Politicians f**k things up: this is Professor Albert Fenech’s succinct take on what happens when the powers-that-be meddle with the healthcare sector. Despite this point-blank assertion, Professor Fenech –a Nationalist MP – says his forced retirement from Mater Dei Hospital has nothing to do with political discrimination.
Professor Fenech was effectively sent packing last Friday when he carried out his last operation at Mater Dei, on the basis that he cannot continue to work full-time beyond pensionable age due to public sector rules.
He is quick to point out that the application of these rules does tend to be flexible, as there are people who are 67 and still operating on and caring for patients at Mater Dei.
He puts his situation down to his vociferous opposition to the government’s decision to split the Cardiac Department into two separate entities – the Cardiac Surgery Department and the Cardiology Department – which ultimately landed him in the bad books of the new head of Cardiology.
Professor Fenech contested the split in court, and successfully ‘predicted’ who would head the new Cardiology Department – Robert G. Xuereb – before it was officially announced.
“Facile, ridiculous excuses were made by an individual advocating the split. Not by the government – the government kept mum about it. The decision was taken by three people, and it was clear at the time that the only reason this was being done was to give the post of Chairman of Cardiology to an individual.
“I can’t stand this kind of snake-in-the-grass attitude towards politics, and this is the only place where politics came in, to split a department to give a job to one of the boys, as has happened in countless other departments.”
‘I was the bad guy’
“Obviously, the new chairman was pissed off that I singled out this crass ignorance. Obviously, I was the bad guy because I caused this flare-up.
“Against the wishes of all the other consultants in the department, I, who introduced certain procedures on the island and therefore was one of the most experienced operators in the field, was stopped from putting in the special pacemakers, I was stopped from putting in valves through the leg – a procedure I started that has saved the lives of 52 elderly people.
“Facile reasons were given. The way you move forward with new techniques is by combining experience with energy. What you need is a person who is experienced in the field working with someone who is young, up-coming and has the energy. These two together are the secret of success and any good manager would combine these two things.
“Yet the most experienced person in the field was sidelined for no decent reason. Whatever reason you might come up with, it makes no managerial sense to get rid of someone who has been doing something for countless years with excellent results.”
Professor Fenech – who turns 64 in October – was given a contract prior to the election that should have seen him through to the age of 65. “That contract was ignored. I went through the Ombudsman, and the Ombudsman said to keep everything as it is, keep on working as you are in your own office until I sort this out.
“Health Ombudsman Charles Messina is a unique man, an honest guy. I was sure he would do his best to arrive at the truth.
“The truth is that there is a law that if you keep on working for 12 days after your contract expires, and you continue to be paid by your employer, then the contract is automatically renewed.
“Surprise, surprise, this only applies to people in private employment; public workers are denied this law. It struck me as strange, but that was the decision of the Ombudsman.”
“The retirement law does not make economic sense. People are living much longer than they did 20 years ago. More people are going to depend on a pension for a longer length of time. It makes sense to get people to work longer and pay taxes and not require so much by way of pensions and still contribute to the coffers.”
(Professor Fenech - left - at the operating table - file photo)
‘Bureaucracy can work against patients’ health at times’
Professor Fenech instead accepted a part-time contract, which allowed him to see out-patients once a week and to operate twice a week. He admitted he was upset by this, as he usually ran an open-door policy that allowed patients to ring up and see him from one day to the next.
“I think bureaucracy can work against patients’ health at times. When you give someone an appointment for six months time, it means you will not see that patient for six months unless they become an emergency case, which doesn’t make sense: you want to see people before they become an emergency case.
“I saw patients every day. I saw patients whenever they needed to be seen. They did not have the usual bureaucracy of going through their doctor. Now I could only see them in outpatients.
“My office was turned into a general office, so I did not have an office any more, but I still operated two days and I could still see my patients, which was a bonus, then one day the chairman cut me back to one operating day a week.”
(Professor Fenech - left - at the operating table - file photo)
Professor Fenech says that “facile and childish reasons” were given for this further reduction in operating days. It happened after he came in to operate on a patient outside his designated two-day operating window.
“I came in to perform an emergency operation on a patient I had been looking after for 20 years who wanted to walk his daughter down the aisle. I cleared it with the consultant on call, but the chairman was furious that I came in to do an emergency case. This is when he cut me down from two days to one day.”
This decision was overruled after Professor Fenech wrote to Mater Dei CEO Ivan Falzon and Medical Director Joe Zarb Adami, who agreed that patients should be allowed to request specific specialists to operate on them.
“Six weeks ago, again the chairman just walks up to me and says: ‘By the way, that day you’re in theatre will be your last day – you’re just going to see outpatients’.
“I taught every single person in that department without holding anything back. This was not political, it was personal. The only bit where politics came into it was this crass, undemocratic and backwards decision to split a department to give jobs to the boys. Sadly, this has been a hallmark of this government.
“When he banned me from my last day in theatre, I ignored him and wrote to Mr Falzon and Mr Zarb Adami. I said ‘look, the least this hospital owes me for having set up this department and run it is to allow me to have my last day in the operating theatre. My last official operating day was last Friday (18 September.)
‘This specific, targeted humiliation would have made anyone resign’
Given the hostility that he has been facing, it would be reasonable to think that Professor Fenech would be happy to finally be out of such an environment.
“Absolutely – this specific, targeted humiliation would have made anyone resign. I have often thought of resigning, but I did not want to give him the satisfaction, plus I still enjoyed looking after my patients.
“I do not miss all the crap. No one misses crap. I miss the fact that you develop a sort of relationship with your patients.”
Asked what he is fighting for, Professor Fenech says: “I am not fighting for anything or fighting anyone. I am not taking anyone to court. The only contract that was made available to me was to only see patients as out-patients, not to look after them in hospital and not to operate on them. That’s no contract. I want to look after my patients as I have done for 20 years.
“It is my loss, but I feel it is a loss to the health service when specific services are targeted and removed. Since they stopped me from putting in these particular valves, the new chairman has chosen different valves, which we know have more complication rates than the ones we were using but they are cheaper. You do not go for the cheapest, you go for the best.
“The complication rate has, in fact, been higher. People stay in hospital longer and more of them are needing permanent pacemakers after the procedure. So now from one procedure they need a second, which increases the risk.
“Democracy is out the window. What pisses me off is that people are allowed to run departments in an autocratic way that does not make managerial sense.”
Parliamentary Secretary Chris Fearne has reached out to Professor Fenech, offering to hear him out.
“Chris is a gentleman: I like him. He phoned me last week so that we could arrange to meet and we will be doing so. I’m sure that Chris had nothing to do with this and that he would not have sanctioned the splitting up of the department. He would have seen the sense of keeping it as it was.
“He was gentlemanly enough to phone me and offer me a chance to talk. I’m just telling the story as it is. I still have a lot to offer and if I can’t offer it here, I’ll have to offer it elsewhere.
Professor Fenech regrets entering politics
It is at times difficult to decide whether you are talking to Albert Fenech the cardiologist or Albert Fenech the Nationalist MP.
Asked if he regrets entering politics, Professor Fenech says: “I do, because everything I say seems to be given a political slant, when I have always spoken against politics. I have always said that the health service should not under the control of politicians, because they do not understand it.
“For the last 20 years I have had constant battles, mainly with the Finance Department, who would stop the purchase of equipment on the basis of having run out of money.
“On one memorable occasion, we ended up with only four stents in the department in October, and were told that no money would be available to buy any more until the first of January.
“And we were expecting to be doing about 100 angioplasties a month. So I took a picture of these four stents and sent them to the then Finance Minister, asking him to please tell me on which of the next 300 patients I should use them.
“I did not receive a response, so I wrote to the Prime Minister and the stents came though. This is what I mean: people take decisions about health, when they don’t have the foggiest of idea about the consequences of their decisions.
“It is the patients who suffer, and we suffer the stress and anxiety because we are on the frontline.
“I have always had run-ins with politicians, particularly when finances are involved, and I still believe that the health service should not be in the hands of politicians.
“If you agree with the principles of a free national health service, then that’s it – you just have to foot the bill and have people who can run it decently.”
Professor Fenech won a seat with the Nationalist Party during the March 2013 election. He admits that his experience of Parliamentary life has been disappointing.
“I’m talking as a citizen here, because I see this happening around me, even more so in the so-called highest institution in the land – which seems more like a kindergarten class than the highest institution of anywhere.
“People seem to think that all you need to do to be a politician is shout, insult, and keep bringing up the past as though it is a justification for the present or the future.
‘I am jaded with Parliament’
Asked if he is jaded with politics, Professor Fenech again specifically pinpoints Parliament.
“I am jaded with Parliament. I sit there, I expect to have a decent adult conversation and discussion, and all you have is people standing up and screeching, just like in the old Mintoffian days.
“I’m glad there is television in there now, because people can actually see it, except they don’t see the whole room, they only see whoever is speaking. It has been quite an eye-opener.”
Asked if he will be championing reforms to the law regarding retirement, Professor Fenech is downbeat.
“We’re talking about retirement in the House. This is where democracy is made complete and utter nonsense of. When people have a nine-seat majority, they can do what the hell they want.
“All you have to do is look at Prime Minister Joseph Muscat’s face when the Opposition is talking about something and criticising the government – it is this sardonic ‘you can say what the hell you like – I am going to do what the hell I like anyway’.”
“One should take a look at a picture of Joseph Muscat before the election and a picture of him now: he must have gone up four dress sizes, which to me says a lot.”
On the prospect of walking away from politics, Professor Fenech adamantly says that he has never walked away from anything in his life, the only proviso being if he has to go and find work abroad.