A plan to expand Mater Dei Hospital has been on the cards for nearly a decade, but it has not materialised so far, former Minister of Health Godfrey Farrugia said.

Ten years ago, the population of Malta was just over 400,000 and space was becoming limited. The hospital now has to deal with much larger numbers, given that the population has now risen to nearly 550,000.

“The hospital at the moment is too small to meet the demands of the Maltese population,” Farrugia told The Malta Independent on Sunday. He said that expanding and further developing Mater Dei has been on plan since 2014 but has never come to fruition.

Farrugia had been appointed Health Minister by Joseph Muscat in 2013, but lost his place to Konrad Mizzi a year later. In January 2014, when Farrugia was serving as the Minister for Health, a tent was set up outside the Mater Dei building to accommodate an influx of patients, primarily people with influenza. The tent had been set up to meet patient demand due to a lack of space within the hospital. Prime Minister Joseph Muscat had overruled his minister and ordered that the tent is removed. Two months later, Farrugia was pushed out of the portfolio.

The Malta Independent on Sunday reached out to Farrugia nearly 10 years after that situation to ask for his thoughts on the state of Mater Dei’s space issues and the lack of updates on development regarding a new outpatients’ block.

Farrugia said that before anything else, when you have an efficient outpatient block capable of providing appointments appropriately and in a timely manner, then the pressure on the rest of the emergency services will be reduced as a result.

“We know that many of the things which were developed in relation to Mater Dei were EU-funded,” he said. He said that when he took over the reins of the health ministry, the idea was to develop the way forward for a 20-year period lasting until 2035.

At that time he became minister, the priority was the Oncology centre, which was still being built. But Farrugia was not given the time to proceed with his plans, as when the Oncology centre opened in December 2014, he had already lost his place as health minister to Konrad Mizzi. The government then shifted its attention to three public hospitals – St Luke’s, Karen Grech and Gozo General – which it passed on to the private sector in 2016, only for the deal to be annulled by a court of law earlier this year.

Farrugia continued that there are two pending problems which have remained prevalent since 2013; one being the state of mental health care and the other being the outpatients’ block.

He said that as it stands, the pressure on emergency services has increased and in addition to that, the number of medical specialities has increased, meaning that these different disciplines also need their own space where patients are treated. He added that the number of specialists versed in these specialities however is not able to keep up with the demand put upon the health system.

Farrugia explained that in 2014 and 2017 two Health in Transition System (HiTs) reports, analysing Malta’s health system, were conducted by the European Observatory on Health Systems and Policies in collaboration with the World Health Organisation. He said that these reports had found that there needed to be an increase in outpatient services according to the rise in demand being faced.

“It was not adequate then, and it definitely isn’t adequate now. That is why the outpatient services seem chaotic.” He added that the HiTs report had clearly shown that outpatient services needed to be, and still need to be, expanded.

The 2017 HiTs report on Malta detailed that Maltese citizens lived around 90% of their lives in good health, which was the highest within the European Union at the time. The report also aligned with Farrugia’s comments regarding the lack of specialists within the medical field. The 2017 report listed the most pressing challenges on Malta’s health system at the time namely a need to increase capacity in order to cope with the growing population, an issue which has been exacerbated since the time of the report’s writing; a need to strengthen the mental health sector; a need for redistribution of resources and strengthening towards primary care and a need for a focus shift towards addressing medium-term financial stability and ageing.

The former Health Minister said that an aspect of the medical services, which has indirectly gone backwards due to the lack of space, is that a patient is now taking longer to get an appointment. He explained that as a consequence of this the individual’s ailment may get worse and during that period they could end up having to use the emergency services. He added that it may also be the case that people feel like “their back is against the wall” and feel as if they are forced to seek out private healthcare.

Farrugia said that there is space in the area around Mater Dei for the outpatient block to be developed as well as space for the expansion of mental health services and an administrative block if necessary.

“There are certain things in the hospital, such as the administration block, the medical school and the nursing section which do not need to occupy big spaces within Mater Dei. They occupy a space which could be changed into permanent wards. The administrative block could be moved outside of the hospital and into a nearby building.”

“Apparently there is a lack of finances,” he remarked. He said that some people may blame Covid for the situation but he continued that Covid has passed and the country’s priority should now be the health of the people, “which is the greatest investment a country can have”. He said that if the health sector is not being provided with the necessary finances to provide wellbeing to the people, then something is wrong.

This newsroom reached out to the Ministry for Health for updates regarding the development of the outpatient block but has not received a reply. It has recently been reported that a site in Swatar has been identified for a mental hospital, but no timeline has been given.