Bad practices blamed for lack of hospital beds

The key to tackling bed shortages at Mater Dei Hospital is through changing work practices, Health Minister Joe Cassar has insisted.

“I’ve said it before and I’ll say it again. If work practices don’t change we will still have a lack of beds,” he reiterated.

Bad practices were blocking about 100 beds a day at the hospital, he said.

During a press conference on Tuesday, Malta Union of Midwives and Nurses president Paul Pace said the chronic patient overcrowding afflicting Mater Dei would only be resolved if the number of hospital beds increased, possibly by opening an additional acute hospital of 500 beds.

But Dr Cassar said opening an additional hospital would require 1,500 to 2,000 extra staff – that went beyond nurses – which was not available.

Yesterday, Mr Pace dismissed the minister’s claims saying: “If we divide those beds into 25-bed wards and man each ward with 12 nurses, the 500 extra beds would require 240 nurses.”

He also touched upon ongoing overcrowding issues at Mater Dei, saying that 75 patients lay in beds strewn across hospital corridors over the past few days, “even though the cold weather’s disappeared”.

Dr Cassar said that as part of the plan to change work practices, the government was proposing that doctors and consultants work afternoon shifts so that the outpatients department, for instance, could stay open till 5.15 p.m. This should not disrupt their private practice as they could schedule such appointments in the morning.

When asked why he is still proposing these changes as opposed to implementing the necessary measures, he said Mater Dei management had started holding meetings with individual doctors to encourage more of them to work afternoon sessions.

He elaborated that consultants worked according to job plans which they negotiated with the management.

They could choose contract A, where they were employed full-time with the hospital, or contract B where they worked a minimum number of hours in hospital and retained their private practice. Those who chose contract B may also work additional four-hour sessions in hospital.

“We are asking that if someone asks to work extra hours, they work in the afternoon,” Dr Cassar said.

Malta Medical Association president Martin Balzan agreed that the government should tackle waiting lists by increasing output. Some consultants already worked afternoon sessions but there was room for more capacity, he said.

However, the government should make afternoon shifts more attractive by improving overtime rates and speeding up the granting of promotions.

Dr Balzan said it was important that the government did not compete against private practice, which was a way of reducing public spending and waiting lists and allowing patients to have a choice.

On Tuesday Mr Pace had also said increasing bed space in the manner the government was doing jeopardised patients’ safety. Single rooms were being fitted with two beds that were not equipped for two patients.

Reacting to this, Dr Cassar assured the public that patients in these rooms were safe.

Dr Cassar was speaking during a visit to the orthopaedic wards where patients with broken limbs, in need of hip and knee replacement or back surgery, are treated.

Last year 4,881 orthopaedic operations were carried out, of which 2,214 were scheduled while the rest were emergencies.

The number of operations carried out in February, throughout the hospital, had increased over the past years. Last month, 3,507 operations were done compared to 3,175 in 2010 and 2,910 in 2008.