Barts invite doctors to join board, but it will be government which pays

Barts medical school will be making an unspecified contribution to the government coffers, according to an agreement between the two sides to host a new medical school.

But it will be the State which will remunerate specialists who take up clinical tutor posts with Barts when these join a new board to implement the Barts medical course programme, MaltaToday has learnt.

The system has puzzled doctors who in the past weeks were informed by Professor Anthony Warrens, the dean for education at Barts School of Medicine and Dentistry, that the medical school was soliciting applications from medically qualified individuals, to join the implementation board for the Barts bachelor of science programme in Malta.

It will be an honorary appointment, Warrens told the Maltese doctors, which means that postholders on the Barts Malta programme implementation board will not be paid. “However, as part of our agreement with the government of Malta, they will be remunerated for their time spent at meetings of the board.”

 Barts said that the honorary appointments would be promoted to clinical senior lecture, clinical reader or clinical professor “as the staff contribute more” – an indication that the school is after ambitious medical professionals seeking a foothold in the medical programme.
A senior medical consultant who is privy to the agreement with the health ministry and Barts, which is part of Queen Mary, University of London (QMUL), said that Malta’s hospital caseload will be “too small to cater for two universities”.

Effectively, Barts will create a new medical school for paying students who need access to Mater Dei Hospital’s clinical resources – surgery and patient ward rounds – to be able to complete their degree course.

While Barts will be charging €35,000 every year to each of the 60 students who will form the annual intake, Mater Dei’s consultants are expected to make room for this cohort of students on top of some 445 student-doctors from the University of Malta’s medical school.
The main bulk of clinical teaching will not begin until 2019, when the first 60 students complete their third year and start clinical practice. By 2021, that number will have grown to 180 Barts students at any given year wanting access to clinical practice.

So while Barts will be raking in €10 million each year when it reaches its full complement of 300 students each year, Mater Dei Hospital will have to open its doors to the medical school for clinical practice.

Barts is lending prestige as the consortium that clinched a €200 million privatisation deal for the Gozo, St Luke’s and Karen Grech hospitals, which is banking on attracting medical tourists to the Maltese islands. On its part, the government sees Barts as a way of attracting paying students to a Gozo campus, even though their clinical training in the third, fourth and fifth years will actually happen at Mater Dei Hospital.
That has rankled medical students like Alexander Clayman, the Malta Medical School representative on the Faculty of Medicine, who says Barts is the brand name for the privatisation of the hospitals. But a high-quality medical school like Malta’s barely has sufficient access to clinical resources, with too many medical students already in operating theatres, wards and outpatients’ rooms.

“That is bad for clinicians, students and patients alike,” Clayman had told MaltaToday. With seven Maltese students to each consultant, this ratio is itself testimony to the strained resources at MDH, but Barts operates a strict tutor-student ratio: two students to each consultant at outpatients and in theatre, and four students for ward rounds. “Introducing more medical students into Mater Dei will almost inevitably be to the detriment of UoM’s medical students’ quality of education,” Clayman said.

Indeed, Professor Anthony Warrens himself is aware of the effects that the privatisation will have on doctors, as he says in his letter which he sent to all doctors on the register of the Medical Council.

“We recognised that we are inviting you to become involved during what is a period of change in the delivery of healthcare in Malta: there are significant plans to expand the sector and some of what has traditionally been delivered entirely from the public sector will now also be delivered from the private sector.

“We appreciate, as with any new system, it will take time for organisations to adapt to the new partnership during which it may be an unsettling and demanding period. We at Barts are committed to playing our part to ease the transition.”