A bipartisan policy on health

he editorial of last Sunday’s issue of the Labour Party’s weekly paper KulĦadd deserves a prize for the most misleading half-truth ever to grace a leader in that paper. The editorial dwelt on the health sector and had the temerity to boast that it was a Labour government that decided to enlarge Mater Dei Hospital - implying that had it not done so, the bed shortage problems there would have been worse.

This implication is nonsense, as the precursor of what today is ‘Mater Dei’ hospital was not originally intended to be a general hospital to replace St Luke’s, a decision taken by the Alfred Sant administration. It was this decision that necessitated the increase in beds and the enlargement of the hospital.

The story of how this switch was made is, unfortunately, a tale that should give all political parties a lesson not to let lobbies use the eternal political tussle to their benefit and to the disadvantage of the common good.

The hospital at Tal-Qroqq was intended to be a specialised hospital that would reduce the load on St Luke’s in particular areas of medical treatment and would complement St Luke’s, not replace it. This was what the 1987-96 Fenech Adami administrations had planned and started implementing. The idea was also for the state to have a hospital with a different management system than the one prevalent at St Luke’s – a system that would eventually be adapted in other hospitals.

Immediately, the doctors’ lobby smelled an imaginary rat. They objected to the idea, saying that there was no need of another hospital. They objected to the involvement of an Italian hospital group (San Raffaele) because in our medical confraternity anything that is not British is frowned upon… and because they realised that in this new hospital they would not be able to call the shots.

From the opposition, then Labour leader Alfred Sant seized on the widening crack between the PN and the doctors’ lobby and immediately adopted their line. He started referring to the new hospital as a useless Fenech Adami whim (kapricc ta’ Fenech Adami) while promising to dump the project.

When he assumed power in October 1996, Alfred Sant stopped the project and took quite some time until he got technical advice on what the building, in its advanced stage, could be used for – as well as legal advice on the commitments that the government had entered into with the main contractor. He also consulted the doctors’ lobby, with whom he probably had some pre-electoral deal. I say ‘probably’ because there is no proof to what, in effect, is a hunch of mine.

The end result was that, with the connivance of the doctors’ union, Alfred Sant decided to switch the half-built hospital project at Tal-Qroqq into a much larger one: a general hospital replacing St Luke’s. That is how Labour ‘enlarged’ the hospital that was afterwards baptised ‘Mater Dei’ by a later Fenech Adami administration. 

To this day, I do not know why the subsequent 1998 Fenech Adami administration - elected just 22 months into the Alfred Sant government – did not reverse the decision and revert to the original plan. My hunch, again, is that it did not want to rock the boat again with the doctors’ lobby. So it continued on the Alfred Sant plan and invested a record sum in what became the most expensive ‘state of the art’ hospital in Malta’s history, a hospital that is now considered to be inadequate as far as the number of available beds is concerned.

There lies the tale of woe that is the history of ‘Mater Dei’. The two political parties that allowed themselves to be swayed by the doctors’ lobby working in its own interest also used the project and the hospital to gain other brownie points in their short-sighted electoral wrestling matches.

During its construction, Labour had a field day with unproven allegations of imaginary corruption lurking behind every contract and then, when the hospital was functioning, it had another field day with its bed shortage problems. Now in government, it is the PN’s turn to have a field day on the bed shortage problem!

Most of this problem is a management problem: the management of St Luke’s was practically transferred to Mater Dei together with work practices that benefit doctors and nurses to the detriment of good management.

Subsequently we have had uncosted deals in the form of agreements with unions that lead to the agreed salary increases but not to the promised improvement in efficiency - usually signed on the eve of elections. Add political interference and you get a rough idea of the mess that former Labour Minister Godfrey Farrugia could not sort out and that the incumbent Konrad Mizzi is grappling with.

The mess is simply a management problem because the medical treatment has always been, and still is, first class. Our doctors and nurses deserve maximum points for this but they get zilch for using their clout to emasculate attempts at efficient and cost-effective hospital management, to their advantage.

In the meantime St Luke’s hospital has been left underutilised with most of it abandoned while the politicians (of both parties) cannot think what to do with it.

Considering this retrospective of the Mater Dei tale in mind, the PN spokesman on health, Claudio Grech, should be congratulated for proposing that the two political parties should agree on a bipartisan policy and approach on health. Such an approach has never been arrived at because the party in opposition has always sought short term advantages in the electoral tussle, rather than cooperation with the government for long term efficiency in health services. As a result, they have fallen victims of the doctors’, nurses’ and other lobbies that have historically excelled in using the rivalry between the political parties to their advantage.

In Opposition, the PN has the opportunity to emulate Labour in opposition and take the sides of the various lobbies that push for their interests and then denigrate the government for not delivering the promised results.

Instead it has looked at the matter with a wider and saner perspective: it has suggested that a consensus should be found on health issues with an agreed bipartisan policy. In doing so it is consciously ditching the opportunity to use problems in the health service as short-term electoral ploys.

Rather than publishing editorials that talk of health policy in terms of the permanent confrontation between Labour and the PN, KulĦadd should have given us the official Labour reaction to Claudio Grech’s proposal.

This is an opportunity not to be missed.