“Two years ago, the general rule was that if you visited the emergency unit at Mater Dei Hospital, you would be seen to the day after. It is thought that the average waiting time stood at 12 hours. The medical treatment being offered was good, but the waiting time was simply unacceptable. The measures introduced have now brought down that waiting time to an average of four hours,” the parliamentary secretary says.

This inconvenience was not only frustrating for patients, but also members of the staff themselves. Dr Fearne has worked at the emergency unit as a doctor himself and he is well aware of how swamped with work medics are. “There is really nowhere like the emergency and causality ward,” he says.

The government set out to analyse what was causing the mismanagement. Dr Fearne explains that it boils down to three major issues.

First off, a fifth of patients were being made to wait for hours only to be then told that they need to go elsewhere. Emergency issues to do with Ear, Nose and Troat (ENT), Ophthalmology and Gynecology, as an example, are dealt with in their respective words not the emergency unit. Today, a receptionist clarifies the need of each patient that walks into the emergency and directs him to the right location.

Secondly, some people visit the emergency unit even when they can easily be helped at the local health centre. Because patients with more major issues are seen to first, this group of people would end up waiting for hours. To deal with this, a minor care unit has been set up close to the emergency unit where people are being served within an hour.

Thirdly, junior doctors were seeing to patients first, only to then having to wait for senior doctors for advice. Today it is the senior doctor which sees what the case is and decides accordingly.

Dr Fearne explains that because the emergency was too small to cater for all patients, an X-Ray machine situated in the middle of the ward has been relocated, allowing for double the cubicles as a result.

Taking blood tests and waiting for results was also extending waiting time. Today two people have now been assigned with taking blood tests and producing results from the laboratory – this has reduced waiting time by at least an hour.

By the end of this year, an emergency ward specifically for children will be opened.

To properly measure the improvement such measures have induced, a tracking system has been introduced. Patients are given a barcode device that updates the waiting time with every minute that passes. A console highlights in amber those patients having waited for over two hours and in red for those over four hours.

5,000 medical tourists a year expected from 2021

Earlier this year, the government announced the three major projects for the health sector - the private sector has been asked to develop and run Gozo General Hospital and St Luke's hospitals under a government investment proposal worth €200 million. Meanwhile Karen Grech hospital will also be refurbished.

“Let’s start from the basics. Unlike the perception of some, medical tourism is not when tourists need medical intervention in Malta following an accident or sudden illness. That already occurs, and will continue. Medical tourism is rather about attracting patients to Malta specifically for medical treatment,” Dr Fearne says.

It is estimated that the global market of the medical tourism sector is valued at €50 billion - it is the fastest growing sector in the world’s economy, at a phenomenal rate of 30% growth each year.

Dr Fearne explains that Malta’s geographical position – close to both Africa and Europe – is ideally positioned for such a sector.

“Our target is that once the first phase of project is completed, in 2021, we will start attracting 5,000 medical tourists a year.  What’s more, these patients would bring their relatives along – relatives which are mostly likely high-end spenders. These will be staying at some accommodation, purchasing food and using our transport services and therefore the multiplier effect is huge,” he says.

“We are well aware that our health sector needs to continuously improve and to do that, finances are needed. We want to keep health services free for the Maltese, but to that it needs to be sustainable. Medical tourism is part of the solution,” he explains.

There are three groups of patients targeted for medical tourism. The first group are those residing in countries with inferior health standards, who want a better service in another country. 

The second group reside in a country with satisfying health services, but because the waiting lists are too long or the expenses too high, choose to get treatment in another country. These are usually self-paying or covered by health insurances. It is estimated that last year 1.5 million US patients flew out of the states for medial tourism.

The third group are patients who go to the country where the best surgeons are, and therefore Malta is in negations with top-notch surgeons for this reason.

Government employees will have same job conditions

Last week, the Medical Association of Malta (MAM) said that it is completely against the management of the public health system by the private sector.

“We’ve made it clear that all government employees will continue being employed by the government with the same conditions they have today. The government has spoken with the General Workers Union, (GWU) Union Haddiema Maqghudin,(UHM) Nurses and Midwives’ Union (MUMN) and doctor’s union (MAM). It is true that MAM have not yet been informed of all details, but that it is because negations are still on-going – everything will be made clear in due time,” the Parliamentary Secretary says.   “At the end of the day, we believe that the service offered to patients will be of high quality if the employees are satisfied with the job conditions,”

The consortium to take care of the three major projects, Vitals Global Healthcare, was chosen after a call was published and three companies applied. Projects Malta were in charge of the evaluation process.

“We are now going into detail of what is needed and the standards we want.  We are laying down key performance concepts that specify the waiting time we want, the accepted complication rates for each intervention and other factors.  This is to ensure that the service by the concessioner is of high quality.

Refurbishment of Mount Carmel Hospital on government’s radar

Mental health care is often put aside when the health sector is discussed, perhaps due to the stigma that still exists.

Following the refurbishment of practically all hospitals in Malta, the government is hoping to get working on Mount Carmel Hospital, giving it the push it has needed for long.

Meanwhile, authorities have set up a youth residence for children and adolescents – a residential home with a non-hospital setting. The house is divided in two and three-bedded rooms, a games room, classroom and multi-purpose room. In collaboration with The Malta Football Association, a football ground will also be introduced.

“We no longer wanted these youngsters in the same place as adults and we are encouraging shorter residential stays,” Dr Fearne explains.  The residence is not within Mount Carmel, however close, allowing specialist to work at both institutions.

In collaboration with Richmond Foundation and Suriet il-Bniedem, a half-way house has been set up for former Mount Carmel Hospital patients, allowing them to get back on their feet before fully reintegrating into society, given they would have become completely institutionalised.