‘Small patch to cover a big hole’: Doctors critical of plan to outsource emergency services

The government’s plan to outsource emergency services to private hospitals in an attempt to reduce waiting times at Mater Dei hospital has been met with scepticism from doctors.

While the nursing union led by Paul Pace has promoted the initiative, doctors are warning that it is a temporary fix at best and that problems may arise.

The President of the Medical Association of Malta (MAM), Martin Balzan, said despite an agreement that any outsourcing needed the consent of MAM, which should be given six weeks’ notice, the association’s advice was not sought.

“If he asks for our consent, we would probably give it,” Balzan said, pointing to the problems at Mater Dei hospital, which, he added, resulted from a lack of infrastructure investment over the last 11 years.

“We have been telling them they need to invest in more buildings… but the €400 million to VGH / Steward was more important,” he added.

Balzan described the government’s approach to planning and managing the health sector as “amateur,” adding this new proposal was nothing more than a “small patch to cover a big hole.”

Patients needing emergency services at Malta’s main public hospital are facing waiting times of 12 hours or more before they are admitted.

The root cause of this, according to Balzan, is the mismanagement of public funds, longer life expectancy and population growth. “The service did not grow with the population’s increase in mind.”

Kevin Cassar, professor of surgery, agreed that emergency services at Mater Dei were “in constant total chaos” with long waiting times, but he warned against outsourcing the service to private hospitals, saying the idea was “complete bonkers”.

“Farming out to the private sector will be an unmitigated disaster,” Cassar told The Shift. “Private sector does not have specialists on site or access to certain specialised services that are life-saving.”

In line with what MAM said, Cassar added that the huge pressures on Mater Dei emergency are the result of a number of factors coming together: an increasing population, hopeless primary care service, inadequate hospital beds, antiquated processes at Mater Dei emergency department and the mismanagement of available human resources.

Meanwhile, members of the public who pay for health insurance – mostly to avoid having to go to Mater Dei and forced to wait in queues – are concerned that they will now have to face the same queues at private hospitals, wondering if they should not bother paying it anymore.

The only union supporting the initiative so far is MUMN, led by nurse Paul Pace, who was found guilty of abusing overtime payments. Pace admitted to misappropriating public funds, a criminal offence, by claiming overtime while he was, in fact, on holiday.  Despite the conclusions of the inquiry finding him guilty of abuse, Pace was not dismissed.

This week, Health Minister Jo Etienne Abela inaugurated a “new ward” at Mater Dei for 40 patients, saying the project cost some €1.4 million and an additional €140,000 in medical equipment.

The MAM immediately called it out. The association accused the government of misleading the public, pointing out that the new ward (M10) was the former staff canteen at Mater Dei that was set up as a temporary ward during the COVID-19 pandemic. The association stressed the ward did not offer the same level of privacy and toilet facilities as Mater Dei’s original wards.

Meanwhile, private hospitals have requested an extension of the deadline of only eight days to offer proposals for emergency services. In reality, only Josie Muscat’s hospitals can come close to providing such services.

The health ministry did not reply to questions sent.