Labour promises review of hospital migration plan

Opposition health spokesman Michael Farrugia said yesterday that a Labour government would review the plan for the migration of services from St Luke's to Mater Dei Hospital.

He told parliament that the overriding priority in the migration plan just published was for a section of the hospital, the Outpatients' Department, to be opened by the present government, and the interests of patients had come second.

Dr Farrugia was speaking during the budget debate on the health ministry.

Health Minister Louis Deguara said in his reply that the hospital would open fully in 2005 but should the people have to wait for so long when some services could be provided earlier?

One of the biggest source of complaints was the outpatients' department and it was for this reason that the new department would be opened next year.

Patients complained over the way St Luke's Hospital was being managed, overcrowding, lack of privacy and lack of parking facilities.

The new hospital would be managed differently and the environment would be totally different with much better use of natural light. No room would have more than four beds, and each would have a bathroom. The hospital would be fully air conditioned and have parking slots for 1,600 cars. There would be restaurants for patients and staff.

There would also be an improved customer care service on every hospital floor and patients would be represented on the hospital's management board.

The new hospital would have more operating theatres and more consultants so that the waiting lists for operations would fall.

Dr Deguara denied there was no consultation on the migration plan. He observed that the last migration of hospital services in Malta took place 70 years ago. There was therefore no local expertise. The government had thus engaged foreign experts who had just been involved in migration of hospital services of equal size in the UK.

As soon as they submitted their report, experts started mushrooming in Malta, all wanting to have their say.

Those who claimed that patient care was not given a priority in the plan had clearly not read it, Dr Deguara said. The drawing up of the plan was made in consultation with the commissioning teams, including doctors' representatives, who had also been involved in the design of the layout of the hospital sections where they would work. And annex three of the plan pointed out that even more consultation would be held. But decisions had to be taken too.

Nationalist MP Francis Agius denied that patients' interests had not been given priority, and he pointed out that the migration plan would be implemented in stages over three years starting from next year. The Nationalist government intended to be there throughout that period. He added that doctors should be involved in the migration plan, because it was they, rather than the administrators, who worked most in hospitals.

Dr Farrugia, in the first past of his speech, said one of the major concerns which needed to be tackled was that of the environment, which had a direct consequence on the health sector. Surveys showed that respiratory diseases were rising at an alarming rate, particularly at Zejtun, Fgura and Naxxar. Particulate matter and some gases like benzene in the air were higher than permissible levels abroad particularly in high traffic areas, near power stations and landfills.

Another problem was smoking. Tobacco prices were raised in the last five budgets but had consumption decreased? Was the health protection unit campaign being successful? He feared it was not, as unfortunately was also the case with regard to drug abuse.

Dr Farrugia said a Labour government would be committed to introducing breast screening within months of taking office.

The Labour MP said there was need for stricter port health control. It appeared that a quantity of medicines that had not been destined for Malta had somehow found itself here after contraband or some other illegal activity abroad, which did not involve the local importer.

Dr Farrugia said vehicles being bought for use by patients, including ambulances, were second hand, but cars for department officials were all brand new.

The Labour MP observed that the working hours of a number of health centres had remained restricted. It was true there was a shortage of doctors, but the government needed to introduce the necessary changes, after discussions, for this problem to be eased.

One of the consequences of the current situation was an increased load on the emergency department at St Luke's Hospital. The outpatients' department was also overloaded because of the failures of health centres.

The quality of services at St Luke's, excluding actual medical care, left much to be desired. That included the fact that patients were leaving hospital without discharge letters.

Dr Farrugia complained over a shortage of nurses in some wards at Mt Carmel Hospital and said there was discrimination in the award of overtime.

He said he was not against overtime for nurses, but some were working an excessively long number of hours. The opposition, he added, was against definite contracts of work for the employees of Mater Dei Hospital except for those in senior posts.

Dr Farrugia defended the Labour government's decision to review the plans for Mater Dei Hospital and enlarge it, rather than have hospital services split with St Luke's. That decision, he said, had been widely welcomed.

He insisted that costs for the building of Mater Dei had risen because of the way contracts were awarded and the way the project was awarded to Skanska contractors.

Near the end of his speech Dr Farrugia insisted that the government should publish reports made by a British company on the adjudication of tenders for the supply of the new hospital's medical equipment and furniture in view of allegations of irregularities.

A Labour government, he said, would evaluate the way such tenders were awarded in the interests of transparency.

Health Minister Louis Deguara said the opposition spokesman on health was right to be concerned about the environment, but he had not said anything about the measures being taken by the government to tackle environmental problems, including cleaner emissions from the power stations and plans to close Maghtab.

Dr Deguara said the Maltese health service was widely praised for its quality. Over the past four years a total of 100,000 operations were performed, 300,000 new patients were seen at the outpatients' department and there were a million follow-up visits. Some 500,000 patients were seen at the emergency department, 700,000 x-rays and 11.5 million blood tests were taken. Some 600 heart operations were performed by Maltese teams.

The budget on health promotion had been tripled. Spending on medicines had risen from Lm6.5 million in 1996 to Lm17 million now. Spending on the health sector in general had risen from Lm57 to Lm93 million.

Dr Farrugia had once said that the new hospital would be a monument to a Labour government. Yet as recently as last June, Dr Sant said that Labour's initial position was to scrap the new hospital plans and concentrate on St Luke's because the new hospital was the costliest drain on the public purse. He had said that Labour only continued the project because it had been started, and stopping the project would have raised unemployment and made the government liable to penalties.

Unfortunately Dr Farrugia was obsessed with claiming there was corruption or irregularities in the way contracts were awarded, but he was being ignored by everyone. He would be well advised not to let anyone use him. All tenderers could go to court to challenge the decisions of the contracts committee. Yet none had instituted a court case yet. At a meeting of the Public Accounts Committee the only complaint that was raised was whether the soft drinks seller at an open day on the hospital site was issuing VAT receipts!

Dr Deguara denied that employees would be engaged on a definite contract at Mater Dei.

He also denied there was a shortage of nurses. The manpower plan called for 1,176 nurses and there were now 1,290.

It was also hoped that by 2006 there would be enough doctors to man the health centres round the clock, but obviously priority would continue to be given to hospital manning.

Dr Farrugia had said a Labour government would introduce breast screening within months when he knew that according to a document prepared by a team which included an MLP representative, screening for all women could not start before 2005.

Dr Deguara said it was irresponsible for Dr Farrugia to have claimed that medicines that were involved in contraband abroad had found their way in Malta. He should give full details to the authorities so that such claims could be investigated.

Nationalist MP Frans Agius, who spoke earlier said doctors should have more chances to progress in the health service, especially when they reached a particular level of training.

There was need for more sensitivity in issues such as when doctors were questioned by the Tax Compliance Unit. Although it was true that the income of certain specialists was very high, this was not the case with everyone.

At the end of the sitting, Opposition leader Alfred Sant protested to the Chair over language used by Dr Deguara. He pointed out that when referring to remarks by Dr Farrugia, the minister had said "kif kien jghid Censu Tabone, irid ikollok wicc ta' kahba..." Dr Sant said this was unacceptable and if it was allowed, the opposition would reply in kind. Dr Deguara said he had been speaking in a light vein, but he apologised and said this did not reflect well on Dr Sant's sense of humour.