Tremors in the Health Ministry

The media has been full of "revelations" that raised concerns about the goings on at the Ministry and ruffled the feathers of the local business community.

The first story to make the headlines related to the development of a new Patient Administration System for Mater Dei. According to the news reports, the software in question was developed in-house by "an internal team" of software developers employed by the Ministry, with particular mention made of Dr Mark Sammut, who was reportedly employed as a consultant to the Minister last June.

This news immediately raised major concerns in the local IT sector, of which I form a part. A Patient Administration System is a critical system for a hospital and is not something that should be developed in haste. A few months are definitely not enough time to develop a software product which is the information systems backbone within the national public healthcare service.

When it comes to systems that are critical to the running of an organisation such as a hospital, the best practice approach is to err on the side of caution. This means that what usually happens is that the system that is deployed is one that is "tried and tested" - in other words, a system that has already been used in other hospitals and gone through its baptism of fire elsewhere.

Unfortunately it appears that a decision was made to take a more risky approach when it came to rolling out a new Patient Administration System, but it is not clear whether the people making the decisions were actually aware of the risks involved. Given the recent change in administration and the fact that the programmer who allegedly developed the system was only employed by the Ministry four months ago, it is impossible not to question the attention to detail that went into the development in question and the length of time dedicated to testing the application.

This rapid development timeframe exacerbates the concerns that the system will fail or that it will have a number of bugs that will impact performance - something that is undoubtedly not in the best interest of patients at Mater Dei. This haphazard approach to deploy an application of national importance gives rise to some serious questions about the privacy of personal health records including how this privacy is being secured.

Clearly these are issues that are of major concern and they need to be addressed by the Ministry. Saving money is all well and good, but cost savings should fade in comparison to the risks posed to patients. Who will be held accountable and responsible if personal health records are lost or attributed to the wrong individual, resulting in mistreatment or more tragically, death? 

Minister Farrugia needs to have a serious word with his advisors (and should perhaps consider getting a second opinion) regarding the decisions that have been made and he should have the courage to reverse the decision before it is too late.

In addition to the saga relating to the Patient Administration System, another local newspaper also published articles that questioned the procurement process at the Ministry - showing screenshots of a request for quotations issued by the Ministry for Health where the cheapest bidder was a company owned by the very same consultant that the Minister employed four months ago and who allegedly developed the Patient Administration System.

This immediately raised a number of question marks for local businesses who bid for government contracts. When it comes to putting together a tender and costing the financial offer, information is key and there is no doubt that consultants in the Ministry of Health have access to information and details that outsiders do not. This raises questions regarding the fairness of the procurement process and sheds a bad light on the Ministry.

It is all well and good for Minister Farrugia to state that he does not interact directly with business people and that he in fact has an official who takes on that role, but what about the man he engaged to advise him on matters relating to IT, who is a businessman himself, and one who is actively bidding for Ministry for Health IT business to boot? It is clear that there is something amiss in the scenario above and the Minister must act rapidly to eliminate all conflicts of interest.

In conclusion, there are many questions that must be asked about what is happening at the Ministry for Health. I tend to agree with comments made by Martin Balzan in an interview with MaltaToday last week when he questioned who exactly is running Health. This is a difficult sector and it needs a strong hand to guide it. The minister must indeed use the services of advisers and consultants, but he must insist on the highest of ethical standards and transparency.

Unfortunately, what appears to be happening so far is the complete opposite, with scandals coming to light in the media and the Ministry scrambling to control the damage. This is not a good indicator of how the Ministry is being run, bringing to mind a scenario based on management by crisis.

Given the sensitivity of the sector in question, it is certainly to be hoped that the situation will be resolved.

Claudine Cassar is the Executive Chairman of the Alert Group of Companies - www.alertgroup.com.mt