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Saturday 17 March 2018

Not business as usual

The breakdown of the arrangement for dialysis treatment facilitated by the St Clair Medical Centre highlights the challenges of public-private partnerships. In order for such partnerships to work they must be based on a shared comity which prioritises the welfare of citizens above all else.

According to a report published last week, the private hospital took the drastic step of advising dialysis patients they would have to seek treatment elsewhere due to a pending government debt.

The private hospital is within its rights. Why should such an entity tolerate breaches from the State that would be intolerable in the private sector? Continuing as though it is business as usual risks making the company complicit in any breaches, a matter which will work against its legal interests in a court of law.

No one should have to wait for nine months to be paid what they are entitled. But it must not be forgotten that public-private partnerships are very beneficial for the companies involved. These partnerships provide these entities with consistent levels of business. They also generate goodwill and bring in customers who might otherwise feel unable to access service there.

Any breakdown in cooperation is unfortunate. However, it can only be in the interest of a private entity to preserve its relationship with the State given the long-term benefits. Also, there is a human dimension: this is a matter of life and death.

On the other hand, the State should never abuse its position. While it is understandable that tough economic times will call for cutbacks, the provision of healthcare should be treated as a matter of priority. Surely, dialysis treatment, which is needed in large numbers, is something which should be facilitated.

The State also has an obligation to fulfil its arrangements and to avoid making itself vulnerable to costly litigation.

In the end, both sides must do what is in the interest of patients. Private entities offering sensitive services pursuant to public-private arrangements need to put patients first, exercising restraint and human compassion. Doctors in particular have an oath to do no harm to those they treat. Surely there are many steps than can be taken to enforce a debt that will not involve turning away patients who need care.

And the State needs to stop putting such medical entities in impossible positions. A better job must be done when it comes to timely payment of debts. When it comes to healthcare, it cannot be business as usual.


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