Former St James Hospital Chief Operations Officer Charlotte Sant Portanier, now working for a healthcare consultancy firm, explained that the private health sector struggles with recruitment in Malta and Gozo.

The new company she works for, Me& Co, has only recently been established and offers consultancy services in private healthcare, beauty and cosmetology, and Spa Management. By profession, she is a pharmacist who graduated from the University of Malta in 2000, and left Malta in 2001 for the Middle East and Australia, later returning to the island.

The private sector’s main competitor is government, she explained. “People feel more secure working with government, as it’s a life-long guaranteed job, so you can’t blame the Maltese graduates. When it comes to recruiting resident medical doctors for hospitals, full-time physiotherapists, nurses and specialised nurses, the private sector struggles.”

She continued: “We tend to look oversees. When we find an EU national with a degree obtained from an EU institution then the respective professional body, such as the Medical Council for Doctors, would need to recognise that qualification. Some councils and boards are more efficient than others. We are trying to register a Chiropractitioner and we’ve been at it for four or five months, and we can struggle with the professional’s registration because of time taken.”

She said that for the registration of a certain type of EU healthcare professional, which she would rather not identify, would take 3-12 months. “It all depends on the professional body involved”.

“As for non-EU professionals, they must first have their qualifications recognised in Malta. They would then register with their respective professional body and look for employment. Once they find employment they must apply for a work-permit. If you have a position and someone resigns and delivers their notice, and then nobody with that skill is found in Malta, then its takes time to find a replacement, and can even take up to 12 months or longer if they are from outside the EU”.

Reducing red tape

Reducing the bureaucratic process can help, she said, “but this process is very important and must be well regulated, otherwise we run the risk of fakes and dodgy professionals working on the island. Most of the skills missing on the island are the same skills missing in other countries, especially when looking at specialised nursing professionals. We have a shortage of them here just as they are in short supply in other countries, where conditions are probably better”.

“While waiting for applications to process, there is nothing stopping these professionals from accepting jobs elsewhere, and thus if we are not efficient and aggressive, we can lose these people. We have to be more efficient in our process as at the end of the day it is affecting local business and the patients”. She stressed the need for more accountability and efficiency in the bureaucratic process.

Quite a number of medical professionals come to Malta on working holidays for 6-12 months she said, with quite a number coming from the UK.

Dr Sant Portanier mentioned that in some cases, patients are not able to seek a second opinion on the island, as no such specialist would be available within the private sector. “One example of this would be in relation to neurosurgery, or haematology, where no such specialists are available within the private sector. Thus patients unhappy with public service would have to go abroad”.

Migrants needed

She said migrants are needed, those with specialities in order to offer and maintain a service. She mentioned the need for proper orientation and induction programmes due to possible cultural clashes in the workplace. She also spoke of the need for the Maltese to be more tolerant. “We have a lot to learn and we can work on each other’s strengths”. 

A rather interesting public dialogue will take place this Friday at 1pm, titled – “Living with Migration” which will try and bring to the fore the local realities of migration and its different facets. Charlotte Sant Portanier is expected to take part. The dialogue, which will include insights from MEPs, will be held at The Fortress Builders, Fortification Interpretation Centre, St Mark Street, Valletta.

As for Maltese medical graduates leaving the island, she has, as she put it, a rather controversial view. “Let them go and develop their skills. It’s good for them to work in a different system with different standards. We have to entice them to come back and accept what they have to offer. Unless we go out there and learn from other countries, we would not actively bring new knowledge to the country. Having worked in Australia for a number of years, I have seen and dispensed medications that I have never seen over here, as we wouldn’t be able to afford them as a country. The more our graduates learn abroad, the more they can convey their new knowledge and Malta will advance”.

“I am no longer registered as a Pharmacist in Australia. In order to maintain that registration, you need to prove you are keeping up to date with medicine and related material in Australia while attending conferences there.  Over here, in Malta, we don’t have that. You can be a 96-year-old demented person still licensed to practice as a Pharmacist, or a physician. You just need to pay for registration. It would have to be regulated eventually, and the sector is still developing. So I welcome graduates working abroad, bringing back with them new knowledge”.

Bringing graduates back

In order to bring these graduates back, she explained the need to empower them. As an example, she suggests making it easier for them to lecture at University, or develop national guidelines.

She spoke of the need for more private operators for further competition. “This would result in an increase in healthcare standards. Instead of having a single department of surgery in Malta, there would be two, from two large teaching hospitals which would result in increased competition for standards - and the Maltese patients would benefit”.

She told this newsroom that “We have a long way to go in healthcare. None of our hospitals are accredited through international accreditation”.

“There are standards you need to meet in order to receive such accreditation. No one is really working or striving towards that, while most EU and non-EU nationals working within the healthcare profession on the island tend to come from internationally accredited hospitals. So when they come to Malta listen to them, as they are used to operating at a higher standard. There’s a lot we can learn”.

Asked why no Maltese hospital has strived to achieve such accreditation, she said that there hasn’t really been a need, and nobody would go through the hefty, lengthy costly accreditation process if there is no need for it. “As soon as one provider would do it then the others would do the same and compete for it”.

She mentioned that things work differently in Australia. ”If you weren’t accredited, you wouldn’t receive funding or support. In Australia, unless your pharmacy was accredited by the Quality Care of Pharmacy Practice, then you weren’t eligible for certain tax benefits etc, thus the Australian government was encouraging pharmacies to maintain standards, and the same was for hospitals”.

Asked if in Malta Pharmacies had something similar, she said no, not for Pharmacies and not for hospitals. “Hospitals have their own international accreditation programmes, such as the Joint Commission International (a known accreditation body for hospitals), which is the most common one for hospitals”.