The new hospital Mater Dei should be operational in 2007. Juan Ameen has been in contact with the Foundation for Medical Services to find out more about the plans for the hospital, how they are being carried out, and what one is to expect once the complex is opened next year.
The concept behind Mater Dei was discussed in the early 1990s with the original idea of building a centre to complement the 50-year-old St Luke’s Hospital, which was about to undergo an extensive refurbishment programme.
In the original plans, the hospital was to have 480 beds and specialise in diabetes, cardiology, degenerative diseases and other chronic illnesses prevalent in Malta and other Mediterranean countries. The initial preparations for the new hospital started in the early 1990s.
The Foundation for Medical Services was set up in December 1990 and eventually design work started in 1993 by Ortesa Spa and the construction in 1995 by Skanska Malta JV.
In 1996, the Labour Party was elected to government and it was decided to upgrade the project into an acute general hospital with a capacity ranging from 825 beds to 1,000 beds with the intention of replacing St Luke’s Hospital.
In 1998, under a Nationalist government, it was decided to re-evaluate and re-dimension the new hospital project to 825 beds.
It will cater for Malta’s acute medical needs while incorporating secondary and tertiary services including all major specialities.
All the clinical functions will have a strong research and teaching component.
An official Design and Build Contract was signed between the Foundation for Medical Services, on behalf of the government and Skanksa Malta Joint Venture on 29 February 2000.
Following extensive negotiations that began in July 2004 between the state and Skanska Malta Joint Venture, an amendment agreement was reached on 6 November 2004 establishing a lump sum set at Lm145.5 million as opposed to the previous cost plus contract. It also established a final completion date set for July 2007, which carries penalties for a delay of up to a maximum of Lm5 million.
The materials used to construct the hospital are all environmentally friendly. The entire building will cover Lm250,000 and the parking area will accommodate 1,600 cars.
It will have around 1.4km of corridors, with 52 elevators and a card reader access control system linked to a CCTV and intruder alarm.
When completed, it will also boast a pneumatic tube document transportation system saving time and human resources, as documents will be sent from one end of the hospital to another.
It will have 825-bed capacity and state of the art medical equipment. The hospital will also treat patients in the acute phase.
The hospital will offer rehabilitation including physiotherapy, psychology, podology, occupational therapy, speech therapy and social work.
The Medical School and Institute of Health Care will also be incorporated in the new hospital. It will also have a library and research facilities.
Data and telephone points will be available at each bed and food will be provided through an outsourced catering system.
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Medical equipment
Inso SpA provides the medical equipment for the operating theatres under a contract signed with the Foundation for Medical Services on 23 January 2004. The total value of the contract with Inso SpA for all the medical equipment in the hospital is E62 million.
Mater Dei will have a total of 25 operating theatres distributed in the hospital. It will also include four endoscopy theatres, one of which is equipped with an Image Intensifier Unit.
The mock up theatre is located one level below ground floor and all wards are located within the same block where the mock up theatre is located. In fact, all the wards will be located on the ground, first, second and third floors of this block.
To reduce the distance, and for logistical reasons, all surgical wards are located directly above the operating theatre and day-care departments.
The operating theatre and day-care department provide an important support service to the intensive care area. However, the operating theatre and day-care departments also require the backup service of the central supplies sterilisation department and radiology department. As a result all these departments have been placed adjacent to each other on the same level.
The equipment available in the theatre depends on the type of intervention carried out. However, all the operating theatres will be equipped with standard equipment, including ceiling mounted vertical pendants, an anaesthetic machine complete with a ventilator unit, suction pumps, an electrosurgical unit, and a multi-parameter vital signs monitor.
Equipment will be transferred to the operating theatres according the surgical procedure that will be carried out.
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Environmentally friendly measures
Mater Dei Hospital will be the first building in Malta with thermally insulated external walls and with high performance glass in the windows.
These will reduce cooling costs between April and November and heating costs during the other months.
Rainwater will be collected, stored and used for irrigation and grey water will be recycled. Low flush toilets and environmentally adapted refrigerants will be used as well as polypropylene (PP) piping.
Construction waste will be separated at source to ease recycling. Preparations will be made for the recycling of topsoil from excavation work, as well as stones from the demolition of stonewalls.
Instead of cutting down trees during construction, they were replanted at other sites.
Rubble walls and buildings of cultural heritage value have been moved and rebuilt in a safe environment.
Excavated material is partly used on site as road base and surplus material is used to refill an excavated quarry, which will later be used as an orange plantation.
It also boasts a computerised building management system with more than 13,000 control points to manage the heating, ventilation and air-conditioning systems.
The entire building is designed to maximise the full use of natural light and has energy saving lamps and electronic ballasts for fluorescent tubes.
Motion sensing detectors will be installed in various areas to automatically switch lights on and off.
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Ward facilities
The hospital will incorporate all the medical services found in a modern acute general hospital. These include inpatient accommodation, ambulatory services – outpatients and day care, emergency services, clinical support services (such as radiology and laboratory). There will be a greater emphasis on ambulatory care and day care, compared to St Luke’s Hospital.
With the heavy investment in the state-of-the-art equipment, new services will be offered and patients can fully utilise the 25 operating theatres.
Mater Dei Hospital will have 38 wards including medical, surgical and speciality wards.
There is a Blue Code CPR button at the entrance to all the patient rooms to signal an alarm to the resuscitation team to the ward.
All the patients’ beds are equipped with a nurse-call panel. The panel consists of oxygen and suction points, up and down lights, nurse-call system with alarm, speech and light control and an emergency pull button.
Through the nurse-call panel, the patient can communicate with the nurse directly from the bed.
The windows of the patients’ rooms are double glazed with adjustable inbuilt micro blinds.
Most of the beds will be electrically operated by means of a handset. Each room has an en suite bathroom with a walk-in shower, toilet and sink.
The nurse station is accessible to people with a disability and is equipped with a nurse-call system with speech facilities, intercom, telephone system and panic alarm system.
There will be three rooms behind the nurses’ station: a treatment room for minor interventions on patients in the same ward, the clean utility for the storage of drugs and consumables, and the ward manager’s office.
Within the same area, there is a pneumatic tube station for the transport of items such as blood samples and pharmaceuticals to and from other departments including pharmacy, stores and laboratories.
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The utilities building
The utilities building includes the central chilled water and hot water plants used for the air-conditioning requirements of the hospital.
The plants consists of 14 air-cooled and two water-cooled chillers together with four large capacity boilers to provide the necessary cooling and heating water to the air-handling units that feed each separate building.
The building is split in four levels and holds one of the four electrical substations that feed electrical power to all of the building blocks.
The main substation is composed of 10 transformers with the related medium and low voltage switchgear and a computer controlled system that manages the switching on of critical electrical loads in the even of a mains power failure.
The emergency power is supplied by three emergency diesel generators totalling 9MVA capacity and accounts for about 40 per cent of the estimated total load.
The building also houses fuel storage system, reverse-osmosis plants and hot-water recovery units.
In the utilities building, there is an Enemalta incoming feeder supplying the main 22.5 MVA transformer at 33KV which in turn feeds the substation with 10 transformers with capacity ranging from 1.6 MVA to 3.2 MVA.
The hospital also has another three substations connected in the form of a ring and supplied by a further two 8MVA standby secondary feeders.
Mater Dei will also have three emergency diesel generators totalling 9MVA of generation capacity in the event of a power outage on the main feeder. The power generated will supply the operating theatres, all clinical areas, emergency lighting and special security features in a short time.
It will also power critical medical equipment such as chillers, lifts, fire sprinkler pumps, water circulation pumps, air movement plant.
When the Power Network Control Centre (PNCC) senses a power cut from Enemalta, the system automatically starts up the three stand-by generators simultaneously and within 15 seconds will be ready to take up the maximum load.
When the Enemalta electricity supply is back to normal, the generators are synchronised to the Enemalta network before they are switched off thereby eliminating another power interruption to the hospital electricity network.
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FMS and FSWS
The Foundation for Medical Services (FMS) is an autonomous public body. It is responsible for the building of Mater Dei Hospital – an 825-bed, general acute hospital.
The Foundation for Medical Services came into being in 1990 as the Foundation for Medical Sciences and Services (FMSS).
In March 1998, the statute of the said foundation was amended to include a change in the name of the Foundation to Foundation for Medical Services (FMS) and the setting up of a sister foundation called Foundation for Social Welfare Services (FSWS). The two foundations are separate, and have a distinct legal and juridical personality.