Health Minister Chris Fearne explains how waiting times have been brought down to two hours at Mater Dei Hospital and assures Matthew Xuereb that he has a good working relationship with his predecessor Konrad Mizzi.

Read here: Plans to build mental and child hospitals at Mater Dei

Are patients still being treated in the corridors at Mater Dei, or is this a thing of the past?

It is mostly a thing of the past. In 2012, there were 8,200 bed nights with patients in corridors. This year, we had three bed nights in January, at the height of the influenza. In February and March, there were none. So we’ve come a long way. Will we ever have more? I cannot guarantee that we won’t, but we are working flat out. We have opened new wards to accommodate more patients.

Are there any social cases still at Mater Dei?

I wouldn’t describe them as social cases. They are not there because they want to be but are people who are in their 80s or 90s, whose children are probably 65 or 70, and they probably need help themselves. When we have long-term cases, we need them in long-term facilities. With the ageing population and the increasing demand, the government policy is to encourage the private sector to open more centres for the elderly, and we buy services from them.

According to the patient charter, the hospital waiting time is between two and four hours. Is this being respected?

The patient charter comes into effect in November, because we gave people time to put their house in order. We started in 2013 with an average waiting time of 13 hours at emergency, and we have brought it down to two hours. On 90 per cent of the days, we are better than this. Every one in 10 days, it goes beyond the two hours, so there is still more to be done.

How did you achieve this?

We increased the number of doctors and nurses, doubled the number of cubicles and opened a paediatric casualty, because 30 per cent of people who go to emergency are children.

We also introduced an IT system whereby all patients are colour coded. Within two hours, the patient is green, beyond two hours, it goes to amber, and after three hours, it starts flashing red. The monitors are accessible to doctors at emergency, and they are also in the CEO’s office. The doctor knows that the CEO is watching, so it works.

The doctor knows that the CEO is watching, so it works

There were efforts to get people away from the emergency department. Is it working?

Every year, more people come to Mater Dei. At the same time, more people are going to the health centres, too.

We need to continue improving health centres. We’ve done a lot. We are also working with family doctors so that they can access medical records, results and blood tests from their clinics. But the new, big step has got to be prevention.

When you go to emergency, they assess you and put you in one of five sections: level one is life threatening, so you’re seen immediately; level two is urgent, so you skip the queue; level three is serious but not urgent. And then there are levels four and five – people who could have gone to a health centre. We do not send them away, so we opened a minor care clinic and employed a GP to see to these cases.

They make up almost half of the total number of patients, so we published a call to get more doctors to work in this clinic to reduce the number of people waiting for more than two hours.

The hype about the inferior concrete at Mater Dei Hospital was followed by total silence. What is happening? Has the court case against Skanska started?

We engaged a group of architects to examine the extent of the problem. This report showed that the concrete was weaker than contracted, the design was inferior to what was signed off, and there was evidence of fraud, since concrete tests were falsified. These were passed on to the police.

Initially, Skanska would not even talk to us. Their lawyers were constantly quoting a project closure agreement signed in 2009, saying that they were not responsible for anything more. But in December last year, we started arbitration on the basis of fraud, and that was when they started talking to us.

At the moment, we are in arbitration, and there are also talks with Skanska on a without-prejudice basis, with a view to trying to reach an out-of-arbitration agreement.

Why was so much of the contract between Vitals Global Healthcare and the government blacked out? What are you hiding?

The contracts with VGH are some 400 or 500 pages. A substantial part of the blacked-out clauses, about 30 or 40 pages, was a separate agreement between VGH and Barts. They need to release it.

The rest was removed on the advice of lawyers, citing commercial reasons. There were absolutely no political reasons behind the redaction.

Having said that, we have given the National Audit Office the go-ahead to look at all the contracts, including the commercial parts. The NAO is usually more meticulous in looking at these things than any journalist or politician. We are being fully transparent and the NAO report will be public, so any inkling of impropriety will be out in the open, and I have absolutely no problem with that.

The Labour Party’s manifesto promised consultation with stakeholders over healthcare. The MAM is complaining about lack of consultation. Why have you broken this promise?

We’ve discussed repeatedly with all unions, including medical students and all the stakeholders, including doctors, issues related to the private-public partnership with VGH.

About a year ago, we reached a written agreement with MAM on the way forward, but it was never signed. I understand that when there are changes, people are anxious, so we are keeping people in the loop as much as possible.

What assurance does the patient have that profit will not be put before patient care at the privatised hospitals?

VGH have partnered with Partners Healthcare International, the institution that runs the Harvard teaching hospital. PHI are introducing systems, including the Joint Commission International classification.

JCI accreditation means that you are monitored continuously. Mater Dei does not have JCI accreditation, so it will be even better than Mater Dei.

We are also beefing up the Superintendence of Public Health to make sure that standards are met. The contracts include key performance indicators that are inbuilt and also a quality assurance committee that has to report on a monthly basis. And with each performance indicator, there are penalties. The committee has representatives of VGH, Barts and the government.

How much money will the government be saving through these agreements?

VGH have to invest in excess of €200 million: around €140 million in infrastructure, another €40 million in equipment and the rest on training. We are not paying anything for this.

On our part, we will continue to pay what we have been paying in recurrent expenditure over the years. We paid more or less €50 million to keep St Luke’s, Karin Grech and Gozo Hospital going. We are saving on the capital expenditure.

So how does this make financial sense for VGH?

We told them we need 250 beds in Gozo, but they are building a hospital of 350 beds. We told them we needed 80 rehabilitation beds at St Luke’s, and they are building 120. They are using the extra beds for medical tourism. It is good for VGH and also good for us, because every patient who comes here brings his family and spends an extra week or two. It is estimated that they leave €10,000 per person in the economy.

For these hospitals to attract patients from America and Canada, which will be covered by insurance companies, we need the highest possible standards, so even in that aspect, we need to be tops. So we are raising our standard for locals, too. The VGH business model is medical tourism.

Is the government planning to privatise or reach public-private partnerships in other sectors of health care?

No. As a government, we are obliged to give excellent care. Our vision is to have Malta as a centre of medical excellence in the region. We also want it to be accessible to everyone, so it has to be free. But for this to be sustained over time, we have to be clever with funding.

You were parliamentary secretary when Konrad Mizzi was health minister. When he was mentioned in the Panama Papers scandal, following a reshuffle, you inherited the ministry. One of the first decisions you took was stopping a Nexia BT contract, and then there was the Neville Gafa medical visas issue. Were these the only two things you had to clean up?

It’s not a question of cleaning up.

When I became minister, of course I changed my advisers… That was the story.

So it was not because the advisers Nexia BT were mentioned in Panama Papers: it was just a coincidence.

No, it has nothing to do with Panama. I felt I needed to change my advisers. With regard to the allegations regarding Neville Gafa, I was informed about the allegations three or four days after I became a minister, and the next day, I asked the permanent secretary to inform the police.

Were these the only two?

Again, it’s not a question of cleaning up but a question of a different style of doing things. I have a very good relationship with all my colleagues, and we work excellently together.

We started arbitration on the basis of fraud, and that was when [Skanska] started talking to us

It’s an open secret that there was tension between you and Dr Mizzi even before the reshuffle, and this is still evident. You did not attend a Barts Medical School event last week. Why not?

I can explain why. Do candidates from the same party who are contesting the same electoral district always get along on everything? The answer is no.

It has always been like this, and our [electoral] system is designed that way. With regard to Konrad Mizzi and myself, we have had a very good working relationship, and our people work well together on a district level.

With regard to Barts, I was intending to go to the event, and we informed the DOI that I was going.

But when I realised that there were another two ministers attending, I felt the government was already well represented.

So you’re not embarrassed about Konrad Mizzi?

A year ago, this was a major topic of discussion, even internally. The consensus was that the Prime Minister’s decision to move him to a ministry without portfolio and ask him to step down from deputy leader [of the Labour Party] was enough. If, in the course of time, rather than just poor political judgment there was also an element of fraud, we felt the matter had to be revisited. But a year has passed and everyone agrees, including Konrad, that there was poor political judgment but no fraud.

How would you rate Labour’s performance, out of 10?

I would say we have done extremely well, and I would give us an eight. Eight out of ten, because we are in year four out of five. By the end, it will be 10 out of 10.

Are you worried about the growing perception of corruption?

I think you’re right when you say perception because what’s happening is that we’ve been overenthusiastic in wanting to get results quickly so we may have not given enough importance to governance.

But this is just a perception, because the checks and balances are all in place.

I think it’s a question of governance rather than corruption. I don’t like the fact that there is this perception, but I don’t think it’s justified.

What are your political aspirations?

I feel that I am working within the level of my competence, even on a European level. I have the full support of my wife, children and parents.

I feel that I am getting results, and I am enjoying myself.

So I will of course be standing for the next general election on two districts, and my ambition is to get elected again.

‘Make or break’ deal for doctors

Doctors have postponed their planned industrial action to April 10, giving the government time to accept their proposals for improved working conditions.

Medical Association of Malta general secretary Martin Balzan told The Sunday Times of Malta yesterday that the decision to postpone came following a meeting with Health Minister Chris Fearne and representatives from Vitals Global Healthcare (VGH), which has taken over the running of St Luke’s, Karin Grech and Gozo General Hospital.

“They were quite receptive, so we have decided to postpone the directive for one last time. But this is the final postponement, and it is make or break. We are expecting just a yes or a no. Not counter proposals. They either accept what we want or they don’t. That’s it,” Dr Balzan said.

He explained that the association had individually met members of its different sections and the members expressed their agreement with the way the association was handling the issue.

“Members are foursquare behind us, and they are ready to obey any action. But we told them to retain the same level of preparedness, because the directives will kick in unless we have a positive reply,” he said.

Mr Fearne also spoke about goodwill from all sides for reaching an agreement. He said he was in discussions with MAM over a new collective agreement to replace the one that had expired, as well as on issues related to the agreement with VGH.

“We have had meetings as recently as Wednesday. Even though there are differences, these are not insurmountable. There is goodwill to reach an agreement on both sides, and MAM has decided to allow more space for negations. We are still in discussions and we are due to meet again soon,” he said.

The doctors’ union has been in dispute with the government over the privatisation agreement with VGH, part of the Singapore-based Oxley Group, which was given a 30-year lease to run the three hospitals. The MAM sought a number of guarantees over its members’ working conditions, but attempts to iron out the differences with the health authorities failed and no progress was registered.

The doctors’ union recently registered an industrial dispute and gave notice of industrial action starting March 20 but postponed it by a week, before the latest postponement.