Tnissil assistit

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L-Ministeru tas-Saħħa ħareġ sejħa għall-offerti biex ikun jista’ jimplimenta l-liġi tal-IVF. Jew biex nitkellmu bil-Malti biex min ma jistax inissel l-ulied b’mod naturali jkun assistit biex dan it-tnissil ikun jista’  jsir.

Il-liġi Maltija dwar l-IVF bit-titlu bombastiku ta’ “Att tal-2012 dwar il-Protezzjoni tal-Embrijuni”  kienet approvat mill-Parlament li għadu kif spiċċa. Din il-liġi tirregola t-tnissil assistit u tillimitah għall-koppji miżżewġa kif ukoll għal dawk il-koppji li għalkemm mhux miżżewġa huma f’relazzjoni stabbli.  Il-liġi hi ċara għax fid-definizzjoni ta’ ġenitur prospettiv (artiklu 2 tal-liġi)   titkellem fuq koppja magħmula minn żewġ persuni ta’ sess oppost.

B’mod ċar mela il-liġi tiddiskrimina kontra koppji ta’ l-istess sess u m’hemm l-ebda dubju li attakkata fuq kriterji ta’ drittijiet umani, u preċiżament fuq il-fatt li tiddiskrimina  jkollha tinbidel b’mod li d-diskriminazzjoni li hi parti intrinsika tal-liġi titneħħa.

Li titneħħa d-diskriminazzjoni mill-liġi jkun pass tajjeb. Il-kontroversja iżda m’hiex ser tisparixxi meta titneħħa d-diskriminazzjoni. Għax id-diskriminazzjoni jkollha titneħħa f’data mhux il-bogħod. Imma mbagħad ikun meħtieġ li niffaċċjaw diversi materji ta’ kontroversja relatata. Irridu nibdew naħsbu dwarhom.

 Kif għandha tkun regolata d-donazzjoni taż-żerriegħa tar-raġel jew tal-bajda tal-mara ? Direttament bejn il-partijiet konċernati b’mod li tista’ tagħti lok għal abbuż?  Permezz ta’ bank għal dan l-iskop?  Bi ħlas jew bi pjaċir?

Xi drittijiet għandu jkollhom il-ġenituri bioloġiċi? Jiena naħseb li l-ġenituri bioloġiċi għandhom jagħtu l-kunsens tagħhom qabel ma jsir it-tnissil fil-laboratorju. Mhux sempliċement jagħtu ż-żerriegħa jew il-bajda. Mhux dan biss. Għandu jkun hemm informazzjoni sħiħa dwar l-identita’ tal-persuni involuti. Mhux informazzjoni pubblika imma informazzjoni li għandha tkun magħrufa bejn il-ġenituri bioloġiċi, l-ġenituri prospettivi u eventwalment l-ulied. M’hemmx lok għal anonimita’. Id-donazzjonijiet taż-żerriegħa tar-raġel u tal-bajda tal-mara jridu jsiru b’mod trasparenti biex kull min ikun involut ikun jaf x’inhu jagħmel u b’hekk jerfa’ sewwa r-responsabbiltajiet tiegħu/tagħha. Dan hu essenzjali l-iktar in konnessjoni ma’ mard ereditarju.  Jiena konxju li dan iwassal għall-argument dwar jekk hux etiku li nagħżlu l-ġenetika tal-ulied għax fil-prattika dan hekk ifisser. Imma din hi l-konsegwenza loġika tal-IVF miftuħa għal kulħadd.  It-tnissil tal-ulied a la carté. Punt li ma jqumx direttament bejn koppji miżżewġin jew koppji f’relazzjoni stabbli.

Hemm imbagħad l-issue tas-surrogate motherhood. Jiġifieri l-ħtieġa li mara tislef jew tikri ġufha biex twelled tarbija li m’hiex tagħha għal ħtieġa ta’ ħaddieħor.  Fil-kuntest wiesa’ tal-applikazzjoni tal-IVF din hi miżura li tista’ tkun meħtiega biex mara jkollha l-ulied (li anke jkunu bioloġikament tagħha) kif ukoll jekk l-IVF tkun tapplika għal koppji tal-istess sess.

Kif għandu jkun regolat dan is-self jew il-kiri tal-ġuf?  Dan mhux sfruttament?  Imma fl-istess ħin mingħajru l-IVF ma tistax tkun verament aċċessibli għal kulħadd.

M’għandix tweġibiet għal dan kollu. F’pajjiżi oħra d-diskussjoni bdiet. S’issa f’Malta ta’ l-inqas fil-pubbliku għad ma bdietx.

L-ebda wieħed mill-partiti politiċi f’Malta għadu ma tkellem fuq dawn l-affarijiet. Għalkemm f’ Alternattiva Demokratika iddiskutejna xi ftit internament is-suġgett l-anqas AD għad ma ħadet posizzjoni. Imma ma nistgħux nibqgħu naħarbu minn dawn l-affarijiet għax l-introduzzjoni tal-IVF ser twassalna inevitabilment biex niffaċċjawhom. Ikun aħjar jekk inkunu ippreparati.

kif ippubblikat fil-blog ta’ iNews it-Tlieta 10 ta’ Settembru 2013

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Ministru hands-on !

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L-Ministru tas-Saħħa t-Tabib Godfrey Farrugia għandu uffiċċju fl-Isptar Mater Dei, ħdejn l-emergenza. Iħoss il-ħtieġa li jkun hemm viċin biex ikun jista’ jevalwa l-problemi.

X’inhu xogħol il-Minstru?  It-Tabib Farrugia jidher li jaħseb li xogħolu hu ta’ Manager li mexxi “day to day”. Mhux l-ewwel wieħed li ħasibha hekk. F’pajjiż żgħir bħal tagħna nifhem li l-politku, billi ħafna drabi bhu f’kuntatt dirett man-nies iħoss l-obbligu “politiku” li jintervjeni b’mod li jidher biex ikun jista’ jagħti sodisfazzjon immedjat lill-votant.

Imma allura x’inhi l-funzjoni tal-Management tal-isptar? Għax jekk il-Ministru jħoss il-ħtieġa li jkun viċin il-problema l-konklużjoni loġika hi li l-management jew qiegħed hemm għal xejn inkella mhux jagħmel xogħolu kif meħtieġ! Jiġifieri iktar minn kamra għall-Ministru hemm bżonn li kulħadd jerfa’ r-responsabbiltajiet tiegħu.

Ir-rwol tal-Ministru m’hiex ta’ sehem dirett fit-tmexxija tad-Dipartimenti li għalihom hu responsabbli. L-anqas ma hi sorveljanza diretta tal-ħidmiet diversi fil-Ministeru tiegħu. Hi li jagħti direzzjoni politika u li joħloq l-istrutturi neċessarji biex ikun possibli li l-politika tal-Gvern tal-ġurnata titwettaq.

M’għandix dubju mill-intenzjonijiet tajba tal-Ministru Godfrey Farrugia. Imma anke Austin Gatt kien Ministru hands-on! ir-riżultati ta’ Gatt nafu bihom ilkoll.

A case of bad governance

The full process leading to the agreement whereby St Philip’s Hospital is leased to the Government with the option to purchase requires careful examination. Even after Monday’s parliamentary debate, the information is substantially under wraps with only small snippets having been made available to date. The little that is known however, already points towards bad governance.

The Government opted to start negotiations with the owner of St Philip’s Hospital late in 2008, that is four years ago. Commencing negotiations relative to St Philip’s Hospital signifies that alternative sites and options were being excluded: alternative sites were ignored, considered as not being suitable, or as being less suitable than the site under consideration.

The Minister for Health said in Parliament that it would require just under €40 million to rehabilitate St Luke’s Hospital. What the minister forgot to consider was that a basic rule for comparative statements is that, for the comparison to be of any significance, one has to compare like with like. You cannot compare what is required for a 1,000 bed hospital to justify the relative smallness of the sum required relative to a 75-bed or a 110-bed hospital.

The cost to rehabilitate St Luke’s is obviously substantially higher than anything related to St Philip’s. Such comparisons are deceptive. Moreover, parts of St Luke’s are no longer available as they are being used for other purposes.

The potential use of St Luke’s was discarded when negotiations started way back in 2008. If St Luke’s was then considered as suitable, the Rehabilitation Hospital would be up and running by now, saving millions of euros and lots of time. It could have been operational at least three years ago. As a result, it would have been possible for medical personnel at Mater Dei Hospital to deal more appropriately with patients because overcrowding there would have been substantially reduced three years ago, at least.

This is one of the issues which the Auditor General should consider when he examines the process that led to the Government’s decision. I understand that detailed reports are existent. It would be appropriate if these are immediately made available for the consideration of the Public Accounts Committee and the Auditor General.

It should also be considered whether the Government acted correctly when it opted to initiate direct negotiations with one hospital operator to the exclusion of other suppliers of potentially suitable sites. The fact that the Government is not legally bound to issue a call for tenders does not signify that it is good practice to start the process without such a call or, alternatively, with a request for the submission of expressions of interest. The Government, instead, inversed the process linking itself with a call for an expression of interest issued by the owner of St Philip’s!

The tendering procedure is a basic characteristic of public sector procurement so much that even local councils are expected to issue such a call when leasing or purchasing property. Why is it that the Finance Ministry insists on good practice at a local level but then opts for bad practice at a national level? The reasons brought forward by the Government to justify direct negotiations are equally applicable at a local level, yet the ministries of finance and local government justifiably insist on the tendering procedure.

In view of the above, Franco Debono (actively supported by Jeffrey Pullicino Orlando) is insisting that the agreement reached should be shelved until such time that the Auditor General and the Public Accounts Committee of the House of Representatives have examined the whole process.

In view of the seriousness of the matter, that is the possible overriding by Parliament of the Executive’s discretion, the honourable way for the Leader of the House was to deal with the motion submitted by Debono with urgency. It should take precedence over all the Government’s business as it strikes at the most basic of uses.

When documentation is submitted for the Auditor General’s scrutiny there is one particular scrap of paper that I will look out for. This is the advice dished out by the Malta Environment and Planning Authority indicating the possibility to consider an application for the increase in beds at St Philip’s to about 280.

A quick visit to the site of St Philip’s would remove all doubts as to the suitability of the site because it is clear that there is hardly sufficient parking space for the hospital’s current size. The only remote possibility for increasing the facilities at St Philip’s in my view is to redevelop it completely, in which case, costings made have to be calculated afresh. And I have serious doubts whether this can be done.

As I see it, there is no way in which St Philip’s can function as projected. Public funds invested in this project would be monies down the drain. Hence the need for the intervention of the Public Accounts Committee and the Auditor General before the deal is concluded.

 

published in The Times of Malta, Saturday 20th October 2012