The health system needs fixing

The death of police officer Stephen Mangion in the waiting room outside the triage clinic at Mater Dei Hospital’s emergency is cruel because he was metres away from the care he required. 

According to several accounts, Stephen first went to the Floriana health centre complaining of severe chest pain. For some reason, the doctors at the health centre instructed him to go to Mater Dei Hospital and while waiting to be seen by the triage team – the first step that determines the severity of the medical condition – he collapsed and died. 

No words can console Stephen’s family and friends. Here was a man who felt something was wrong with his health and sought medical assistance. From the information available thus far it appears that Stephen did not receive any treatment because he was kept waiting and waiting. Something somewhere went wrong. 

The Health Ministry did the right thing to immediately set up an independent inquiry led by retired judge JD Camilleri. Minister Jo Etienne Abela’s commitment to full transparency is also welcome. 

This inquiry board is expected to focus on the treatment Stephen received but will also examine broader systemic issues within the healthcare service. 

This leader hopes the inquiry will be thorough in its exercise to uncover the truth and will endeavour to put its finger on any failures that may have contributed to Stephen’s death and establish who could have been responsible for them. 

This inquiry is distinct from the duty magistrate’s inquiry, led by Magistrate Joe Mifsud, which is tasked to establish criminal responsibility if this is the case. 

A glaring issue, which the independent inquiry board could shed light on is the adequacy of care afforded at health centres. The health authorities periodically organise educational campaigns to encourage people to first visit regional health centres rather than hog Mater Dei’s emergency if they feel sick. 

But if patients fail to receive adequate diagnosis and care at the health centres and after spending hours there are eventually sent to hospital, where they end up waiting in another interminable queue, people will obviously choose to go directly to hospital. 

Unfortunately, Stephen appears to have acquiesced to the advice and visited the health centre first before being sent to hospital. It may have been a fatal decision but one that he should not have been making on his own. 

From a layman’s point of view, Stephen’s case suggests not enough attention was given to his condition at the health centre, so much so that he was not even taken to hospital by ambulance. Whether this was the result of negligence or misdiagnosis is for the inquiry to establish. 

But the issue goes much further than Stephen’s particular circumstances and we hope that if there are gaps in the services offered by health centres these should be identified and solutions proposed. 

Stephen’s incident comes on top of several complaints on the public health service over the past months. From lengthy waiting times at hospital emergency to screening and treatment appointments given months into the future, the public health service has been struggling to cope. The demand has grown, the bed space for in-patients is limited and doctors may be intransigent when it comes to changing work practices. 

But the problems besetting the public health service have only been made worse by the delayed investments in public health infrastructure. We do not say this flippantly, but the lack of significant investment was the result of the corrupt Vitals hospitals deal, which siphoned off millions of euros and on which government had been banking on for increased bed space and services. 

It may be premature to conclude that corruption killed Stephen since the facts have not been independently verified yet. But it is plausible to say that corruption is a primary cause of many problems besetting the public healthcare system and which have been accumulating over the past years. The delay in opening the Paola regional health hub despite works being completed is a case in point. 

This leader hopes that the independent inquiry into Stephen’s death and the magisterial inquiry leave no stone unturned in determining the truth. If anyone is to blame for his death, justice should be served. And if the failings are systemic because the procedures and protocols in place are inadequate, these should be changed irrespective of any resistance unions may put up. 

But at a political level, Health Minister Jo Etienne Abela must work harder to ensure adequate and prompt investment is carried out in the public health infrastructure. The country urgently needs to move beyond plans and get cracking. 

In the words of Stephen’s niece, we are witnessing “a failed system that needs to change.” Stephen’s death should serve as a wakeup call.