Billboards sprouting up around the island are evidently stating the obvious. Displaying a plaster on a finger, the billboard reads 'Are you sure it's an emergency? The Emergency Department is for serious and urgent cases'.

One cannot help wondering why the authorities have had to resort to such basic, possibly ludicrous campaigns, to drive the message home. But figures released during a press conference last week show that people may need to be taught the basics if the Mater Dei Hospital queues are to be cut down.

Only 20 per cent of people who go to the hospital's admission and emergency department actually need emergency treatment. Just under 36,500 patients resorted to the Emergency Department this year, the majority of whom - almost 28,000 - were classified as third priority and had to wait.

"People are resorting to the hospital's emergency even to check their blood pressure. We're simply trying to instil a culture where the emergency service should only see to emergency cases," Mr Dalli says.

He insists that Maltese families still have the facility to turn to their family doctor and with eight health centres that offer a range of preventive, curative and rehabilitative services - not to mention three private hospitals - people have ample choice.

Mr Dalli says the issue boils down to expectations - people seem to believe "miracles" are conducted at Mater Dei, since it is a state-of-the-art, free hospital equipped with all the facilities. But aren't people turning to the hospital because of the inadequacy of primary health care?

"Health centres aren't working well. We have X-ray machines locked up inside health centre rooms. But we're going to invest in equipment. We need to reach a stage where private general practitioners need to have full electronic accessibility to patients' records."

Does he think the massive propaganda campaign accompanying the inauguration of Mater Dei hospital has backfired, to the extent that some people actually consider a visit to the cafeteria at Tal-Qroqq as an outing?

"If that impression was given, then it's wrong. People should go to hospital when they're unwell and not for coffee mornings."

Despite being an MP for several years, Mr Dalli says he was unaware of the problems mounting at Mater Dei, until he assumed the health portfolio after the March election.

"I've been cut off (from Cabinet) for four years but today I'm facing it - we've carried out the assessments and we now need to start implementing reform, which will mean a change in practices and mentalities. This isn't always easy."

From the outset, he had to ward off criticism from his predecessor. When Mr Dalli first described the problem of waiting lists at Mater Dei Hospital as "scandalous", former Health Minister Louis Deguara hit back and described Mr Dalli's claims as "simplistic and reflecting a poor knowledge of the real reasons behind the problem". So, who was right?

"I'm sorry that Deguara took it that way, since he's a close friend of mine. The comment was not meant to criticise him or the way he ran the hospital. However, we might disagree on the issue of management. You might have good resources, but unless you balance them out you will not solve the problems. We invested around €600 million in the new hospital, we've drawn up collective agreements which awarded doctors and nurses very good salaries, and yet just 13 of 25 operating theatres are working... because they say there aren't enough human resources.

"Why shouldn't any consultants be at the hospital after 2 p.m.? We've reached a situation where practically nothing is done at the hospital at weekends. How can we be sitting on a €600 million investment and utilising it on a part-time basis? Our methods today mean we have a part-time hospital. The hospital has to work full-time.

"I still think it's scandalous for a patient to have to wait four to five years for an operation."

The minister is well aware of the health system backlash emanating from horror stories appearing in the media. Recently, a man complained about a relative who had lost sight from one eye while on the waiting list for a cataract operation and is risking losing use of the other eye because specialists are still operating on patients from the 2003 list.

The minister says these stories are unacceptable: "We're not producing spare parts. We're dealing with people's lives and health."

There are no centralised statistics for waiting lists at the hospital despite growing concern about the issue. Shouldn't this have been pre-planned?

"We've started collecting statistics and centralising them. We're taking other steps, which I can't divulge for the time being, to ensure more discipline in the clinical side of the hospital. We need more control and audits," says Mr Dalli, pledging to eliminate waiting lists in the coming five years.

He insists that the political will to overhaul systems is there and hopes that those who have been complaining about the situation will not object to the reforms.

"A good number of the hospital staff will realise these changes are necessary; it's others with part-time jobs who might be concerned."

Is he optimistic about finding a solution?

"Many will seek to serve their interests and there will be those who manipulate the system... Reforms have to be carried out because they are required.

"For example, since we're talking about the shortage of nurses, we should insist that they stick to nursing duties. We need to go for international benchmarks and not opt for traditional methods. Solutions should transcend personal interests."

Despite the radical reforms he promises, he echoes Prime Minister Lawrence Gonzi's electoral pledge and excludes payment for health services.

"Nowhere on our political radar do we have plans to introduce payment for health services. If we pull together - the government and the public - everyone has a stake to make sure it remains viable."

The minister is reluctant to comment on a recent report drawn up by the Directorate-General for Economic and Financial Affairs of the European Commission, which said that technical economic computations made by EU experts indicate that Malta can save up to three-fifths of its current spending on health care.

Mr Dalli says he prefers to wait to analyse the formulas used to reach this figure, which he feels is exaggerated, especially since the biggest chunk of the health bill goes towards wages. Nevertheless, he says there are areas where the hospital can save money.

Health sector reform is a problem which has been crying out for a solution for some months - but an even more drawn-out issue has been rent reform, which also falls under Mr Dalli's portfolio.

The minister recently unveiled a White Paper on rent reform which limits the right of tenants to pass on rented property to descendants.

So why did the government wait so long to tackle an issue which has frustrated landlords for decades?

"I only started working on it three months ago and I wanted to publish the White Paper as soon as possible," the minister says. However, he denies that the White Paper had been shelved because of the March election. A number of draft papers had been drawn up, but Mr Dalli says he revisited the workings.

Though the White Paper, which is now subject to public scrutiny, has not stirred particular controversy, he admits it is difficult to appease both landlords and the tenants.

"We're receiving a lot of comments in favour and against. Our job is to try to strike a balance," says the minister, who admits that tenants have been turning up at the ministry to complain about specific cases.

While many deem the annual minimum rent payment of €185 as ludicrously cheap, most tenants think otherwise.

"I also think the minimum fee is very low, but we reached that figure by carrying out a sensitivity analysis. The majority of those renting out are elderly people living on social welfare - when you increase their cost of living by three to five per cent it's tough for them."

Before it is given the go-ahead, the White Paper will be revisited and retouched, Mr Dalli says.

Ultimately, although the government is trying to reduce the exploitation of landlords, the government is not in a position to provide alternative accommodation to each tenant - as that would cost some €1 billion.

Mr Dalli clearly wants to leave his mark on his new job and says he is enjoying steering the social policy ministry. However, he is quick to point out that he is "terrified at the way Maltese society is losing its robustness, its cultural and traditional strength."

He describes recently-released statistics as "terrifying", and says he is getting all the advice he can to provide social support for "the traditional family".

In view of such alarming statistics, should Malta start discussing the introduction of divorce?

"I think a discussion on divorce should start, and it should be a serious debate, steering away from emotions. We should avoid discussing certain aspects, which should not get into the debate."

Such as the Church?

"The Church rightly has its own position. I believe religion is a personal matter and if I'm Catholic, it's up to me to analyse the Ten Commandments and the Church's project. But I shouldn't impose social systems on others. I believe it's high time to start discussion on divorce in Malta. But we have to be careful not to go to extremes since the destruction of families is not pleasant."

Is he saying that divorce brings about 'destruction'?

"If divorce is easily attainable, if couples split up after a single argument, then yes, it will destroy families. If divorce means the level of tolerance towards our partners' mistakes will go down, then the effect will be negative.

"But if divorce encourages couples to embark on the road to understanding each other and reconciling as much as possible, then yes - we should seek that path. In my opinion, if divorce offers couples the opportunity to seek other social ties where relationships are irreconcilable, especially where children are concerned, then it is a positive thing."

Considering the statistics in hand, is he willing to engage in a discussion for the introduction of divorce at once? "Yes, as Minister for Social Policy, I am willing to engage in this important topic... of course, though, something like this is subject to a Cabinet decision."

However, he was coy when asked whether divorce could be introduced during this legislature. "Don't draw me into that for the time being, but I think we should engage in some serious discussion. I have not made a formal proposal to the Prime Minister but I intend doing it."

Is the issue of divorce a priority for his ministry?

"The priority list in this ministry is long and divorce is one of the priorities, but now that the White Paper on rent reform is out, in my opinion we should tackle health next, while looking at the welfare system and social systems... including divorce."

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