list of 13,000 OVER 13,000 patients were on the national health service's waiting list for operations that mainly in- clude cataract removals and arthroscopies for the examination and treatment of joints. The statistics were presented by social policy minister John Dalli in parliament. Over 5,600 patients are waiting to have a cata- ract removal, while over 3,700 are on the wait- ing list for a knee arthroscopy. Another 2,700 are on the waiting list for knee replacements, 700 for hip replacements, and 400 for gall bladder removals. Mater Dei Hospital has seen a significant in- crease over the past year in the number of opera- tions and surgical interventions it carried out. Over 21,000 surgical interventions were car- ried out this year until June – 1,445 more over the same six-month period in 2008. But according to parliamentary statistics pre- sented by Dalli, the frequency of operations for hip and knee replacements and arthroscopies seem to have remained constant. Only cataract re-movals seem to have been increased, with 225 more extractions taking place over last year. Dr Josie Muscat, the chairman of the St James private hospital group (and leader of the right- wing Azzjoni Nazzjonali), says the country's lim- ited resources render the free healthcare sys-tem unsustainable. "It's useless trying to copy other countries larger in size and wealth. Our national and private systems are flagrantly abused. We in the private sector are struggling. Government costs are escalating fast – meaning more taxes and less money in people's pock-ets – and the latter believe they are getting all for free," Muscat says. While waiting lists are part of the reality of free national healthcare systems, they also reduce people's quality of life, making a mockery of the free provision of healthcare. "Instead of argu-ing over data and statistics, I would rather sit round a table and seek systems and solutions that suit a small island. We must change or else we'll suf- fer. How fast we do either, depends solely on us," Muscat says. Dr Frank Portelli, chief executive of St Philip's Hospital, points an accusatory finger at the sys- tem that permits doctors to practice privately, in parallel with their job in the NHS. He says it creates the financial incentive for surgeons to maintain a waiting list. "The Ombudsman is on record stating that consultants 'keep a stranglehold on waiting lists'," Portelli says. "I am in favour of engaging full-time doctors dedicated only to the NHS without the need to work in private practice." He praises the creation of one common wait- ing list at Mater Dei as a move in the right direc- tion: "What we need to see to now is 'updating' : to clean up the list, remove patients who have died, and patients entered in more than one list." But he adds that waiting lists should not be managed by individual doctors, which he says can lead to conflicts of interest. He also believes targets should be set for maxi- mum waiting times, as in the UK, which has a maximum 18 weeks' waiting for most surgical procedures. "Cases would be ranked by a priori- ty system based on progress of disease, disability, dependency, age, loss of ability to work, etc," Portelli said. MaltaToday 10 years ago Raising the green bar Editorial BUDGET 2020 pulls the levers and presses the buttons to ensure the economy contin- ues run-ning while spreading out the wealth. It is an exercise in continuation that is expected to deliver another surplus in gov- ernment finances next year, and bring down the debt-to-GDP ratio to 40%. These are important numbers because they ensure the government has room to manoeuvre if the clouds start to mushroom over the economy. More importantly, the surplus will still be achieved even when the portion of funds from the Individual Investor Programme that are accounted for in ordinary income, are removed from the equation. The measure to overtime at 15% for those on a basic pay of not more than €20,000 is ex-pected to leave more money in the pock- ets of those with modest and low wages. Similarly, the income tax refund, the new baby bonus, the wider parameters for first- time property buyers, and the increase in pensions, will provide a financial impetus to many fam-ilies. How significant that impetus is will de- pend on inflation. The government has en- sured, for the third year running that there will be no tax and excise duty increases, which helps miti-gate inflationary pressures. The introduction of a one-off bonus to make up for higher milk prices announced this year by the only Maltese dairy company partly mitigates the spending erosion, espe- cially for families on the lower rungs. But while these measures and others are targeted to help families keep up with the pace of economic growth, Budget 2020 also provides a blueprint for environmental sus- tainability by including several measures intended to address climate change. A decision on the cut-off date by when to stop the importation of combustion engine cars, is now expected next year. This is argu- ably one of the biggest decisions that need to be tak-en but one with commercial and social impacts that cannot be ignored. Free public transport, which will continue being available for young people, will be extend-ed to people 75 and over. This rep- resents a slow transition to a radical propo- sition to make public transport free for all users. The individual climate initiatives are inter- esting and some provide tangible, immediate benefits, such as changing the lighting in public squares, to make them self-sufficient through renewable energy. The €200,000 incentive to contractors to invest in environmentally friendly machinery that decreases pollution, is another tangible benefit, as will be the roofing over of the Santa Venera tunnels exit that will be con- verted into a green open area in a congested urban envi-ronment. Government could have been bolder in some aspects such as targeting the use of private cars, which remain the single biggest source of harmful emissions. Increasing the driving age to 21 would give the country re- prieve, while fostering a generation of public transport users. The government could have extended free public transport to pensioners over 65, cou- pling it with an incentive for elderly people to give up their driving licence. It could have been bolder on urban green- ing by changing planning policy to ensure new buildings retain gardens and large back- yards to allow breathing space within the built-up environment. However, it has to be noted that the cli- mate initiatives in the budget have set the bar. It may still not be high enough but it is important that every budget in the coming years in-cludes measures that target climate change. Going back is not an option. Financial resources have to be directed towards battling this global phenomenon, not least to ensure equity when addressing key issues that may impact those on lower incomes more than anyone else. Budget 2020 sets the tone but it will be fruitless unless there is the political will to go for the green paradigm shift in our life- time. This shift will require recalibrating how we envisage economic growth, to take into account mental, social, and environmental wellbeing. Malta may be a small country with an insignificant carbon footprint on the world stage but nonetheless, taking measures to address climate change will benefit our com- munities through cleaner air, and a healthier environment.