Interview 14/07/2002

On abortion, the future of health and solutions

He has the nation’s health to worry about, and loves collecting classical cars. Health Minister Louis Deguara talks to Mario Schembri Wismayer

The building, which houses the ministry of Health is an imposing edifice, which saw service as the court of justice under the tenure of Grandmaster Pinto. As I walk in, I notice that the ground beneath my feet is shaking and the air is filled with the noise of an air-compressor. Structural works are going on all over the place. Up two flights of stairs and I find myself in a room.

In the office of the minister’s secretary, a young woman is chipping industriously at a computer keyboard. In through an office and we enter the inner sanctum. The minister is sitting at his desk. He stands up and we shake hands. "Good morning. How are you?" "Very well, thank you and you?"

I start the interview by asking him about the abortion organisation ‘Women on the Waves’ and the government’s stance on the subject. "I am not one hundred, but one thousand per cent against abortion. I was government representative on the Council of Europe and our stand against abortion received commendation from Pro-life and the Vatican. We are ready to use all means possible to stop abortion. Of course, if these people operate outside our territory then there isn’t much we can do about it, and let’s face it you might stop people flying directly from Malta to the boat, but you cannot really stop people from flying to another country and then going to the boat from there."

Staying with feminine topics, I asked him if he viewed his wife, who is the mayor of Naxxar, as a competitor. I also asked him if he had been the one to encourage her to enter the field of public service. "Not at all. She is not my competitor. Rather, we make a successful team. My wife specialises in gynaecology and I practice general medicine and paediatrics. In politics I receive a lot of support from my family. It is impossible to stay long in this field unless you have the support of your wife and family. It was she who had encouraged me to enter politics." I ask if his wife ever thinks of entering the field of national politics. "No. She entered the local councils to give a service. There was a rumour a few years ago when I had a heart attack that she might enter the field instead of me. We probably wouldn’t both get elected, anyway. The people wouldn’t want to lose the service of two doctors."

I asked Dr Deguara whether he thought that pollution was a big problem. "It’s definitely a big problem. It’s bigger than most people imagine. We have the statistics to prove it. When we stopped planting acacia trees because of asthma, we thought we would see a slowdown, but asthma has been increasing steadily over the years. This phenomenon is directly attributable to the number of cars on our roads. Recently we introduced sulphur-free fuel and that has had an effect. We have also started to use this fuel at the power station. It is only now that governments are starting to pay a certain amount of attention to the environment. It is partly thanks through the pressure of the NGOs that we have finally started to be more aware of the environment in this country. There are many long-term environmental problems in Malta; Maghtab, which should close down fairly soon the hospital incinerator, the Gozo incinerator, to name but a few. The government has to decide about these things and come to the right decision for the country. Too often, however, the people’s attitude is "I elected you to your office, now you solve the problems and don’t touch my pockets!" When it comes to these things, it is necessary to have teamwork from all parties. It must be kept in mind though, that one recipe for disaster is to try and please everybody all the time."

I asked the minister about the dangers of having incinerators. "We have been waiting for a tender to implement non-burn technology and replace the incinerators for two years, but it has become bogged down in bureaucracy."

What about the locations for the landfills?

"These sites would be waterproofed and contained. The two sites may not present enough options. We may have to carry out in-depth studies of other identified potential sites before coming to a definite decision, but this is not really my field."

I asked the minister if Malta needs such a large hospital as the new Mater Dei. "While the hospital grounds occupy an area of 250 tumoli, the hospital itself will contain only 850 beds, compared with St Luke’s 1000. The big difference is in the focus. And the way the new hospital will be run. The new hospital will offer much better care and facilities. St Luke’s potential is lost because it is run using an antiquated philosophy. The approach of those who are going to be involved in the new hospital has to be more flexible. Many lessons can be learnt from St Luke’s and applied to the better running of Mater Dei."

I point out that one of the great encumbrances about St Lukes is the parking problem. "We are going to be able to accommodate 1600 vehicles. We could even increase the number to over 3000 but the problem is that the more parking space you have the more cars will come. The last thing you want around a hospital is the congestion and pollution that cars bring with them. What we need is a change in mentality. We would like to see people using an upgraded public transport. The trouble with the public transport is that many people talk against it without actually discovering it for themselves."

I ask the minister whether we are making adequate provisions for our ageing population. "There is a waiting list of 600 for St Vincent hospital, which we have extensively refurbished. We now have professional geriatricians working there. In fact, thanks to these improvements, residents of St Vincent are now living longer. Our philosophy is that preferably, old people should remain in their own homes. That is why we have meals on wheels, Telecare and other services, to enable people to live independently for as long as possible. Having said that, the last six years of a person’s life are usually spent in care. We have Zammit Clapp which was built as a geriatric hospital, designed to cure and return old people to the community. One of the changes that we will be seeing when we move to the new hospital is that we will have a geriatrician on the admittance team."

What will happen to St Luke’s?

"With regards to St Luke’s, many options exist. One is to convert it into an old people’s residence. Some services could be left at St Lukes. Boffa and Monte Carmel will become empty when the new hospital becomes fully operational. Again many options exist with what to do with these premises.

How is the migration to the new hospital going to be managed? "We are employing foreign consultants to help us plan the migration. We haven’t moved hospitals around before and don’t have much experience in this field. Everything is linked and therefore the process has to be carefully thought out. Our first target is to move outpatients."

I asked if the unions were being consulted or prepared. "Discussions with the unions started a little late because we took longer than was expected to select a CEO for the new hospital. There are 16 commissioning teams to plan things as smoothly as possible. The staff is involved in these teams. The more efficient a system becomes the more expensive it will become. This is because if, for example, by increasing efficiency you increase the number of operations performed per day, then you are going to increase the cost by every extra operation you perform."

What will be the running costs of the new hospital? "The new hosptial will cost Lm1.2 million a week to run, which is around the cost of running all the other centres on the island."

We change subject and start to talk about smoking, drugs and alcohol. "I am an ex-smoke, but I had to stop when I got a heart attack five years ago. I would say that in Malta smoking as a trend is increasing, which means we have to re-evaluate our campaigns and who they are targeted at. Youths are starting to smoke earlier, especially the women. This is very worrying as smoking is linked to cardiovascular diseases, which are the most common diseases in Malta.”

I asked the minister what he thought about the sponsoring of sport by tobacco companies. "The trend is to ban tobacco and alcohol sponsorship. This might prove to be a problem in Malta because there really aren’t many alternative sources of sponsorship. Smoking cannot be banned outright, but those who choose to smoke should be fully conscious of the facts so that they make an informed choice."

How is the war on drugs faring? "There is a market for drugs in Malta and the tendency seems to be increasing. The fight against drugs is a continuous one."

Changing tack, I ask Dr Deguara if he thinks the 50 cent tariff on prescriptions introduced by the Labour government was a good idea. "No, and I’ll tell you why. It was anti- social, because it had an impact not only on those who could afford to pay, but also on those who could not. It actually increased costs for the department because people began to ask for more medicines to be put down on one prescription, to save having to pay more tariffs. The scheme was not means tested and was of great disadvantage for the poor."

I asked the minister what, in his opinion, are the main differences between the Nationalist Party of today and that of yesteryear. "The deeply-held beliefs remain the same. The party has changed and adapted itself to the democracy in which it exists. I think the greatest change that party has experienced is that it has moved away from being perceived as the political party of the rich and the elite to being seen as the party of the people."

What about the EU? "The majority of the people are for the EU. By joining the EU the Maltese nation will place itself on the same platform as other European countries. It would also remove any inferiority complex that we might have."

Who is Louis Deguara, the private individual? "The best analysis is carried out by those who know you, rather than yourself. To become a good politician you need to be known as an individual – one who is there to help. This is where being a doctor can be something of an advantage."

Any pet hates? "Inefficiency and dishonesty in people. I don’t like kidding myself and I truly dislike being disturbed when I have some time on my own with my family."

Favourite hobbies? "I like cooking, classical music and walking."

Before escorting me out of the suite of offices, Dr Deguara shows me round the building. We stop to admire some stunning paintings by Cali and Mattia Preti. My favourite one, however, is a gloriously illuminated crucifixion of unknown authorship.