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‘It’s a storm in a tea cup’

He was given a waiver to continue working as an eye surgeon in breach of the ministerial code of ethics. Parliamentary Secretary Franco Mercieca defends his actions and tells Kurt Sansone it is in his patients’ best interest.

Franco Mercieca: “In ophthalmology there are different sub-specialisations... and we all train in a particular field”. Photo: Matthew MirabelliFranco Mercieca: “In ophthalmology there are different sub-specialisations... and we all train in a particular field”. Photo: Matthew Mirabelli

When Prime Minister Joseph Muscat offered you the post of parliamentary secretary was the ministerial code of ethics ever brought up and by whom?

I don’t think it is a problem if I just do a few hours in this field because the full-time job is going to be my parliamentary secretary post, which is very busy

When Joseph Muscat offered me the secretariat we discussed the issue; we discussed the situation with the code of ethics and there was an agreement that there will be a waiver for me to continue my practice in a limited way for the sake of patients.

Who brought up the issue of the code of ethics?

Joseph Muscat.

Until the media pointed out that you were still seeing patients, nobody knew you were given a limited waiver by the Prime Minister. Isn’t this veil of secrecy the same as that of the honoraria issue in the last administration that caused so many problems?

Not at all. The honoraria issue was something done underhand and nobody knew about it for a year or more. I went to Mater Dei Hospital, the most public of places you could go to. I don’t think it was so secretive.

But nobody knew about it until the media asked.

No, I don’t agree with that. I actually informed the hospital CEO and the head of department, Thomas Fenech. They were informed that I would be going to hospital to have a clinic and actually perform operations on Sunday.

The special waiver was given on the premise that you are the sole medical practitioner in particular ophthalmic fields. Who determined this?

Medicine and surgery has evolved... nowadays we also have sub-specialities. In ophthalmology there are different sub-specialisations... and we all train in a particular field. I was appointed a consultant in cornea and anterior segment surgery. You can actually check the call of my consultant post and verify this.

Was it you who informed the Prime Minister of this speciality or did he verify it himself.

I don’t think he had to verify it. I told him and this is public knowledge. You can actually check the call...

Because the head of the ophthalmic department [Thomas Fenech] seems to disagree with this line of reasoning that underpins the special waiver. He said that what you can do, other ophthalmic surgeons can do also. What is so special about what you do?

If you are a general ophthalmologist you can do all operations but nowadays we are all trained in sub-specialities. You get better results by actually doing the same work in the same field. I can do a retinal detachment operation and Mr Fenech can do a corneal transplant but it doesn’t mean that we get the same results in those fields unless we are doing our sub-speciality. Our understanding of the last 10 years has been for me to refer any retinal [patient] problems to him [Mr Fenech] and if he has a cornea [patient] problem he refers it to me. He has now decided to start doing this work as well and that is fine.

Wasn’t the impression given that if you stopped working in hospital patients might suffer because there will be nobody to replace you?

Nobody is indispensible. There are people who are trained in special fields and others better trained in other areas. I am formally trained in cornea and anterior segment surgery. I trained in Manchester and have been practising this sub-speciality for the past 10 years. We’ve been doing this for the benefit of patients so they can get the best possible treatment.

If nobody is indispensible then why get this special waiver, which is premised on the argument that the country will lose the services of someone who is not replaceable?

There is limited expertise in this field and in certain situations expertise is important. I will not indulge in self-praise but if you have a sub-speciality you can give the individual a better service. You can perform this operation but the outcome is more important than just performing it. Is it better for an individual to have a surgeon who does a particular operation once a year or does he go to a surgeon who does 100 a year? You answer that... who do you prefer?

I think the answer is obvious, you will prefer the surgeon who has done 100 a year but surgical operations in hospital, even the ones you perform, still continued when you were caught up in the election campaign and your presence there was much reduced.

Of course, nobody is indispensible.

I am informed that last week you conducted two cataract operations in a private hospital. Cataract operations are done by others and are also offered in the public hospital. What does this waiver cover that is so special?

I had been seeing these patients and they had the other eye done. They had to have the second eye done and you cannot expect me to say ‘now I’m not going to see you anymore’. This has been the way for cornea and anterior segment surgery and this falls within the remit.

You had an option of not accepting the parliamentary secretary post and all this would not have erupted. Why did you not choose this road?

I discussed this with the OPM and I don’t think it is a problem if I just do a few hours in this field because the full-time job is going to be my parliamentary secretary post, which is very busy.

You made it a point to say that your work at Mater Dei is now for free but you still get paid for services in the private sector. Is this about the money?

No, it is a service to the patients.

You would have earned good money.

The private sector has been the best source for doing my work in corneal surgery. The private sector has invested in [various] machines that are used in corneal surgery, which are lacking at Mater Dei for reasons I do not understand. I have been asking for them since 1998 when I came back from the UK but there was no investment. Now we are just setting up the cross linking machine and there has been a call to get a corneal topography machine but it has long been coming. Patients and I are actually forced to do particular operations in the private sector because they cannot be done at Mater Dei. It is a service to the patient as well and if these patients are not being served in the private sector they will have to go abroad.

You are operating in the private sector that has invested in all this machinery that allows you to offer a service that is not offered at Mater Dei hospital but you are also part of a Government that decides on what Mater Dei should offer and what funds should be allocated. Couldn’t this put you in a conflicting role?

No. It puts me in a position where I can actually push to get all the equipment possible at Mater Dei so that patients do not have to go to the private sector.

This controversy has potentially distracted you from your parliamentary secretary role. Isn’t this a problem in its own right?

I don’t think it is a big problem. I got the waiver from the OPM and I think it’s a storm in a teacup.

A storm in a teacup? Are you a full-time parliamentary secretary?

If I operate on a Sunday instead of visiting a band club to see my constituents, I am a full-time parliamentary secretary.

Aren’t you more important in the public hospital performing totally as a doctor rather than a parliamentary secretary?

Time will tell. Let us wait and see. Let me deliver first and judge me on delivery.

Have you ever considered resigning?

If the Prime Minister was showing any sign that I was in a difficult position I would not have been reluctant [to resign] but he was behind me all the time and we never discussed it.

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