SPEECH DELIVERED BY THE HON. LOUIS DEGUARA, MINISTER OF HEALTH, AT THE WHO WORLD HEALTH ASSEMBLY, HELD IN GENEVE

Mr. President, Director General, Fellow Ministers and colleagues,

We note with satisfaction and support the continuing efforts to make the WHO a more focused organization with a clearer vision and direction. The four strategic directions chosen for the next general programme of work are well thought out, as are the organization-wide priorities that match very closely my own country's health priorities.

Malta too has recently been working very hard, continuing to reform, the basis of the national public health services. We are finalizing our plans for the total restructuring of the Ministry of Health that will enable us to move on to the next phase of the reforms – the phase where the government ceases to be a direct provider of health care services and becomes a purchaser and regulator of services. We are confident that this will increase the focus on the quality and efficiency of the services given while at the same time, improve the motivation and work conditions of the providers. The mechanisms for contracting out, including the executive structures who will manage the systems have been established.

We are also revising most of our basic public health legislation to bring us closer to our client's expectations and needs. At the same time Malta is also deeply involved in the accession negotiations for membership in the EU.

We have been collaborating with the WHO Euro office and have undergone an external review of the health system under the ‘Investment for Health' initiative. This Health Appraisal was carried out by external reviewers who were seeking to make recommendations on how best to shift the balance of investment from health care to health. We are expecting the finalised report from the WHO and I hope that I shall soon be able to formally present the main recommendations to parliament's Social Welfare committee. These mainly call for a more holistic approach to health, the need for mechanisms to increase the multisectoral involvement, the importance of partnerships in health and the importance of funding adequately such programs as health promotion and health education. I firmly believe that we must bring the message home that the major health gains are not to be achieved, as the public increasingly demands, by investing in the more costly high technology curative interventions. If we really want health, we must be ready to alter those lifestyles, habits and beliefs that we now know lead to ill-health.

With regards to this year's main theme, we echo the WHO's feeling that for far too long mental health, this significant cause of morbidity world-wide, has in the past not been given the attention it deserves. We strongly endorse your direction putting mental health in the forefront.

We have been very active in improving the quality of care for those persons suffering from this disease. While making structural as well as therapeutic improvements in our mental hospital, we have ensured that in our new modern general acute hospital which is currently being built, all the necessary facilities for the management of all acute cases of mental disease are available. This will not only ensure that such sufferers are treated in a more humane manner, side by side with patients suffering from physical ailments but we strongly believe that this will in addition facilitate the early return of these persons to their families, loved ones and communities; reduce the risk of institutionalisation, and eliminate their stigmatization. Learning from the experiences of other countries in this field and following the guidance of WHO, we have devised a comprehensive Community Mental Health Strategy which aims to expand a multidisciplinary approach to mental health care and to create a seamless service from hospital to half way house to hostel, to sheltered housing, to units of independent living and to the families and other carers. We hope that this will not only contribute to further reducing the population of patients currently in our mental hospital, but will also reduce the need for referral to hospital through earlier identification and intervention.

These key projects have not detracted us from keeping up with our international obligations. In September this year my government, in collaboration with the WHO and the World Bank, will be hosting a sub-regional conference to debate the Economic and Political implications of the Framework Convention on Tobacco Control. There we hope to see countries from three WHO regions, united by the common Mediterranean sea, participate with experts from the health and finance sectors – discussing the far reaching implications of this bold WHO initiative. At the end of this conference we hope to see a common strategy to deal with the delicate political implications of combating the Tobacco Epidemic in a structured manner.

Finally, listening to the speakers before me, it is reassuring to realise that the majority of our issues and problems are common to many other member states – both large and small. I feel comforted that we do not face these issues in isolation. I feel that we need to continue to support each other in tackling these issues and learning from each other's experiences. I wish to thank the WHO for the opportunity to do so at this forum.