Ian C. Ellul

Last month, the Ministry of Health issued a white paper entitled Ensuring Your Right to Entitlement Medicines at the Time You Require Them. Obviously this has been heralded by the degenerating out-of-stock situation of the POYC scheme which has been accompanying us for several years. At the time of penning this editorial, even the flu vaccine which is distributed freely from health centres is out-of-stock! Although there may be many reasons for this, including mismanagement and abuse, ultimately it is always the patient who is forced to bear the cross.

Before continuing, I would like to explain what a white paper is. Many actually point to the Churchill White Paper of 1922, which clarified how Britain viewed the Balfour Declaration, as the earliest well-known example. White Papers aim to perform the dual role of presenting firm government policies while at the same time inviting opinions upon them. So there you are … you as healthcare professionals are being invited to voice your suggestions. Actually, by the time you read this editorial one hour meetings will have already taken place with the Chamber of Commerce, GRTU and MAM, amongst others.

The 61 page document is fraught with literary terms which if minced thoroughly seem to indicate that with respect to the POYC scheme, the Ministry of Health actually means to take the bull by the horns and empower healthcare professionals and patients alike to effectively tackle the problems. However, as always, (and to be seasonal) the proof of the Christmas pudding is in the eating …   

I will not waste time to regurgitate what has been said in the document. What I wish to recount is a personal experience which highlights the extent to which a lack of communication between the different entities involved in the supply chain of medicines to patients through the POYC scheme can actually deflate stalwart terms such as motivation, goodwill and empowerment, leading to a general disgruntlement amongst healthcare professionals and patients alike.

A patient of mine had both the pink and yellow cards since she is diabetic and also suffers from other chronic conditions. All her medications were automatically transferred onto her yellow card in June of 2012 with her pink card being revocated in the process. Upon phoning all the different entities involved in the supply chain of medicines to patients through the POYC scheme, I was consistently informed that those patients who had their pink card revoked were eligible to reapply and attain again the pink card; however the expiry date for this derogation was 31st May 2013. Upon challenging this date, every entity referred me to a mysterious DH circular; nevertheless no-one was able to give me either the DH circular number or a link to it.   

It was only through an intervention by the Health Minister, Dr Godfrey Farrugia that this saga  finally resolved. Basically, previous diabetic pink card holders who opted for a diabetes yellow card before 1st June 2012 can still revert to the pink card. The patients can telephone the Medicines Entitlement Office (Schedule V office), leave their details and after checking is done, an appointment is made for the patient to return the diabetes yellow card. A note stating that the yellow card was returned is given to the patient so that the Social Security Office issues a new pink card. There is currently no derogation date on this practice.

I wish to conclude this year’s editorial by first of all reiterating the importance of maintaining good communication channels with healthcare professionals. This investment is logically very cost-effective. I wish to augur you and your loved ones a New Year filled with happiness and good health … the only two things which, in my opinion, really matter …