[WATCH] Steward deal has failed, government should cut its losses, doctors’ association says

Government must stop giving money to Steward Health Care, who have to either fulfil their PPP contractual obligations or leave, Malta Medical Association head Martin Balzan insists

The government's PPP deal with Steward Health Care has failed, MAM president Martin Balzan said
The government's PPP deal with Steward Health Care has failed, MAM president Martin Balzan said

The government’s public-private partnership (PPP) agreement with Steward Health Care has failed, and the US consortium’s deal should not be extended, Malta’s doctors’ association said.

The Medical Association of Malta (MAM) said that, to date, a promised €200 million investment in a new Gozo hospital, a state-of-the-art rehabilitation hospital at Karin Grech and the complete refurbishment of St Luke’s has not materialised.

This when both Gozo and Karin Grech hospital are begging for basic maintenance, and St Luke’s hospital is in a state of abandonment.

Addressing a press conference on Tuesday, MAM president Martin Balzan said that the 2020 budgetary estimates indicate that the government has either approved or is planning to approve an increase in payment to Steward.

He emphasised that no more money should be given to the US health care giant, and that Steward should either carry out its contractual obligations or else leave Malta.

“We should not give Steward more money over and above what is in the contract. This is not what the Maltese people and patients deserve,” Balzan said.

The government had bought the proverbial “fish in the sea”, he said, because it had paid Steward money but not received what it was due in return.

In light of this, the government should cut its losses and move away from the PPP model, he said.

Read also: Nurses’ boss: Steward ‘failed miserably’ to deliver on all hospital projects

MAM held a press conference about the PPP deal on Tuesday
MAM held a press conference about the PPP deal on Tuesday

The government, Balzan highlighted, had in fact opted to not utilise a PPP arrangement to fund its plans to build an outpatient’s block at Mater Dei and a new psychiatric hospital.

Instead, it intended to fund the projects itself, indicating it had acknowledged that the PPP model didn’t work.

“This shows the government is agreeing with us, as it chose to not use PPPs for these new projects,” he said.

National Audit Office institutional failure 

Following statements by MAM against the PPP deal, Parliament’s Public Accounts Committee had two years ago voted for the Auditor General to evaluate the agreement, Balzan said.

However, the National Audit Office has to date conducted no inquiry, in what amounted to institutional failure.

“The Auditor General has to do his duty or at least admit he is scared to evaluate the contract. This is an institutional failure.”

Balzan said that while according to the legal advice it had received, MAM didn’t have the grounds to start a formal dispute on the PPP deal, it was actively evaluating whether it could do so on the basis of a breach of EU state aid rules.

€1.5 billion over 30 years for Steward

The government’s budgetary estimates show that, after excluding salaries, there has been a progressive increase in disbursements to Steward, Balzan said.

These now amount to €50 million a year, resulting in an expense of €1.5 billion over the 30-year period covered by the government’s concession for Steward to manage three of Malta’s hospitals.

Moreover, Balzan said that, according to what a source – an unnamed middle grade Steward official – told some doctors, the US consortium is considering leaving Malta unless government payments aren’t increased.

“We verified what the middle grade official has claimed – that Steward will leave if not given more money. […] And nobody has negated the claim.”

The substantial increase in budgetary expenses for the PPP also gave credence to the official’s claim, he said, showing the government had either increased what it would pay Steward or intended to.

The savings in the additional payments the government would give to Steward should be used in providing more up to date medicines and equipment for all patients, Balzan said.

“We are treating the patient as if Malta were a poor country, by not providing certain medicines for free. We have to give patients the treatment of a wealthy country.”

Barts Medical School constructed for far less than government will pay

Balzan said that the construction of Barts Medical School – which was inaugurated yesterday – unlikely cost in excess of €3 million to carry out.

The medical school he said, consisted in lecture rooms and offices, and would therefore cost far less than a bigger project, such as a hospital, to build and run.

Despite this, the Maltese government would be paying Steward €1.3 million over 30 years for Barts Medical School, resulting in a €35 million total expense for the taxpayer.

“But at least it’s a fish in the bag not in the sea,” he said.

The new medical school was taking in 30 students annually he said, which led to two problems, one where GPs at health centres were being asked to leave their place of work when they were teaching Barts students, and the second where most hospital consultants were resisting taking up Barts students at Mater Dei.

On the first issue, he said MAM had reached an agreement with Barts and the government whereby doctors will not be required to give all their attentions to students and will continue treating their patients.

Regarding the second, Balzan said MAM’s position was neutral on the matter, and that any doctors who felt loyal to the University of Malta and wanted to teach only university students could do so, while those who were open to taking on Barts students were free to do that.

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