The Medical Association of Malta (MAM) confirmed that no strike will take place tomorrow pending the outcome of a meeting with government to resolve its current issues. Should the meeting prove inconclusive, a one-day strike will take place this coming Tuesday.
In comments to The Malta Independent on Sunday, MAM’s General Secretary Martin Balzan remarked that the union is not against Public-Private-Partnerships, but does not agree with the current model agreed upon with Vitals Global Healthcare.
Last year, the government announced that a concession for the maintaining and operating of three state hospitals, Karen Grech Hospital, St Luke’s Hospital and Gozo General Hospital, had been awarded to Vitals, which had no track record in the medical sector.
In December, two years after the 30-year concession was signed, Vitals transferred the concession to Boston-based Steward Healthcare.
“At present, the Vitals deal is what we a call a lease to maintain and operate. That means the private investor [Vitals] was supposed to bring capital worth €220 million, and the government was supposed to pay rent. The private investor was then supposed to provide maintenance such as equipment and, according to the agreement, oversee operations.”
He explained that in the UK, PPPs “do not have such an extreme model”. He said that the government receives capital from the private investor, pays that investor rent but retains the operations of hospitals.
Balzan described the deal with Vitals as “flawed”.
“Instead of Vitals providing the capital injection, the government spent €60 million and got very little in return. It is paying rent and contributing to operations before anything has been invested.”
The €60 million being referred to deals with the revelation that Government is paying €188,000 per day to Vitals for the use of hospital beds, as revealed by the Times of Malta.
Balzan vehemently said: “This chap [Vitals] did very little, and after two years there is nothing to show for it. We believe that this kind of deal is flawed against the patients as we can do a lot better with those €60 million.”
To put things into perspective, Balzan described how the annual budget for all medicines within the Health Ministry is worth some €32 million.
The issue surrounding the Steward concession transfer is “that according to the collective agreement, the government had to give us six weeks’ notice and get our consent before it could give its consent for the transfer to go through”.
“What is the solution? We think that unless the deal is changed, two years will pass and the same thing will happen because it is a deal that does not safeguard the interest of the taxpayer or the patient.”
He said that the concern expressed by doctors is because with the operations being in the hands of private industry, the bottom line will be profit generation rather than patient care.
“We think that patients will lose out. We think that we have a right to reverse the deal, legally speaking.”
Balzan said that the aim is to reverse the deal with Steward.
“We are ready to live with a PPP but in a scenario where the operations remain in the hands of the state.”
Asked about whether MAM is considering taking the government to court over the breach in the collective agreement, Balzan said that going to court is one option.
“Our aim was to persuade the government; persuasion alone has failed so now we are trying persuasion and industrial action backed by the legality of the collective agreement. The government has to honour signed agreements.
“From the patients’ point of view, we have no problem with private capital acquired by the government from private investors.”
He went on to say that the implication of riding roughshod over the collective agreement is a concern that the government will do the same with other agreements. He referred to a government agreement that Mater Dei Hospital and Sir Anthony Mamo Oncology Centre will not be privatised.
“If the government bulldozes the agreement this time, what will happen next time?”
Pressing on about what is at stake, Balzan said that the MAM wants to send a clear message: “If you [government] want to privatise everything, Houston we have a problem”.
Government injunction against MAM strike
Government said that it will issue an injunction against the industrial action in the name of patients, to which Balzan said, “We do not agree and feel that striking is a basic right and freedom.
He went on to say that the law provides for the numbers needed to provide essential service.
“We will certainly be providing many more doctors than is stipulated by law. There are no grounds for a prohibitory injunction against the strike.”
Balzan said that “if the government had lawyers and money to spare, we suggest they try to recoup the €60 million given to Vitals since little was provided. That would help patients.”