Ivan Falzon, CEO Mater Dei Hospital

Mater Dei is responsible for more than 50 per cent of the nation’s health care. This, and its position as the only general hospital capable of handling acute cases, means that it is frequently on the national agenda. And one issue that crops up from time to time is the matter of security, both that of our employees and, crucially, that of the patients entrusted to our care. 

Our approach and resulting strategy are both very clear. We have had to regain operational control of critical aspects of the hospital’s security. And we have done this by stopping the madness of relying completely on outsourcing to cover this most important aspect of hospital life. For the first time, Mater Dei has a chief of security directly employed by us, and directly responsible for the massive security operation that is necessary to run a site the size of a small Maltese village. 

For the last three years, the chief of security at Mater Dei has been responsible for the development of an entire security strategy from scratch. We have introduced countless measures whose effect has been felt on the ground – positive changes which have been noted and commented upon favourably by staff, visitors and patients alike. For obvious reasons, I will not give away any details connected with these security measures, but I will offer some facts instead.

Today, Mater Dei receives more alerts from its dedicated and newly trained team of security personnel

Today, Mater Dei receives more alerts from its dedicated and newly trained team of security personnel than it ever did in the past. That’s because its security patrols have increased by 300 per cent and because its entire security team is now more present, more visible, and more proactive than ever. Security procedures are at last effective across the hospital. We believe that a security presence acts in the first instance as a deterrent and only intervenes when the deterrent hasn’t worked. 

Over the last few years we have registered improvements in key areas. Having said that, we know that security is a volatile, highly unstable and fast-changing environment. Increasing demand for security puts pressure on Mater Dei and in turn requires us to go on giving security the priority it merits. With this in mind, Mater Dei is working to strengthen still further its inner security structures. Continuous staff training, coupled with investment in the latest technology, top the agenda. 

Such initiatives alone will not work unless accompanied by a change of culture. We need to start with ourselves, driving home the message that any type of aggression, verbal or physical, is wholly unacceptable. Unfortunately, a hospital is a place where people – relatives and patients – are experiencing moments of great grief, and also life-changing circumstances over which no one has control. Yet having accepted that, I’ve noticed there is still a general notion – a mistaken one – that aggression is somehow ‘acceptable’ when bad news is being broken. It is not acceptable. 

And so our first challenge is to get this message across to our staff. Aggression should not be tolerated under any circumstance. Sympathy and support by all means, but a definite no to any kind of aggression. With this in view, members of staff have over the past few years attended training sessions dedicated to the development of emotional intelligence, enabling them to support grieving families, communicate bad news, and to address aggressive behaviour from colleagues and third parties.

Last but not least, we need to deliver the message to the public and to all users of the hospital that Mater Dei is not a place where you can just flex your muscles or exercise your vocal chords.  Of course we’re not perfect – we know that. Sometimes we do make mistakes. But the best way to address our failings is through meaningful dialogue, using various structured ways to redress the difficult situations we face on a daily basis. Mater Dei makes it clear that, in order to protect you, it will protect its own against any form of aggression.

Peter Agius, Nationalist Party European elections candidate

The concern reaching the media of late about security at Mater Dei merits two readings. One relating to management, the other relating topolitical responsibility.

The management issue is, I am sure, being tackled by the hospital administration. In that regard, our channels with the health professionals at Mater Dei tell us that the present security arrangements need to be beefed in certain departments. Not all staff is affected in the same way. Many wards have good security handling. Other departments require a serious analysis of weaknesses and perils to allow management to take sound measures to strengthen security.

Some health professionals point out the delay in security intervention. It goes without saying that security is the one service that is useful only if timely. Indeed the whole point with security services is that they should ensure that their need does not even arise.

Staff at Mater Dei also mention the difficulty of the contracted private security staff, who are not police officials and hence by definition do not carry legal authority, to prevent and apprehend the occasional criminal acts of aggression of physical and moral threats.

The security incidents are the symptom, not the disease itself

Escalations are thankfully not a daily occurrence at our hospitals but even an occasional incident can build up stress and anxiety among nurses and medics. Health professionals already have one of the most difficult jobs around, the least we can do is guarantee a secure and serene working environment. 

We must demonstrate our appreciation to our health professionals by heeding to their calls for better security in the parts of the hospital where this is needed. One clear way forward is to disseminate best practices within the hospital itself.

There is then the political reading of these incidents. We are living in a country with an oversize population living in an undersized infrastructure. Mater Dei, the departures lounge at Malta International Airport, the waiting area at ARMS and most of our main roads have one thing in common – they can hardly cope with the expanding population of 2018 using the services planned for our population in the 1990s. There were roughly 70,000 less of us in 1990.

Taking Mater Dei as one example, health professionals in several wards tell of the expansion of cultures and backgrounds of patients they are dealing with nowadays. Our nurses for instance need to be equipped with a wider set of skills to interact with patients with different cultural backgrounds, which as we know, tend to play their role when people are stressed or in pain as one may happen to be in a hospital ward or waiting room.

The expansion of our economy with foreign help has therefore its effects across the board. This need not be a major challenge as long as it is planned and handled with caution. Is it?

The security incidents are the symptom, not the disease itself. We must of course address the symptom in the short term. We must strengthen security and heed to the calls of our nurses and doctors who give their heart and soul to each and every one of us facing difficult times at Mater Dei and across our health services. But while addressing the symptoms we must be clear that they are indeed symptoms of a more wide-spread phenomenon.

To address the phenomenon we must come together and plan this country’s needs for the next 20 years starting from an honest analysis of the current situation. Unless and until we do that and start acting accordingly, we will be having more and more manifestations of the disease all across our public services.

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This is a Times of Malta print opinion piece