A song in Maltese that had tried to take the mickey out of politics a few years back spoke of the people springing into action at the pull of a string from those on top. The Dalli report on Mater Dei Hospital paints a similar picture when it probes the management of the place.
“If the hospital is to function to an acceptable level of efficiency, efficient management, with full authority to decide on the structure and processes of the hospital (within the political objectives of the government and the health ministry) without any interference from outside, must be installed,” the former minister and European commissioner noted among other shortcomings.
He also pointed out that “deficient management” was exacerbated “by the continuous political involvement”.
Hospital CEO, Joseph Caruana, told this newspaper that political intrusion over the years weakened the management, rendering it ineffective. Judging by what he had to say, the top management ended up being very little more than a caretaker, a janitor. Strategic decisions were taken by the Health Ministry and unions went straight to politicians to obtain what they wanted.
“Trying to find people to shoulder the responsibility may not be an easy task as most problems are system failures and not people failures,” Mr Caruana noted.
This must be music to those coming from the private sector who are given public assignments. For the situation prevailing at Mater Dei, as expounded in the Dalli report, is found in other government entities too.
Such instances occasionally come to the fore, sometimes by accident but also when flagged by civic-minded individuals. In the case of the health service, both the Health Ombudsman and the National Audit Office have publicly referred to different aspects, including the Accident and Emergency Department and out-of-stock medicine, where they felt remedial action was required.
Some time ago, it emerged that a top Health Ministry official had drafted a report, entitled ‘Health financing reform policy proposal’, suggesting the introduction of fees for healthcare.
Such initiatives usually give rise to controversy and the powers-that-be more often than not opt for the road of least resistance: let the dust settle and leave everything unchanged or with just cosmetic adjustments being made.
We can only hope the same does not happen with the Dalli report, though the noises made by the Medical Association of Malta and, more specifically, the Malta Union of Midwives and Nurses, seem to have already had a calming effect on the Health Minister. He says he does not plan to go on a head-on collision course with unions. And so say all of us, especially where patient safety and hospital efficiency are concerned. However, what the facts show needs to be addressed and the sooner the better if the main State hospital is to be run better.
Mr Dalli may have nothing to lose in raising the points he did. But this was no routine report or the initiative of some top civil servant.
This was mandated by the government, perhaps to embarrass the Nationalist administrations, which Mr Dalli of course formed part of, and highlighted on a number of occasions by none other than the Prime Minister himself.
The government must now practise what it has been preaching and set the ball rolling by getting all stakeholders together to agree on a plan of action.
It cannot and should not be discouraged by any sabre-rattling, irrespective of the source.