I watched John Dalli on Dissett and like many, I could not help but reflect on the irony of it all.
Here was the man who had been minister for health, now consultant to this new administration, offering a report criticizing the running of the hospital and saying, as he repeated yesterday, that running a hospital is not for politicians but for professional managers.
If we but for a moment block out the man behind the report, what emerges from the report and the overall criticism is what would emerge from any analysis conducted by an accountant, as Mr Dalli is.
An accountant susses out the gaps, the totals that do not add up, the payments made twice, or without a proper backing, the stores that are not accountable, and the many other things that any accountant gets to have an eagle’s eye for.
An operation as complex as the main and only hospital that Malta has, has so many levels and areas, so many inconsistencies, so many gaps where management is absent, that an accountant would either go mad trying to iron out the faults or else has to have Herculean powers to clean up this awful mess.
He says his earlier efforts, as minister, were undermined by ‘someone’. I assume he means undermined by Castille, which was a frequent occurrence under Lawrence Gonzi.
Ask Austin Gatt how angry he was when his stand on kerosene sellers was ‘undermined’ by Castille and how he erupted when he happened to bump into Paul Abela, GRTU president, outside the GRTU office when he was going home. But he did not get sent to Brussels, as Mr Dalli was. He did not up and go.
Mr Dalli is probably right to say that his successors did not continue what he was trying to do. Over the intervening years, one cannot say the situation at the hospital did not improve, but the delays, the beds in the corridors, the queues for operations and the many things that have been highlighted in the Dalli report remained.
On the other hand, Mr Dalli’s successors tried a different approach, especially in getting help from the private sector, which this government, so far has been rather unwilling to go for.
The Dissett vox pop, such as it was, showed that people in general are not too upset by what they have come to see as the hospital’s usual standard (which is not to say these faults have become acceptable). The hospitality environment – new hospital, big rooms, clean environment, masses of nurses and the like, and above all the quality of the healthcare, overcome the problems in the background. As long as the government is there to fund it all, who’s to complain? Nobody, except the government itself seeing the continually rising costs of healthcare.
The situation at the hospital would undoubtedly improve if more money were thrown at it, though not all problems would be solved, but the government would then be saddled with the increased problem of keeping its finances to the right side of things. I have long been convinced that only through getting the extra and the improved services paid by patients while retaining a bedrock of free healthcare for all, could get us some improvement, but the two parties have time and again refused to countenance this.
An accountant-manager would probably begin trying to get some order in the huge amount of shifts, timetables at the various levels of the hospital. Sooner or later, he will find he has to deal with so many unions and associations, all with conflicting demands, and to top it all so many stands taken by doctors, consultants and the like.
But he will get nowhere. Mr Dalli tried this as minister and got nowhere. He is trying it again as consultant and he seems to be getting nowhere once again.
He may be right that the hospital needs a professional manager who keeps a steady eye on the accounts, but this is Malta and it is the government that runs the government’s hospital. We are back to square one, after spending so much on a new hospital.
Claudio Grech, Simon Busuttil’s surprising choice as shadow minister of health, has come out with an appeal for a bipartisan approach to the problems of the hospital.
This is well meaning (and also good politics) but likewise it will go nowhere.
The government got itself elected on a platform that included sorting out the mess at Mater Dei and got the support of a vast majority of the electorate and it is the government that must solve it.
The hypothetical professional manager would find it impossible to deal with the many intractable problems of the running of the hospital without running into political flak. Such issues can only be dealt with at political level.
But they require a government that is not afraid of taking unpopular decisions, that is not afraid of cutting the many Gordian knots, banging a few heads together, removing many hidden empires, and getting the entire workforce to sing from the same hymn-sheets as against every man (and woman) on his own.
Whether the government is up to this remains to be seen. Certainly it has a majority that makes taking such steps easier. Prime Minister Muscat has often expressed anger that in his view things have not improved substantially at Mater Dei, as he (and the population) would have wished. The spat that erupted between Mr Dalli and Minister Farrugia does not help matters at all.
This is new ground for Labour. The Mintoff administration found itself at odds with the doctors and Malta was the loser. The Sant administration found itself faced with the Fenech Adami plan for two hospitals and realized this could not work. The Gonzi administration focused on getting the hospital open but the flaws in the design only became evident when the hospital was opened and running. The post-Dalli team tried to patch up the most evident things. Now is the time for a coherent, strategic, over-arching strategy for the hospital.
Mr Dalli is right when he tells Minister Farrugia to stop micromanaging from an office in the hospital. In truth, there seems to be little evidence that this micromanaging has improved things. Dr Farrugia’s explanation, during Question Time some days ago, as to the delays in the Oncology Building showed me, at least me, a cluttered mind with too many knots to untie and a partisan approach as well.
I am sure this approach will not work but I dare the minister, and the government, to prove me wrong.
[email protected]