Rehabilitating St Luke’s Hospital

Last week, The Sunday Times published an interesting article written by Ian Baldacchino, a specialist in family medicine, about the many components of our health infrastructure that exist in substandard buildings and facilities while St Luke’s Hospital is rotting slowly away, unused and abandoned.

The number of health-related facilities that survive while being offered in dilapidated buildings is astounding. In his article, Baldacchino counts about 10 such facilities. All lack someone to co-ordinate their renewal. The Department of Health tries to cope with its current problems, without thinking of rehabilitating the premises occupied by these facilities and without a sensible long-term plan.

While agreeing completely with what Baldacchino wrote, I think that the current state of St Luke’s Hospital deserves an even bigger condemnation. It is the political class that is to be condemned, of course. The two Gonzi administrations knew beforehand that St Luke’s was to be vacated but did nothing regarding its future use. Joseph Muscat’s administration dreamt of a rehabilitated hospital as part of the Vitals/Stewards deal and used for medical tourism. Everybody knows how this dream turned into a nightmare.

Mater Dei was opened in 2007 and St Luke’s has been left to rot, abandoned for all of 17 years. One can hardly imagine what happens when a building is left abandoned for so long. The cost of this waste will be borne, of course, by the public while the politicians who caused it will never be punished for their irresponsibility.

It is obvious that our investment in health facilities is being made by fits and starts. A new cancer facility – Sir Anthony Mamo Oncology Centre – was built near Mater Dei. A large health centre was built in Paola. Named after former health minister Vincent Moran, who died in 2017, the centre was planned to cater for around 130,000 patients thus relieving Mater Dei of some of the pressures it has to face. It is not just a coincidence that Paola is part of the electoral district that former health minister Chris Fearne contests.

It is obvious that a holistic plan for health services does not exist.

Every time a new health minister is appointed, the plans for specific facilities of the previous minister are replaced by new plans for some new facility while what we already have is left to rot.

It is by now obvious that Malta needs a long-term holistic plan for health facilities and their supporting administration. Such a plan must have the support of the party in Opposition to ensure that a change in administration does not lead to a change in priorities, besides the frequent changes that are somehow related to the electoral districts from which the successive health ministers are elected. 

It is normal that such plans need to be updated as time goes by, but the most important aspect is that such plans are not altered according to the whims of the minister responsible for health at the time.

Malta invests millions of euros in its health infrastructure and in its medical services offered to every citizen free of charge. In this aspect, Malta is far advanced when compared to other countries. It is a pity that this is achieved in spite of the absence of a long-term plan that would, in the end, lead to the decrease of the current health spending per capita.

Meanwhile, the buildings that once housed St Luke’s Hospital is being left to rot as if this existing infrastructure has no value.

But doing something about it is not an electoral issue. Both parties are to blame for this. This why many react by saying that for politicians, personal votes are more important than giving the country what it deserves.

Assisted dying

On 29 November, British MPs voted in favour of a private members Bill that allows assisted dying under certain conditions. At present, laws throughout the UK prevent people from asking for medical help to die. 330 British MPs voted in favour with 275 against.

The proposal put forward by a female Labour backbencher – Kim Leadbeater – is intended to set out the safeguards that would govern assisted dying for the terminally ill.

The Bill – called the Terminally Ill Adults (End of Life) Bill – would make it legal for over-18s who are terminally ill to be given assistance to end their own life.

But there are conditions: They must be residentS of England and Wales and be registered with a GP for at least 12 months; they must have the mental capacity to make the choice and be deemed to have expressed a clear, settled and informed wish, free from coercion or pressure; they must be expected to die within six months; they must make two separate declarations, witnessed and signed (by them or a proxy on their behalf), about their wish to die; and two independent doctors must be satisfied the person is eligible with at least seven days between the doctors’ assessments.

A High Court judge must also hear from at least one of the doctors and can also question the dying person, or anyone else they consider appropriate. There must be a further 14 days after the judge has made the ruling, although this can be shortened to 48 hours in some circumstances.

The Bill is in its early stages and nobody knows how many amendments will be proposed to it and whether it will eventually become law.

A commentary published under the name Bagehot in a recent issue of The Economist pointed out that when the current British Prime Minister was born in 1962, the Lord chamberlain censored plays, abortion was outlawed and divorce permitted only rarely beyond cases of adultery. Gay sex was a criminal act. Eventually, the commentary pointed out, ‘individual liberties triumphed over collective moral prohibitions. My rights beat your qualms.’

Except for abortion, Malta followed suit, even though the timeline is different.

The political observer goes on to explain that both sides of the debate on assisted dying can be considered liberal. It is no longer an issue between the liberal idea of personal autonomy and the Christian idea of a public morality.

He quotes Isiah Berlin, a political theorist, who in a 1958 lecture had said there is a contrast between ‘negative liberty’ or the ability of a person to do as he wished without interference from others and ‘positive liberty’ that was about the triumph of a person’s ‘higher nature’ over his low impulses and outside influence.

Interesting, but some would also say confounding.