Stephen Brincat’s recent resignation as chairman of the Oncology Department has hit the news with a bang, amid serious allegations. It is not my intention or within my remit to judge but as a practicing medical professional for the last two decades one fact strikes me most. I have always known the highly esteemed Dr Brincat as the head or chairman of the Oncology Department. My question is simple: Should a chairman remain in post for life?
The rotation of consultants as head of departments will lead to a better service for patients- Franco Mercieca
In this particular situation there wasn’t much of an option as Dr Brincat has carried the flag on his own for years.
The rationale of this escapes me, as I am aware of several Maltese oncologists who wished to join the department in years gone by. However it seems that the Health Department never issued any call for new consultants until recently.
Was there any particular reason why these specialists like many others in different fields were blacklisted? Why was the Maltese public denied of their services?
Several chairmen or heads of department in other fields have been in their post for several years and one gets the impression that such a post is ad eternum. Even though it is open to competition every three to four years, as the post of chairman comes up for reappraisal, something close to a coup d’état would be required for a change to occur. For various reasons which I would not like to divulge, only rarely does a junior consultant pluck up the courage to compete for such a post. In this way a chairmanship post will only come up either as a result of retirement or the resignation of the incumbent.
In my personal opinion this should not be the case. This statement should not be taken as any kind of disrespect to any current chairman, as I am quite sure they all work hard to improve the output both in quality and quantity of their respective departments.
However, as much as experience is important, fresher ideas are even more crucial. Chairmen staying in a post over a certain period of time may end up with tunnel vision and may find it very hard to discard methods and strategies which delivered past successes but are now outdated.
However, times change and like other walks of life, in medicine the advances move at a rather fast pace and this warrants a regular change in mentality and vision from the leadership in order to keep up with the progress.
Stagnation in medicine will only be bad news to the patients out there and thus the introduction of new blood brings in fresher ideas and much needed new work practices.
Let’s face it, life in medicine and surgery in Malta is very different from overseas. In fact overall it tends to be harder due to the restricted and relatively small catchment population, the very limited number of work colleagues with whom one could share knowledge and techniques, and limited funds to keep upgrading the medical equipment due to economies of scale. All these lead to much more difficult continuous medical education, which is especially so in the surgical fields.
Thus it is even more important locally to inject new blood in all departments and when the time comes to let the relatively new recruits lead the way .
If we insist on the same person heading a department, then progress, if it materialises, will most probably be much slower.
A rotation of all willing consultants, with varied sub-specality training, to chair a given department would offer the possibility of introduction of new treatment strategies and concepts and thus improve work practices.
A sad side of the story is that leaving a chairman or any leader in any field for a very long time will only push the best talent away as they may be seen as a threat. To make matters worse the best talent is slowly replaced with ‘yes’ men who may not be the ideal persons to improve the service.
In the UK, where most of us have trained, we are accustomed to a rotation of the chairmanship equally between all consultants in the particular field.
Therefore all consultants are on the same level and have equal opportunities, thus abolishing hierarchies.
Only in this way is one tapping all specialists’ expertise to better the particular department service provision.
The rotation of a chairmanship may not only improve the quality of the service but also introduce more transparency and accountability in decisions taken over the years.
I am quite sure that some consultants are better than others; this is only human nature but once a specialist is appointed a consultant he should automatically be offered the role of chairman at some point in his career to implement his own ideas, with the consensus of his colleagues.
In my opinion the rotation of consultants as head of departments will not only be a fair deal for those concerned but above all lead to a better service for patients.
This would lead to improved accountability and avoid a stagnation of ideas, leading to a faster rate of progression in the field with implementation of fresher and more cost effective work practices and treatment regimes.
Dr Mercieca is a Labour Party candidate.