Healthcare for the 21st century

Time after time, surveys, opinion polls and focus groups identify health as being one of the top areas of interest for large sections of society. Any administration which does not give priority to health care risks losing support at a very fast rate. Successive administrations have recognised this.

Of course recognising the need to give priority to health care and actually doing it are two different things.

The last Nationalist government had in fact failed to produce any forward change in this sector, with the obvious result that once you stop going forward, you go backwards. Indeed when 2013 saw a change in government, the health service, whilst blessed with excellent professionals, was wallowing in a series of chronic problems, with the resultant erosion of standards of care.

Out of stock medicines, long waiting lists, extreme waiting times at the casualty department, a lack of bed space in our acute hospitals, an underdeveloped community health service and a number of substandard hospitals. These and other problems were the order of the day.

Worse than this, the previous government was giving all indications that it had accepted these situations as inevitable. We were told that waiting lists would only disappear “at the end of the world”; that out of stock was acceptable since “even the grocer had out of stock items”; that overcrowding at Mater Dei was the fault of patients and of professionals.

The Labour Party at the time disputed this and made claims that patients deserved better. We were ridiculed for this. Two years later, what we were told was inevitable, is in many instances becoming a memory of the past.

Out of stock medicines – both at community pharmacy level and at Mater Dei – have faded from our collective memory. For over a year we have kept the out of stock medicines to below five. Every week we publish online (health.gov.mt) our out of stock list. Many weeks it stands at zero.

The next step is to extend the Pharmacy of Your Choice scheme to the homes of our elderly citizens. This month we signed a Service Level Agreement with the GRTU and the Malta Chamber of Pharmacists which will see the start of a pilot project to do just this.

We will start with two localities, one in the south and one in the north, and then extend to the whole country.

We have also started to tackle waiting lists in a co-ordinated, systemic and cost-effective way. MRI, EMG, echocardiogram, bone density, sleep study, cataract surgery and angiogram waiting lists have fallen significantly. This summer we entered into a PPP agreement to utilise theatre space in private hospitals. Our surgeons have already performed over 100 operations, at no cost to NHS patients.

We are maximising utilisation of theatre space at Mater Dei by working afternoons and evenings and on weekends. Over 800 day case procedures have been done in a minor op theatre at Mosta Health Centre. Next we will be addressing hip and knee replacement surgery to slash the long waiting list we inherited here.

Casualty at Mater Dei was a mess. Whilst our staff are dedicated, well trained and provide an incredible service, waiting times in this department were unbelievable.

It was not uncommon to spend 20 hours waiting to be seen for an emergency! The average waiting time was 13 hours. We have changed systems, introduced new IT, increased the number of cubicles and employed more doctors and nurses and waiting times now at the Emergency department are below four hours in over 90% of cases.

The next step in this sector is to open a dedicated Children’s Emergency Department – which we will be doing in the next few weeks.

Building Mater Dei with less bed space than St Luke’s was a sure recipe for disaster. Indeed within two weeks of opening, there was already a bed space problem at Mater Dei.

This administration embarked straight away on extending space at Mater Dei. The concrete problem threatened to set us back seriously. But within 10 months we managed to build a new hospital block which will, next week, receive 68 patients in two new wards. 

We will not stop here and in fact whilst we are refurbishing below standard areas of Mater Dei, we will open new wards to create up to 300 new beds.

Now we will embark on a major project to bring hospitals around the country to 21st century level. Soon we will start works on St Luke’s – which will host a rehabilitation hospital and a regional trauma centre, Karen Grech Hospital, which will become a modern geriatric hospital and the new Gozo General Hospital which will be a 450 bed facility, a state of the art simulation centre, a polyclinic as well as the prestigious Barts medical school.

This is only the beginning. We have bold and audacious ambitions, but likewise we have audacious plans. We want nothing less than to make Malta an international  centre for medical excellence.

Chris Fearne is Parliamentary Secretary for Health