There have been fewer uglier spectacles in recent months than that of some union representatives (rather than the doctors themselves) displaying their short-sightedness, in all its green-eyed jealousy, at the fact that one hospital consultant was paid well for his services, because, incidentally, he was not doing the same work privately – which is the norm in Malta for hospital consultants, for all sorts of historical and financial reasons.

This consultant, in return for working 24/7 for our hospital, was paid close to what, say, a Maltese pilot gets paid (or did get paid pre Austin Gatt measures, maybe?), and I think most of us agree that a top cardiac consultant has the same value as the men and women who look after us up in the skies.

The number of letters praising and thanking Mr Manché are unprecedented for as long as I have been scouring the letter pages here. However, it seems that public opinion has been bypassed by the green-eyed monster that lurks around so profusely, and the green-eyed monster brigade has again had its way, to the detriment of the Maltese public who will now essentially have the benefit of fewer hours of this surgeon’s time.

The headline last Sunday of a Karl Stagno Navarra story screamed submission, and tacitly implied that justice had been done. But had it? “Manché gets salary slashed and submits to interview.”

We read that cardiac consultant Alex Manché had his salary drastically reduced from a gross of Lm36,000 to a gross of Lm10,000 (so take away a third to see what he really earned for himself as opposed to benefiting our taxes), but, of course, he can now work privately. Who exactly has really gained from this, then? Not the taxpayer really, or it is such a silly saving that it is not worthwhile – it won’t even take a cent off our electricity bills, will it? And not the potential patient either – quite the opposite.

No wonder the cardiac consultant is smiling in the photograph accompanying the story. He stands to earn much more this way anyway, and the only losers are Maltese patients who will now either have to pay him privately for his services, or wait longer, since he cannot possibly be expected to work at the hospital full-time for the basic miserable consultant’s allowance, of Lm10,000 a year, (which remember means, taking home very much less).

Perhaps those who are consumed by the green-eyed monster, and are sometimes green-eyed themselves, should start quoting take-home salaries rather than gross ones, as we know more than a third of our income goes to government, so it is a bit misleading to imply that people are enjoying gross salaries when that is simply not the case.

The reason Maltese consultants earn so little, or are paid so little by government and our taxes, but do not complain much, is simple. They get the hospital experience they need and, I assume, in most cases want to have. They are also free to work privately, and the good ones – and good luck to them – can earn small fortunes, more than any government of any colour here would ever be able to afford to pay them.

It is an uneasy truce of sorts. Our hospital, and we as patients, get the benefit of having some of the best doctors for a pittance from our taxes. And yes it is true, our doctors are as good as any you will find anywhere, and many have excelled both here and overseas. So we as patients have the benefit of good doctors but perhaps not enough, in some cases, of their time. The doctors, or I should say our top consultants, have the benefit of being able to earn a huge income, which they know a government could never pay them, and everyone is sort of happy, although it is obvious that the system is creaking in some areas more than others.

It is creaking partly because the system relies on the absolute integrity of many people, including hospital consultants. And while in most cases I know they do refer people to be urgently treated at hospital when necessary, or when patients cannot afford private care, there are a few who are not as scrupulously ethical as they should be. One woman I know, whose father was practically blind as a result of cataracts, was told he had to wait two years for an operation. I phoned up and became angry with the Department of Health staff, asking what kind of health service we have here when people have to wait so long for an urgent operation.

But the fault really lay with the consultant, who did not refer the case as urgent, hoping perhaps that his patient, feeling the pressure of blindness, would then have the operation carried out privately – which is pretty scary.

These stories are becoming more commonplace, and it is imperative that the medical profession controls these abuses so that our doctors continue to enjoy the respect and admiration of the Maltese public, which for the most part they deserve.

On another positive note, I spent some time in the Casualty Department this week and was amazed by the turnover, the pace of the work and the energy of the staff there (including the ambulance staff). The building is as grotty as they come, but the mostly young staff seem to be totally consumed by and dedicated to their work.

They had a very bad, demanding morning last Monday, apparently made worse by the fact that – would you believe it – in 21st century Malta some cheeky people go to Casualty, and waste their precious time, in order to get sick notes to be excused from work! Casualty is busy enough as it is, without this sort of abuse, isn’t it?

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