Eye surgeon Thomas Fenech has expressed surprise at the farming out to private clinics of cataract operations, when his department was working on setting up a cooperative within Mater Dei Hospital to cut waiting lists.
Mr Fenech, chairman at the hospital’s Ophthalmology Department, told The Sunday Times he wished to correct the impression that he was the proponent of this agreement between the government and the private sector.
“I’m not driving this idea. While in principle I agree with this initiative, because anything that can reduce the waiting list is a good thing, I would have explored other options – this should have been a last resort,” he said.
Mr Fenech felt he had to clarify matters after he ended up being dragged into a spat between Health Minister Joseph Cassar and Labour health spokesman Marie Louise Coleiro Preca.
Dr Cassar had defended the decision to outsource cataract operations saying this had been done following consultation with Mr Fenech after Ms Coleiro Preca accused the government of going ahead with this initiative without consulting the chairman.
Mr Fenech – who is also the general secretary of the European Society of Ophthalmology – said he had been consulted about this proposal last March.
“I said yes, in principle, I agree with farming out to the private sector, but I couldn’t give the green light without first seeing the details,” he said.
The procedures have already started being carried out at private clinics, and on Friday Saint James Hospital removed cataracts from the eyes of Carmena Fenech who has been on the waiting list since 2005.
Mr Fenech himself has chosen not to take part in this venture, but insists that at no point has he discouraged consultants from joining in.
“All I’m saying is I have another idea. I’m trying to push the cooperative as an alternative. I’m passionate about this because it’s the one chance to have a morale boost for the staff. As chairman I feel my loyalty is to my department,” he said.
“I don’t want to give the impression I have anything against private clinics; I work there and believe they should be supported,” he added.
The longest waiting list at Mater Dei is for the removal of cataracts, amounting to 4,752, which explains the government’s urgency to address the problem. The ministry has been in discussions with private clinics for the past year to roll out the initiative.
Mr Fenech points out that the waiting list was stopped from spiralling out of control and stemmed by doctors’ decision to work on Sundays, the recent employment of two consultants, and the availability of a second operating theatre.
He believes the way forward to cut into the waiting list is by introducing afternoon sessions and founding the cooperative of ophthalmic care workers.
Asked why these ideas were not introduced earlier, Mr Fenech explained that carrying out the operations in the afternoons had not been easy to achieve as nursing staff were not always available.
There had only been one afternoon slot on Thursdays, which as chairman he felt he should fill to lead by example. He kept this up for two years and from having the longest waiting list he now has the shortest one.
The cooperative, on the other hand, could not have been set up earlier because there were insufficient funds. With the money now available, Mr Fenech had started the ball rolling and hoped it would be up and running by next month.
Mr Fenech is quick to stress this cooperative is not about the money: “Money is not the issue here. This is why I really believe in the cooperative. In the private sector it’s only the surgeon and the clinic making the money, whereas with the cooperative the whole team will have some extra income for their extra efforts.”
Would this not risk leading to a situation where it paid ophthalmic care workers not to work during the day to increase the business of the cooperative?
“You can benchmark the performance of a department. If we start working less than previous years then something is wrong. At least we have to do the same number of operations like last year. The idea is not to turn this into a money-making machine,” he stressed.
When contacted, the ministry confirmed it supported any approach that, “within the context of government policy, maintains the interest of the patient as its priority”.
Despite Mr Fenech’s initial reservations about the concept of outsourcing, he is confident the cooperative can work in tandem.
“Now it’s just a matter of doing something intensive for a year to 18 months and then once we get the list down to a situation where everyone is seen to within six to nine months the problem is sorted.”