This is not the first time John Dalli has found himself in a top position at Mater Dei and the Health Department.

Anecdotal accounts told five years ago how when Lawrence Gonzi offered him a ministry, reportedly the tourism ministry, Mr Dalli refused it and insisted he was given the health one. Mr Dalli later denied this account.

Now following the election result and the change in his fortunes with the declaration by the Commissioner of Police that no charges would be forthcoming with regards to the tobacco case, Mr Dalli is back in charge at Mater Dei having adroitly negotiated his way from one party and one government to another.

Those who remember things may also remember echoes of rumours about Mr Dalli and his reported interest in two huge tenders when Mater Dei was being completed: the medical equipment one and the electronic infrastructure one.

Whatever Mr Dalli’s past, it would seem this government found itself in quite a dire situation when it tried to cope with the many Mater Dei problems. To Dr Muscat’s credit, he took immediate action and has complained over the past days the situation at the hospital has not improved at all.

There seems to be a difference here between Dr Muscat and Dr Gonzi. The ministers appointed by the two – Godfrey Farrugia and Joe Cassar – were both well-meaning but the situation, at least that is the impression the general public gets, was quite beyond them. But while Dr Gonzi stuck loyally to Dr Cassar as the situation never improved, Dr Muscat found a willingness in Mr Dalli to try his hand at tackling the many ills.

Mr Dalli is widely known, and he himself often describes himself, as ‘the man who gets results’. Frankly, not many will be able to list any of Mr Dalli’s achievements as Minister of Health under Dr Gonzi. Maybe, to give him his due, he was stopped by Castille from taking decisive action. This time, hopefully, he will have a freer rein (and also a prime minister eager to get tangible results).

Mr Dalli is an accountant by profession and certain details which have been released by Minister Farrugia over the past days evidence that someone was looking at the hospital’s ills from an accountant’s point of view, like the amount of medicines that had expired in the storerooms.

There is no doubt in our minds by now that contrary to what many thought, a doctor is not the right person to manage a hospital while a manager and/an accountant may be better. Undoubtedly, an accountant will find a huge amount of information in the hospital’s offices which only an accountant can read and a doctor cannot. At least, as long as that information is there.

But then once the information is collated, decisions must be taken and whoever takes decisions must be backed to the hilt by him who put him there. This government, like the one before it, has one sacred principle: healthcare must remain free. One can understand the political reasons for such a commitment but many have questioned ifs validity. There is much that undoubtedly can be done in trimming expenditure and improving efficiency but only up to an extent.

Beyond streamlining and improving efficiency, strategic decisions must be taken and no amount of accountant/managers/non-politicians will be able to do that.

The country and its government must understand that many strategic mistakes have been committed by one government after another. Mater Dei, or to give it its original name, San Raffaele, was never meant to be the only hospital in Malta, but a secondary small hospital. (Thank heavens the link with San Raffaele was cut by Dr Sant, for the mother hospital, Milan’s San Raffaele, has now collapsed amid many debts).

But then it was also Dr Sant who, on the strength of a two-page report, decided that having two hospitals in Malta does not make sense. While that reasoning may not have been bad in itself, it also meant that Mater Dei was never big enough to be able to cater for the whole of Malta.

The successive PN governments were always in time to take remedial action such as building a further storey but never did.  When Mater Dei was being built it was the consultants who took the decisions, and this can still be felt now. Then too there was a total changeover in the long term plans for hospitals and as a result of yet another change, the new oncological unit is now being built. It should take some of the load off Mater Dei.

One other thing the PN government did not quite manage to do in its time was to beef up the Primary Healthcare or district health centres so as to take off more load off the Emergency Department. That should now become a priority along with more human resources where they are needed.

So there is a real workload waiting for Mr Dalli and in the name of what is best for the country, we should all wish him well. At least, this time, there are no tricky personal issues between the man and the incumbent at Castille, which should help simplify matters. But as his predecessors (or even successors) can tell him, there remain the tricky relations with the many unions not forgetting the trickiest relations – with the doctors and consultants, nurses and other operatives.