Hospitals all over the world grapple with overcrowding and delays in their emergency departments, striving to improve things. Malta is no different.

There have been patient education campaigns aimed at diverting some of those who did not need to go there. Of over 9,000 patients in February 2012 who went to the Accident and Emergency Department, a third were low or medium priority and 40 per cent of those referred by doctors were not high priority.

Last year, the previous government tried to forcibly redirect low priority patients back to health centres once the investment had been made there to cope with minor emergencies.

This was merely one aspect of the problem. There were bottlenecks in the patient flow all through the system. There were no statistics gathered on how long people stayed in the waiting room and constant grumbling when newcomers were sped in for treatment, in spite of notices explaining that this depended on medical considerations and not on a first-come, first-served basis.

Once inside, the treatment process drags out while diagnostic machines are fetched from other cubicles, until doctors can tear themselves away from other patients to review results, for X-rays to be taken and reviewed, blood tests results interpreted and, once it was all over, those who required admission – almost two-thirds of them, according to a March 2012 report – could not be moved until there was a bed in the ward, porters to take them up there and so on.

The previous government spent €1.35 million on a report commissioned in 2011 from John Hopkins Medicine International on how to improve the procedures at Mater Dei Hospital, including the Emergency Department. Now in Opposition, the Nationalist Party is claiming indignantly that it acted on many of the recommendations and that not all proposals could be implemented simultaneously.

Why should the plans just announced by Health Minister Godfrey Farrugia, based on both the John Hopkins report and the Health Ombudsman’s, succeed where others have failed?

One of the marked differences is the emphasis on the peripheral services. In the plans explained in Parliament on Wednesday, Dr Farrugia said an agreement was reached with the Union Ħaddiema Magħqudin and the General Workers’ Union on the working conditions of emergency responders. He prodded them into also agreeing to other changes, like having ambulance drivers carry patients into the ambulance, a seemingly trivial concession to outsiders who may have forgotten how long it took to negotiate the colour of the piping on health assistants’ uniforms.

He plans to increase the number of ambulances from seven to 11 and for some of them to be posted regionally to improve response time.

Health centres will, one hopes, once again take on their role as gatekeepers for the hospital, open round the clock.

There will be a bed management and bed discharge policy (meaning some hard decisions once and for all about social cases). Just as importantly, there will be a tracking system and a review after a few months to see whether there has been any improvement.

One thing Malta is never short of is reports. What we do lack is the ability to accept that it is often not the high visibility issues that are the root of the problem but the myriad deep-rooted cultural and occupational mindsets.

Those visiting the Emergency Department are often in pain, deeply concerned, traumatised. No one questions the standard of medical care they are given but we owe it to them to be able to get them treated as soon as possible.

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