Probe on chemo deaths claim
Minister claims ex-cancer chief was resisting change
Health Minister Joe Cassar is investigating the claim that patients of Gozo’s general hospital died from chemotherapy toxicity because treatment was carried out without the necessary expertise.
“Obviously, if there is a case of negligence – whether it happened in Gozo or in Malta – we will deal with it like any other case,” Dr Cassar told The Times.
The allegations were made by Stephen Brincat, the former head of Mater Dei Hospital’s Oncology Department, who resigned last week claiming his advice was repeatedly ignored by the government.
“This is news to me,” Dr Cassar said about the alleged deaths, adding that he had already asked the director generals involved since 2007 for the necessary information. Dr Cassar said the director generals had not recalled any such instances off the top of their heads.
He also called on Prof. Brincat to state whether he had asked the department to investigate this negligence when it occurred. Prof. Brincat, who made the claim in a letter to The Sunday Times, did not specify the number of deaths or when they happened.
Dr Cassar appeared to be suspicious of the consultant’s claims. At one point he said it was disrespectful towards patients to cast doubt on the work of the hospital by mentioning “death”.
“As chairman, his obligation by law is to alert the (Health) Department of negligence. The department is then obliged to carry out an inquiry and, depending on the inquiry, one either asks the police or the respective council to intervene,” Dr Cassar said.
“I hope that, if he put the department in cognisance of the facts, investigations were held.”
Among the reasons for his resignation, Prof. Brincat has claimed there was too much “political interference” in cancer treatment at the hospital.
The remark was picked up by Opposition leader Joseph Muscat yesterday, who said the Health Minister and the Prime Minister would have to answer to these serious and “frightening” allegations, among them that Prof. Brincat was told which patients to discharge and which to admit.
Dr Muscat also said someone must take responsibility for the waste of time and money resulting from the decision to set up a cancer hospital at Zammit Clapp Hospital only to later take it to Mater Dei.
The Times asked Dr Cassar about Prof. Brincat’s claims regarding political intrusion.
“I really don’t know where he is getting this from. I don’t think we have ever told him who to treat or not to treat,” Dr Cassar said.
The minister recalled one incident where the Health Department took a decision to move a number of terminally ill cancer patients to Boffa hospital to make room at Mater Dei so that no operations would be cancelled.
“There were a lot of patients and we needed beds. We realised there were empty beds in Boffa during the weekend and a decision was taken for those empty beds to be filled. “I don’t know if you would call that political intrusion,” he said, describing it instead as a “judgement call”.
Dr Cassar stressed that the department never told doctors to treat a patient over someone else.
“God forbid that ever happened. If that is the problem, I urge him to tell us and I will investigate.”
However, Dr Cassar lashed out at Labour for politicising the issue, saying the party had to decide whether they wanted patients to be kept waiting at the emergency department or if they want the government to find empty beds.
“If there are empty beds in Gozo, for instance, would Labour in government recommend that 20 Maltese long-term patients are transferred from Mater Dei to Gozo?”
Dr Cassar said he was surprised by Prof. Brincat’s resignation but Prof. Brincat had constantly resisted change, particularly on the plans to introduce chemotherapy in Gozo and to include haematology within the oncology centre under one chairman.
“We’re basically talking about treating solid cancers and blood cancers in the same department. This happens abroad... In fact, we originally wanted to include radiology too since cancers are nowadays being treated with radiological intervention too.”
Similarly, the chairman of medicine is also responsible for renal and respiratory systems, while the chairman of neurology is also responsible for neurosurgery and rehabilitation.
Even in the call for applications, Dr Cassar said, the emphasis was on management not clinical acumen.
The minister said the chairman’s role was mostly administrative and required “vision”.
He questioned whether Prof. Brincat had such a vision for the cancer treatment in Gozo, including what sort of training should be given.
“We have been asking for chemotherapy to take place in Gozo for the last number of years, not months,” said Dr Cassar, rubbishing the claim that this was being rushed for political expediency. “And he has been resisting it.”
The Malta Union of Midwives and Nurses has described Prof. Brincat’s claims as an “insult” to Gozitan nurses, saying they were equally capable as their Maltese counterparts.
Dr Brincat had said Gozitan nurses did not have enough training to perform chemotherapy in Gozo.
MUMN president Paul Pace said the union had been lobbying for chemotherapy in Gozo for the past years.
“The suffering of Gozitan patients to travel back home to Gozo after chemotherapy is immense… Chemotherapy in Gozo is a blessing for the Gozitan patients afflicted by cancer.
“There should be no setbacks by any resignations since patients’ suffering is involved,” he said.
Meanwhile, Prime Minister Lawrence Gonzi yesterday made only a passing reference to the issue, saying that politicians and doctors should work together to provide the best care for patients within a sustainable structure.
Instead of criticising Prof. Brincat, he paid tribute to him and other professionals in the sector and urged them to continue working in the interests of patients.
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Leo Said
Sep 3rd 2012, 19:59
WHY IS THE RESPONSIBLE MEDICAL COUNCIL OF MALTA SO; SO; SO SILENT WITH REGARD TO THIS SAGA?
IS THE MEDICAL COUNCIL THEREBY NOT FAILING ITS ENTRUSTED DUTY?
Leo Said
Sep 4th 2012, 08:10
https://ehealth.gov.mt/healthportal/others/regulatory_councils/medical_council/medical_council.aspx
Mission Statement:
the Medical Council strives at safeguarding patients’ rights and safety... by protecting, promoting and maintaining the health of the general public... by ensuring proper standards in the practice of Medicine... as well as by safeguarding the values and integrity of the Medical and Dental professions ....
The Council’s statutory functions are defined in the Health Care Professions Act (HCP Act) Cap.464 (2003), which abides by the EU Directive 2005/36/EC.
M Grima
Sep 3rd 2012, 14:19
All this mess is due that we have an individual in the form of a Minister of Health who because he thinks he is not answerable to anyone he can ride roughshod not only over immortals like me but over those professors, surgeons, specialists and doctors who are experts in their field.
Joe Cassar has completely lost the plan with the result that we have a :-
1. A lot of out of stock medicines, including life saving ones.
2. A waiting list, which notwithstanding his promises to eliminate it, has expanded to astronomical
numbers.
3. Hospital appointments which are set for 12 months and longer.
4. Operating theaters which are not used.
5. New machinery and equipment which although already installed at Mater Dei is not made use of .
6. Lack of nurses and other medical personnel.
7. Lack of beds in the designated wards and making use of the hospital corridors to treat patients
8. An emergency department which takes you ages to receive a service.
9. Lack of pillows and bed-sheets.
10. A hospital with security personnel outnumbering the patients
11. No proper ambulances.
12. Medical professionals treated as morons.
Were it not for the dedication, albeit stressed out, of the majority of staff at our hospitals, the situation would only be described as appalling. Shame on you Joe Cassar.
Joseph Micallef
Sep 3rd 2012, 14:53
Come on Mr Grima. It is obvious that you never needed the services of Mater Dei Hospital otherwise you will not be talking this way. Emergency treats those with the highest risk first so it is not a first come first served service. But I can tell you this, when my second son was born in 1984 at St. Luke's (I do not know how old you are but before 1984 I could choose in which hospital my children were to be born. My eldest was born at St.Cathrine's hospital in 1979. But as was with all other services the socialist government closed all private hospitals) I found our baby wrapped in cotton wool because they had no nappies I was told. Can you imagine a baby grabbing pieces of cotton wool and placing it in his mouth?
If you were knowledgeable of the various wards of the hospital you would know that the busiest is the orthopedic department so I would not be surprised if one would find a need for beds there since no one can know the number of accidents that may happen.
I can go on but I think that repeating what people like Mary Loiuse Coleiro Preca is saying and really knowing the hospital because you experienced it first hand makes all the difference when criticizing.
Peter Shaw
Sep 3rd 2012, 22:16
you mean mere mortals not immortals !
John Azzopoardi
Sep 3rd 2012, 13:41
An independent investigation needs to be thoroughly carried out to identiry and determine the real cause of this death. Less than that is not acceptable, especially to the gozitan community and all the foreign expatriates who retired in Gozo on the hope that we have a world class health facilities.
Pamela Hansen
Sep 3rd 2012, 13:01
"Treatment was carried out without the necessary expertise" Prof Bricncat.
"Obviously, if there is a case of negligence – whether it happened in Gozo or in Malta – we will deal with it" Minister Cassar
Lack of expertise does not mean staff were negligent, but that they were not properly trained. Negligence lies elsewhere.
Franco Mercieca
Sep 3rd 2012, 13:39
Agreed
Stephen Brincat is alluding to neglicence from whoever has the duty to supply the said department, Oncology, with the necessary means to provide a service safely.
The health department is already trying to find a scapegoat but in this case its obvious who the culprit is
M Grima
Sep 3rd 2012, 13:56
Spot on Ms. Hansen.
Leo Said
Sep 3rd 2012, 19:50
@ Franco Mercieca
I am most surprised that your good self, as a medical consultant, do not seem to have understood Pamela Hansen's message.
Please allow me to re-emphasise what Ms. Hansen wrote: "Lack of expertise does not mean staff were negligent".
Leo Said
Sep 3rd 2012, 19:56
Franco, allow me to address you once again. Following is an excerpt from my remarks to Lino Spiteri:
As a medical professional, I would believe that Dr. Brincat would "have expressed himself more clearly":
1. if Dr. Brincat would now publicly identify the person, who was responsible for prescribing and/or administering chemotherapy in Gozo "without the necessary expertise",
2. if Dr. Brincat would indicate whether his department was consulted in the respective cases and, if so, what the department's advice was,
3. if Dr. Brincat was primarily aware of any form of medical malpractice in Gozo and, if so, whether he deemed it necessary to inform the responsible Medical Council.
I personally now view the scenario as a most urgent issue for a competent Medical Council, whose duty would then be to inform the general public accordingly.
George Calleja
Sep 3rd 2012, 12:56
Minn din il-kwistjoni serja hafna jidher li bejn il-Profs u d-dipartiment tas-Sahha kibret animozita kbira imma li nixtieq nistaqsi huwa. Ghaliex il-Profs halla daz-zmien kollu jghaddi meta ilu jaf li hemm nuqqasijiet fl-isptar t'Ghawdex? Ghaliex inqeda bil-midja biex jallarma lil poplu meta seta facilment qajjem il-problema malli sar jafha? Nahseb li hemm hafna iktar milli ntqal s'issa. Il-poplu ghandu dritt ikun jaf l-istorja kollha u l-Profs ghandu jkun ta l-ewwel biex jidher quddiem l-inkjesta. Nispera li jmur jixhed dwar dak li qal.
Ms L Dimech
Sep 3rd 2012, 11:42
First of all let's all try to be a bit mature and level headed and irrespective of what the leaders say stop trying to get political mileage out of health issues especially something as critical as this.
Making a sensation out of such a matter, as an escape valve for one's frustrations, is totally unacceptable, immoral and unethical. Which leads me to the conclusion that the good Prof. Brincat before his 'coming out' must have undoubtedly done all he could to:
1. Verify the accusations he is making.
2. Taken necessary steps for this to be immediately and fully investigated
3. Ensured that this is brought to the attention of the highest auuthority without delay.
4. Take necessary steps to ensure that the public at large and more particularly those patients undergoing chemotherapy and their families are not unnecessarily alarmed at least before somebody gets to the bottom of this.
5. Offered the authorities concerned his full co-operation for a fully fledged investigation into these accusations.
Given the good name Prof. Brincat holds within the medical profession and the many patients he treated, I cannot see him making the public statements he did without at least hitting on some or all of the above points and definitely many more than those. As yet the Minister is not aware of these accusations - so somewhere there are missing links.
The most important thing RIGHT NOW is to put people's minds at rest. Explanations and investigations cannot be put off. No one has the right to put patients and their families in more misery than what they must be undergoing. Believe it or not these patients do not give a damn about anybody's personal ego or political party - they just want to get the best treatment hoping to be cured.
Is it possible to get round a table and thrash this out before a lot more speculation goes on, which will not help any side?
C Sant
Sep 3rd 2012, 13:44
Do not count chickens before they hatch - according to Brincat, this was years ago, so even if the dep did nto take notice, he should have spoken long before today and the right place would have been the Medical Council or the Police.
The way he did it, seems to indicate a case of sour grapes and exaggerated accusations. One has to note that for years he was one of two oncologists, so these were either his or the other oncologist's patients. In both cases, he was duty bound to speak to either the Medical council or the police on this, years ago!
andrew falzon
Sep 3rd 2012, 11:25
@ J Busuttil
Mela xi trid isir quddiem allegazzjonijiet serji bhall dawn skond int? Kullhadd jibqa b` halqu mghaluq halli il- gvern li hu responsabbli ta dawn il- hnizrijiet ma inhammrulux wiccu u hadd ma jerfa ir-responsabbilta u kollox jibqa sejjer qisu qatt ma kien xejn? Fuq il- hajja tal pazjenti qieghdin nitkellmu hawn. Kif dejjem tridu izzeffnu lill- PL fin nofs ghall kull qassata u oxxenita li jghamel dan il- gvern? Il Veru bdiedem vojt u bla qalb int sur busuttil. Il- post tieghek hija insult ghall dawk il- familji li ghaddew minn terrur ghax xi hadd mill familja taghhom marad u miet bil cancer. Trid nghidlek l- storja tal familja tghana? Membru tal familja marad b` cancer aggressiv, saritlu operazzjoni u kellu bzonn ir-radiotherapy immedjatament wara biex jinqatlu ic-celloli tal cancer li thalliet wara l- operazzjoni, l- sptar bdew jitrattjenu biex jghatuna appuntament ghar raggi, gimghat shah incemplu u nigru minn naha ghall ohra biex fl- ahhar tawna appuntament. Meta bdiet it-terrapija il -cancer lahaq infirex u il- persuna mietet ftit xhur wara. Meta Dr Brincat induna b` dak li kien gara deher irrabjat bl- ikrah u ma setax jemmen dak li irrakkontajnielu. Persuna ohra li iltqajna maghha l- sptar mater dei kellha l- istess tip ta cancer fl- istess post u kien ta l- istess daqs ghax konna qabbilna ir- rizultati ta l- MRI, dawn kienu ikkonfermawh ukoll it- tobba fl- isptar, izda din il- persuna inghatat il- kura tar radio therapy mal ewwel u ghadu hajj sal- llum, jghix hajja kwazi normali. Dan il- kaz sehh erbgha snin ilu. Jekk jghogbok sur busuttil thallatx il- mard mal politika, ghalhekk ta gonzipn qazziztu lill kullhadd anke lid deputati parlamentari tghakhom stess ghax sirtu nies bla qalb, kull ma baqalkhom huwa kilba ghall poter u il-flus.
Pamela Hansen
Sep 3rd 2012, 11:18
"treatment was carried out without the necessary expertise", Prof Brincat.
"Obviously, if there is a case of negligence –" Minister.
That the staff were not trained appropriately for the job in hand does not mean they were negligent. The negligence lies elsewhere.
Michael Seychell
Sep 3rd 2012, 11:09
The M UN led by Mr Paul Pace is generally critical of the Medical Health Department and the Ministry, yet in this case has contradicted and criticised Dr. Brincat. yet in this case he went as far as stating that The Malta Union of Midwives and Nurses has described "Prof. Brincat’s claims as an “insult” to Gozitan nurses, saying they were equally capable as their Maltese counterparts."
Comments made by Mr Paul Pace are generally accepted by most commentators, however it seems that today Mr Pace's comments were totally ignored - why?
Michael Seychell Tal-Pieta
David Caruana
Sep 3rd 2012, 11:43
Because Mr.Paul Pace did not have the decency to read what exactly did Prof Brincat say and in turn made a fool out of himself.
Prof.Brincat never said the the Gozitan nurses are less competent but that they were never given the necessary training and resources. This was too hard for Mr.Pace to grasp.
Mr Victor Borg
Sep 3rd 2012, 11:09
So now the health ministry will investigate claims about problems arising in Gozo hospital, because the issue has reached the media. In my case, when I sent a complaint about doctor prescribing wrong medicine and nurse treating us with hostility to the Health Ministry, my complaint was kicked to Customer Care at the Ministry for Gozo.
Unfortuntately, there is serious maladministration in health in Gozo, and I have now sent my complaint to the office of the primie minister. I have lost a lot of confidence in the administration of health in Gozo, and members of my family will certainly refuse to use the Gozo health services in serious cases. Moreover, we will no longer take my daughter to be vaccinated in Gozo - we will now have to cross over to Malta for a simple vaccination. This is because the previous nurse gave my wife the wrong vaccine, and the present nurse is treating us with hostility because I complained about his predecessor.
J Busuttil
Sep 3rd 2012, 10:54
I am sure that it will not be long when we get to know who is trying to gain political advantage about this issue.
Pat Hobson
Sep 3rd 2012, 12:09
Mr. Busuttil looks like you've decided to vote after all. Just as I thought and all spit and no bite!
Pierre Mangion
Sep 3rd 2012, 10:52
Dear Minister,
without a proper whistle blower legislation, how on earth do you expect anyone to come forward and point fingers at those who use and abuse of the system, especially since these would the same individuals possibly signing off his salary???
it seems quite obvious that if these instructions were given out, these would not have come from the cleaner or the receptionist but higher grounds.
not unheard off that you speak to the minister (or anyone close enough) to skip the queue for an MRI or other intervention!!!
Ms.D. Galea
Sep 3rd 2012, 10:37
Stop scaring cancer patients who require life-saving chemotherapy.
This sensationalism is not doing THEM any favours though it might be a good opportunity for some to score political points over the adversary.
John Dee
Sep 3rd 2012, 10:55
Ms Galea - it is only scaremongering if it is untrue. If it is true, then changes need to made to ensure safe treatment.
Indeed, one hopes it IS simply a false report.
Joseph Micallef
Sep 3rd 2012, 11:48
Chemotherapy is a poison whatever does it is given in. It is pushed by the producers because is creates big money in sales.
Joseph Micallef
Sep 3rd 2012, 12:04
John Dee chemotherapy can never be safe. It is a poison. Just notice what a persons system goes through after it is administered.
Anthony Pace
Sep 3rd 2012, 10:30
Stephen Brincat is right to resist chemotherapy in Gozo's Hospital as he would have to shoulder responsibility if anything happened and not the Minister who is appointed for a period of five years at maximum and blames his medical staff for blunders.
This is an election gimmick which is not going down well with those literate enought to know the hazards of chemotherapy where staff are untrained in its use. Otherwise the only thing the minister can do is to pay the oncology deptartment to go to Gozo over he week-ens and pay them well to work there as a kind of bonus and put them up in a hotel.
Reginald Borg
Sep 3rd 2012, 10:22
Please, Minister,
keep the maltese public informed in detail.
Someone along the line is irresponsable
and who is guilty should be held accountable before the nation.
F. Mercieca
Sep 3rd 2012, 10:15
Hon Cassar, Prof St. Brincat allegations are very serious. Both of them. The allegations are of a criminal nature apart from administrative ones. The matter requires serious investigation and should be carried out by an independent body. The Commissioner of Police should also intervene. It's his duty to do so. And he should do so on his own free will. Apart from the fact that he has a formal request to do so by a Member of Parliament. After all, the allegations are coming from a Professor with great experience on the matter. Investigations by the Minister of Health or by your Department is futile. I fully agree with Onor F. Debono that the allegations are so serious that they ought to be debated in Parliament. On other occasions I have also asked for an inquiry into the way how appointments at Mater Dei were made. Some of these, that I know of, are very dubious. We hope that both Government and Opposition treat these matters with the most seriousness and urgency. If not, then the people have the right and obligation to make their voices heard and heard louldly. The AD should also involve itself on this issue of such a great importance.
charles tabone
Sep 3rd 2012, 10:09
And if they were due to inefficient or inexperienced or untrained staff, should we take it lying down? This is a serious allegation coming from a well esteemed professional. We sincerely hope that a true and thorough investigation by non-committed investigators is taken in hand. Nittamaw li m'ghandkomx xi mhallef lest biex jaqdikom!
Joseph Brincat
Sep 3rd 2012, 10:08
Franco Debono asks Commissioner to investigate 'chemotherapy toxicity deaths'
And we thought we had a peace of mind under GONZI PN
Joseph Micallef
Sep 3rd 2012, 11:58
All this argument shows how much people believe what they are told about conventional cancer treatment. The fact is that all chemotherapy is poisonous so the commissioner will find that all patients who were given chemotherapy were poisoned. Chemotherapy devastates the body's immune system.
Mario Tabone-Vassallo
Sep 3rd 2012, 10:04
Rajna fejn hi n-negligenza meta Direttur Kliniku jkun maghfus joffri servizz f'Ghawdex meta hu jhoss li jkun ta' sogru ghall-pazjent. Kulhadd jaghraf li dan id-Direttur aktarx irrizenja meta tassew ma felahx iktar, wara li prova b'xi mod iwettaq it-talbiet li sarulu, minkejja li hass li ma kinux talbiet ta' min jaghmilhom. Niehu gost li f'Malta ghad hawn min ghandu n-'Non plus ultra', kif titlob is-serjeta. Ma nistennix ahjar minn dipartiment li ftahar li nehha wahda minn zewg katarretti lill-anzjana li kienet ilha tistenna bi tnejn ghal iktar minn hames snin, biex ma nghidu xejn ghall-medicini nieqsa, apputamenti ghall-specjalisti xhur twal wara li jintalbu, nuqqas ta' sodod; tghid hadd ma qallhom b'dawn ukoll?
Lucienne Dimech
Sep 3rd 2012, 10:04
I think we all know who is more credible here .
Mario Tabone-Vassallo
Sep 3rd 2012, 10:03
Rajna fejn hi n-negligenza meta Direttur Kliniku jkun maghfus joffri servizz f'Ghawdex meta hu jhoss li jkun ta' sogru ghall-pazjent. Kulhadd jaghraf li dan id-Direttur aktarx irrizenja meta tassew ma felahx iktar, wara li prova b'xi mod iwettaq it-talbiet li sarulu, minkejja li hass li ma kinux talbiet ta' min jaghmilhom. Niehu gost li f'Malta ghad hawn min ghandu n-'Non plus ultra', kif titlob is-serjeta. Ma nistennix ahjar minn dipartiment li ftahar li nehha wahda minn zewg katarretti lill-anzjana li kienet ilha tistenna bi tnejn ghal iktar minn hames snin, biex ma nghidu xejn ghall-medicini nieqsa, apputamenti ghall-specjalisti xhur twal wara li jintalbu, nuqqas ta' sodod; tghid hadd ma qallhom b'dawn ukoll?
David Caruana
Sep 3rd 2012, 09:55
'The Malta Union of Midwives and Nurses has described Prof. Brincat’s claims as an “insult” to Gozitan nurses, saying they were equally capable as their Maltese counterparts.'
An insult would be your lack of intelligence at understanding a simple claim. Prof. Brincat never said that the Gozitan nurses are not capable enough but that the necessary TRAINING was not given to them.
Now go back to whoever is 'pushing' you to spread such nonsense and inform them that people out there grew brains and can see through your spin and misinformation.
David Caruana
Sep 3rd 2012, 09:44
Stephen Brincat vs The Ministry of Health
Dear Dr Cassar, you can spin as much as you like - those who had occasion to know Stephen Brincat know well enough who to believe on this issue.
A Trapani
Sep 3rd 2012, 10:32
.. perhaps same could be said about Dr Cassar.
Please choose the reason of your report below: