Ministry plays down suggestion that Steward unwilling to pay for AFM helicopter

The helicopter being used to evacuate patients from the Gozo General Hospital to Malta, cannot be used for three weeks in a 12-month period since it has to undergo legally required maintenance.

Questions have now been raised as to why the Armed Forces of Malta’s helicopter is not automatically deployed when the Steward Healthcare helicopter  – which is crucial for the evacuation of patients needing additional healthcare at Mater Dei Hospital – is out of service, after another patient with cardiac complications was unable to be evacuated to Malta last Sunday, the second patient not transferred by helicopter in one week.

A print version of this article appearing in MaltaToday Midweek originally reported the downtime period to be three months, not three weeks.

A Steward Healthcare spokesperson said that the decision not to evacuate the patient was agreed upon with the department of cardiology (and in other cases, the relevant department) in Malta. “These clinical decisions, of whether a patient is transferred immediately or not [to Malta] are taken in conjunction with the responsible clinical teams at Mater Dei. We do not solely transfer cardiac patients, but different medical emergency cases which are better treated in Malta. For the recent cases, it was agreed that the patients needed to be stabilised at the Gozo General Hospital,” the spokesperson said.

The Armed Forces of Malta, which operate a helicopter service in emergency medical situations failing the Steward helicopter’s availability, were not informed about the recent two cases. Steward said that the decision to transfer patients via an emabulance rather than the AFM helicopter was a clinical decision basd on the evidence at hand, in conjunction with MDH counterparts, and refused suggestions that the hospital is unwilling to pay the AFM for its service.

Former army lieutenant-colonel Martin Cauchi Inglott, now an MEP candidate for Partit Demokratiku, raised the matter in a Facebook post.

“The Armed Forces provided a professional intra-government Gozo-Malta medevac [medical evacuation] service for decades, and today have even better helicopter capabilities for such a service,” he said. “I ask why this million-euro contract was outsourced to the private [sector] when a 24-hour service cannot even be guaranteed.”

Steward Healthcare has justified the lack of air ambulance service by claiming that the transfer of a patient by ambulance via the Gozo Channel ferry was often faster than a helicopter conveyance. “There is also an agreement with the Gozo Channel in place that guarantees that a patient is transferred as quickly as possible.”

Ever since the new air ambulance started operating, more patients were being transferred than ever before – the ministry

Steward Healthcare said the GGH does offer an emergency service and that the absolute majority of such cases are treated in Gozo. “Over the past years this team has been further strengthened and is now seeing and treateing more patients than ever before. It is only certain emergencies that have to be transfered to Malta.”

Steward Healthcare however said that the Gozitan demographic for emergency cases - which does not only include cardiac patients - was small: in the last three years, the hospital had catered for just a hundred different emergency cases, including childbirth and minor issues. “We have so few patients that doctors can become deskilled. We’ll never provide certain services because of this reason. We can never run a sustainable service where the population is so small,” the spokesperson said.

The Ministry of Health substantiated the statements of Steward Healthcare, saying that not all patients with cardiac issues needed imminent transfer by helicopter. “Treatment protocols for different conditions exist – these are established by clinical teams from both the Gozo General Hospital and Mater Dei according to international best practice and guidelines,” a spokesperson for the ministry said.

The ministry argued that ever since the new air ambulance started operating, more patients were being transferred “than ever before.” It too made a reference to the AFM service that is supposed to function in its stead.

“Previously, with solely the AFM service between the two islands, some patients would not even be considered for air transfer but retained at the Gozo General Hospital,” the spokesperson said.

The air ambulance is now operational agains and on 24/7 standby in Gozo.

On 23 August, a Gozitan cardiac patient died on arrival at Mater Dei Hospital after he was unable to be medically evacuated a day earlier due to the Gozo helicopter being unavailable. An inquiry failed to find any fault with the way doctors had assessed the patient’s condition at the time, and the hospital denied that the helicopter had endured a technical fault.

The health ministry played down suggestions that Steward Healthcare, which runs the Gozo General Hospital, was unwilling to pay for the additional AFM helicopter service when its own helicopter is unavailable for medevacs, saying the number of patients transferred via air to Mater Dei had increased.

The ministry also insisted that two Steward Healthcare employees who had reported first the helicopter mishap of 23 August, had not been forcibly transferred out of their roles at GGH, but that they had re-quested these transfers. “At no point was political pressure or interference applied,” a ministry spokesperson said. “Their transfer was treated as any other transfer within the Health Ministry. Government employees retain the right to transfer and each transfer is treated on a level playing field.”