Issue link: https://maltatoday.uberflip.com/i/634260
maltatoday, SUNDAY, 31 JANUARY 2016 15 Speaking of which: are there any estimates on what impact this sys- tem may have on recurring health expenditure? If we spend half a billion on curing diseases, what sort of cost reduction does he en- visage as a result of prevention? "We're not really looking at this as a means to reduce costs. To us, the priority is to improve the qual- ity of life of the individual. By pre- venting disease we would be able to invest more in other areas, yes, but it's not the main goal. We're looking at cases where people suf- fer from diabetes from age 30 or 40 onwards, for the rest of their lives. Or arthritis, from 55 on- wards. Or cataracts. These are all conditions that affect your quality of life. Look how better that qual- ity would be, if these conditions can be avoided…" Having said that, he concedes that the way medical services op- erate will also be affected. "No matter how good today's medical service may seem in any country, it is ultimately always management-by-crisis. Someone gets sick, and needs emergency treatment. In the future the em- phasis will be much more on pre- vention than cure. This way it re- ally will be a 'health service'…" How close are we to this becom- ing a reality? What sort of invest- ment are we looking at, and how will this venture – of which we haven't really spoken yet – be fi- nanced? "Wait, slow down. At this point we are only discussing possibili- ties. I'm not saying this company is going to set up here next week, or that we'll be signing a memo- randum of understanding…" Have there been discussions with any other companies apart from ICarbonX? "We have spoken to different people… but these seem to be the most cutting edge, and the most interested in working with us…" All the same, assuming an agreement is reached to provide this sort of genetic sequencing technology as part of the national health service – how will the serv- ice-provider be chosen? Will the government issue a call for ten- ders or EOI? "This would be foreign direct investment. If a company does set up here, it would be a private operation, undertaking its own research in Malta. We would enter an agreement to provide the service for Maltese citizens, at our cost. We might go for a private-public partnership, but at this stage, it's too early to say." On the subject of PPPs: we've drifted away from the original question, which concerned re- forms that increasingly seem to rope in the private sector. Isn't this a case of outsourcing, and… going on the experience of other examples of outsourcing in the past… is there any danger that the 'free-for-all' model might be eroded? "No, absolutely not. It remains a government commitment. But let me give an example regarding agreement with private hospitals. The way things were until today was that, if someone needed a hip replacement operation, he or she had only two options: to do it at Mater Dei, but they'd have to wait five or six years; or to do it immediately at a private hospi- tal… and pay for it. "Now, the way we are approach- ing this situation is twofold. One, to improve the service and effi- ciency at Mater Dei so that the waiting lists come down natu- rally; but two, we are also looking at working with the private sec- tor, so that operations are carried out privately but paid for by the government. So we are encour- aging the private sector to invest more and improve its own serv- ices, while providing the capital by paying for their services. Now, you might ask where all this money is coming from…" Judging by earlier answers, I would guess medical tourism… "Up to a point, yes. But it's also a question of using money wisely. The government is committed to keeping the service free, so inevi- tably, it has to pay for it. We're clear on this. But if we work with private institutions… in- stead of building a new hospital ourselves, the hospital would be built privately, using private cap- ital outlay, and we would buy the services at the same cost as if we had built the hospital ourselves. Only without the cost of having to build it…" Dr Fearne sees this as a win-win situation. "We're not pushing people towards private healthcare, as we're still paying for it ourselves. But we are using all the resources the country has to offer." Interview The future of public health will be dominated by Bio-Information Technology: using genetic data to prevent disease rather than cure it. Health Minister Chris Fearne wants to make sure Malta gets to that future first than cure PHOTOGRAPHY BY RAY ATTARD