Former Health Minister and EU Commissioner John Dalli today said that political interference in Mater Dei has rendered the management at the hospital powerless.

“I do not agree that the Heath Minister should have an office in Mater Dei. The Minister should not micromanage in my opinion, I don’t know if the Minister agrees with me,” Mr Dalli said, to a frowning Health Minister. 

“Management needs to gain autonomy. This is not an investigative report, this report says what I think is going wrong at Mater Dei and how it can best be solved. Political interference has to be stopped. I say to the government, hand-off Mater Dei,” Mr Dalli said.

Mr Dalli said that Mater Dei cannot be managed within the strictures of the civil service. He said that the management at the hospital is currently “dysfunctional.”

“Practically every stakeholder has eked out his own territory and devised his own rules. This has led to a lack of coordination. This leads to a lot of waste and inefficiency,” Mr Dalli said.

There is no need to reinvent the wheel, Mr Dalli said. All that has to be done is compare to the best practices and benchmarks of other hospitals, and implement them at Mater Dei.

Mr Dalli said that Unions filled the vacuum left by management, leading to a situation where Union leaders seem to think that they should be running the hospital.

Finances

In a presentation on the financial management of Mater Dei, it was heard how the payroll for 3,920 employees is still calculated manually, and no electronic capture for employees' attendance exists.

One anomaly highlighted was the fact that the annual payroll amounts to 61 million, with annual overtime and allowances amounting to €37 million of this figure. There is no direct relationship between overtime and increased activity.

Mater Dei’s budget amounts to €230 million, which is half of the health budget.

Financial records disclose medical equipment at €110 million against inventory record of €67 million.

Information Technology

At the moment, different “scattered” IT systems exist .Mater Dei did not form part of the decision making process when it came to the hospital’s IT system. Rather, “external” actors imposed the various systems.

There is a need to replace system which dates back to the 1990s.

Patient tracking will be improved, leading to quicker diagnosis, consolidation of data and improved queue control, which will lead to substantial savings on resources.

Procurement

Pilferage and theft exists at Mater Dei, Mr Dalli said.

An effective inventory management system should help to avoid this.

Management is usually informed that a contract is going to expire three months before its closing date, which does not leave sufficient time for a proper tendering process, meaning that the contract is usually rolled-over with the same supplier.

Out-of-stock pharmaceuticals

The algorithm being used to buy medicines is faulty. Shortages are typically the result of incorrect interpretations of patterns of demand, bad planning and incorrect procurement decisions. 

Long-term patient care

Close to 7,000 bed days are spent in an acute medical ward, at a cost of €1,680,000. Often, consultants tell patients that they can go home, but due to various social problems the patients do not wish to do so.

A discharge facilitation team has been set-up in order to indentify such patients when they are first admitted.

This causes delays at A&E for patients waiting for a bed, causing congestion in the admission areas.

Accident & Emergency

300 patients visit the department daily, 1/3rd of them usually require admission.

The government has increased medical staff have been increased by 17, and nursing staff by 20. 

‘I was stopped from implementing reforms in 2008’ 

“Reforms at MDH began in 2008, don’t ask me what happened to them after that, ask those who came after me. For some reason, these reforms were halted. The reforms are the same things that I am suggesting today, but for some reason some bright spark put a stop to them,” Mr Dalli said in reference to former Health Minister Joe Cassar. 

‘Where are the solutions’ – PN spokesperson on health

Claudio Grech, the PN’s spokesperson on health, noted that the report was critical of MDH and its staff, but was short on actual solutions.

He said that Mr Dalli’s theft allegations were futile and irresponsible if no action had been taken in the form of a Police report. He said that the Attorney General should also have been informed about the alleged theft.