New health facilities and old practices

Some years ago when Dr Eddie Fenech Adami was still prime minister, there was a keen discussion about the financial situation of the government, with particular reference to the capital account. Time flies but details do not change all that much. The discussion was triggered by the size of the structural deficit and the dire need to reduce it.

Once the authorities know that outdated practices exist, what are they doing to stamp them out?- Lino Spiteri

In an aside intervention the prime minister referred to the allocation to the vote covering the building of the Mater Dei Hospital. He said that it was common knowledge that the hospital was absorbing large amounts of capital expenditure. He pointed out that construction and equipping were reaching conclusion and that should ease the pressure on the capital account.

I do not think that we are going to build another Mater Dei, said Dr Fenech Adami with a wry smile.

Well, you never know. Further construction has been undertaken, such as the Oncology Unit. This will move from Floriana where it is housed in the building of the former St George’s Hospital. The building may be old and not quite suitable for a modern hospital. But the service given by the Oncology Unit and its entire staff is first class. I can vouch for that with gratitude.

But that is not the end of the story. A proposal has been made that would turn Dr Fenech Adami’s hair greyer if he were still in politics. The president of the Malta Union of Nurses has proposed that a new hospital including 500 beds or more should be built without delay.

He was basing himself on the situation at Mater Dei Hospital, which is far from ideal. There is often a shortage of beds relative to the demand for them, even adjusting for social cases which take up considerable marginal space. There are other gaps, including the pressure on patients and hospital personnel alike, despite strenuous efforts to improve the situation.

Yet what came to the forefront was a new hospital. The union president gave logic to his proposal basing himself on demographic projections. These show that Malta’s population is ageing quite rapidly. Soon there will be more elderly people adding pressure on our hospitals, a result of increasing longevity too.

Perhaps the time will come when another hospital will be required but, in the opinion of Health Minister Joe Cassar, not just yet. What needs to be addressed, said the minister, are outdated practices which bedevil Mater Dei Hospital.

In essence, the minister is correct. Before sinking new capital investment in any sector, hospitals included, one must see that the existing capacity is being maximised for efficiency. It may well be that if such maximisation takes place the demographics will still dictate the need for another hospital. We are not at that stage yet.

No one knows better than the minister what the state of affairs is at Mater Dei. If he says there are outdated working practices I, for one, am prepared to believe him. Inevitably, though, even outside the field of politics, a question immediately comes to mind.

Why does the parlous situation described by Minister Cassar exist? The Nationalists have been in office for an almost uninterrupted 25 years. Did the situation improve over that period or, as implied by the minister, has it grown worse? I hope that no one will jump in and say that the minister is politically accountable for the outdated bad practices. He is politically accountable for the past four years, not the other 21.

The more pertinent question is: Once the authorities know that outdated practices exist, what are they doing to stamp them out? An effort was made with the hospital specialists. It does not seem to have worked enough, even if the output of specialists has increased.

According to the minister more – much more – needs to be done. Well, is anybody trying to do it? Or are we in for yet another period of looking the other way in the six months or so leading to the next general election?

In this period the government will be more concerned with buttering up to voters, as is already in evidence. Buttering up will not solve problems. Once the problems are known, six months could go a long way to start solving them. One cannot expect the health minister to work miracles where necessary corrective ordinary work has not been done for decades.

Yet a move must be made. In a context as objective as can be. It should not be difficult to draw up a picture of what facilities exist, which are underworked, which work well and should serve as an example to all.

Once that is done, the next steps should be obvious and ought to be taken.

Talk of additional facilities can be left to simmer for the time being. But the existing facilities must be made to work in full.