Not all that glitters is gold in Gozitan healthcare

The Gozo hospital privatisation process has so far been no more than a badly run exercise of superficiality made worse by the defensive siege mentality of its management

The Gozo general hospital is now run by Steward Healthcare, a private company
The Gozo general hospital is now run by Steward Healthcare, a private company

As its name so clearly indicates, the Gozo General Hospital should be a centre for primary and secondary healthcare services provision.

Whether co-located or not does not really matter. What matters the most for Gozo’s residents is that they should always have the peace of mind that a conglomerate of reliable healthcare services is a short distance away, should something go wry with their well-being.

This is the most basic of definitions. It is the expectation many Gozitan people share, irrespective of their background and transcending any political or corporate posturing.

It is safe to say that Gozo’s hospital could be considered an institution.

Apart from offering a crucial service, it is one of the island’s main employers and indeed the likelihood of having a family member or one of your friends employed there is relatively high.

The reality of Gozo being a small, close-knit community offers the advantage to quickly appraise whether things are getting on well. As a regular visitor and from thoroughly observing the public’s perspective, one can safely state that the operation leaves very much to be desired.

Let me make one thing clear. The hospital was indeed in dire need of investment. Prior to its privatisation, the upgrade to the operating theatres, which I happen to have made use of, did give a semblance of how hospital operations should be set up and run.

But, come out of those operating theatre doors and clearly the infrastructure was screaming for a long overdue upgrade.

We were then presented with the idea that devolving the operation to a private entity would indeed bring about the necessary change and investment.

I am all for private enterprise and privatisation, only when the conditions for the taxpayers are right and indeed the private entity has the right credentials to operate.

Shockingly, I was also told, that if needed and if you can, make your way straight to Mater Dei and fake your ailment in Malta to get a proper service

The Gozo General Hospital privatisation was a textbook example of how not to privatise a public operation. Insert the words “sole critical healthcare service on an island” and “a company with no healthcare operation and management experience whatsoever” and it takes little imagination to assert that the whole process was doomed to fail from day one.  VGH was indeed a flop and we are still suffering the consequences.

Walking through the main gate of the hospital, a poster emblazoned with the words “a long-term vision of healthcare excellence is unfolding one patient at a time” used to hoard off the gaping hole in which by now should be an operating academic medical campus.

This was quickly taken down following the not-so-long-term 21 months of the VGH fiasco.  The hole is still there and a new poster was erected, albeit unsure of whether things have changed.

You then go through the nice whizzing automatic sliding door and the renovated tiled reception area donned with LED lights and a widescreen television set where you can register for appointments.

Behind the old swinging door

To the right of this illusion, an old swinging door could be found, behind which the harsh reality of the outpatients department immediately strikes back. 

The hall is still donned with 1980’s infrastructure and the daily routine of overcrowded loud chaos is so hard to miss. I always get the opportunity of having to give up my seat to someone who is in more need than myself.

Dentistry, ophthalmic, cardiac, maternity and paediatric patients are all bunched up in one very small room all having different appointment schedules.

Your name is then called or rather blared on a blow horn when your turn is due, generally one to three hours after the appointment is scheduled and this opens another door to another waiting period, this time standing up in a very busy corridor.

Eventually you do get to see a doctor.

I have had the opportunity of making use of primary healthcare services abroad, which happened to be publicly run, and it is nowhere near what I have described above. You are received well, the service is discrete and most importantly efficient.

Make no mistake, prior to privatisation things were the same. However, following two tranches of privatisation of the only hospital on the island I can assert that to date the privatisation exercise has been no more than a badly run exercise of superficiality compounded by a defensive siege mentality of its management.

It is useless to throw in the words privatisation and efficiency unless you get a change of mentality.

I do have a lot of sympathy for the employees and medical staff. They do the best they can with the tools and amenities they are provided with. After speaking to several friends who currently work there, I could easily notice that morale is quite low and dispirited by the lack of direction from a management that still needs to find its proper footing.

The routine statement I get: Things are done for the sake of them being done rather than effectively doing what is needed and required for the patient’s benefit.

Shockingly, I was also told, that if needed and if you can, make your way straight to Mater Dei and fake your ailment in Malta to get a proper service.

Superficial is the proper word to describe this situation.

The helicopter operated by Steward Healthcare at the Gozo general hospital
The helicopter operated by Steward Healthcare at the Gozo general hospital

Mixed reactions from those in charge

Upon asking pertinent questions on what is supposed to be one of the most important and largest investments on the island you get immediately and aggressively shut down.

What management does not seem to understand is that Gozo is a small island and word travels fast.

Take last week’s helicopter incident. Following a tip off that something was not right with what is an essential service possibly jeopardising a patient’s life, we were met with a co-ordinated effort from Steward Healthcare management and some officials from the government to hush the episode without effectively answering any questions.

What was most bewildering was the brash and harsh response from Joseph Fenech, the hospital’s CEO. I was not sure whether I was reading a statement from a political activist defending the government tooth and nail, making reference to external and out of point events or from a CEO of a private healthcare institution seeking to run things smoothly.

READ ALSO: Hospital CEO denies Gozo helicopter could not evacuate cardiac patient

I am not sure Steward Healthcare would be impressed with the sort of response he provided.

We also had a mixed and divergent response from government officials with Gozo Minister Justyne Caruana, previously completely mum, at best repeatedly deflecting questions, on the hospital privatisation issue, giving her full support to Joseph Fenech and emulating his ill-conceived social media post.

On the other hand, Health Minister Chris Fearne refrained from passing judgement on the helicopter incident and asking for an investigation into the matter.

Needless to say, Fearne took the more appropriate course of action given the circumstances and the many unanswered questions, indicating that he may not be fully satisfied with Steward’s response.

In any sort of service provision things sometimes may go wrong; granted.

When questions are then asked by potential customers, in this case patients, authorities definitely should not rebuke or rather rebuff in 1980’s Russian Pravda style to make their point.

Most importantly, Joseph Fenech did not answer any of the questions being asked to reassure and allay any fears that according to him are misinformed. Given what happened, any serious executive would go out of his way to reassure the general public, his customer base, by providing the exact timeline of events, backing it up with records and statements from the medical staff.

Maybe after all the, just like the outpatients department, nothing has really changed and no matter how grandiose the superficiality exercise is, the mentality and modus operandi is still backwards, inefficient and toxic.

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