Health Minister Jo Etienne Abela announced the Mater Dei Hospital short, medium, and long-term action plan on Thursday, which is to free up space for 600 extra beds over the next five years.

The government’s plans had been exclusively published in The Malta Independent on Sunday on 19 May.

Abela spoke in a press conference Thursday, during which he presented the details of the action plan to the media, addressing the three most pressing matters identified; emergency waiting time, total bed status, and the bed status in the ITU department.

Several services currently offered at Mater Dei will, by time, be transferred to St Luke’s Hospital campus, as Abela also said that the plans for regenerating St Luke’s will be presented later this year.

The total cost for the restructuring of Mater Dei’s Emergency Department will amount to over €17.6 million, while around €7 million will go to the plans for the ITU department.

Another €2.5 million will be reserved for additional parking, with Abela also mentioning the €33 million planned for the new psychiatric area in Mater Dei, which is to offer acute mental health services, after they are fully phased out of Mt Carmel Hospital.

Abela gave an overview of the short and medium term plans, which will be attempted in the coming weeks. 

A new emergency call centre will be created – with the number being 1400, where people who are, for example, aware of their condition, can call to discuss their symptoms with a specialist, which will be comprised of either a senior family doctor, or a specialist familiar with emergency systems.

Abela clarified that those who need urgent emergency care should still go to the nearby medical centre but insisted on the emergency line in cases of non-emergency. The person can then be better directed to the most appropriate centre to treat their condition.

He said that a call for tenders will soon be issued with the private sector, so that government can make use of all the country’s assets, to be able to outsource emergency categories 3-5 (less serious emergencies) out of the hospital to be treated in the private sector. 

Emergency category cases of 1-2 (most serious emergencies) will remain at Mater Dei, Abela said. He continued that the professional which the patient first made contact with will be the decision-maker, who can triage and split resources in the least time possible.

Abela said that government wants more nurses trained to work in the emergency department.

Government will also be pushing on the premise that those Third Country Nationals (TCNs) who have been working and residing in Malta for the first year must have insurance covering their health. He said that this is already implemented into law, but this must be pushed to keep the system sustainable.

Abela said that the Mater Dei emergency department needs a direct link to the Gozo Hospital emergency department, which is why government is in the process of regenerating the helipad area near Mater Dei. He said that discussions were already held with Transport Malta, and government is now waiting for final advice by foreign experts on the project.

Abela said that a new helipad in Gozo General Hospital will be built, and there is also a contingency plan for a helipad in St Luke’s Hospital.

“The waiting time for the arrival of a Gozitan patient to the tertiary treatment services in Mater Dei must decrease,” Abela said.

The long-term plans for the emergency department is to expand the existing infrastructure by building floors above it, expanding the current 30-cubicle facility into a 70-cubicle facility within three years.

Additional dedicated parking spaces near the emergency facility are also in the plans, as well as for the new acute psychiatry section.

Mater Dei will be outsourcing around 100 patients who do not need acute treatment, but cannot go back to the community, into public-private partnerships, in addition to services provided by government elderly homes.

Abela said that the reality is that the demand for beds is very high, and the population is increasing, as well as advancing in age. He added that symphony between Mater Dei, community care and private care is needed to break the vicious cycle of elderly persons entering Mater Dei and needing long term care.

Non-clinical staff at Mater Dei will also be relocated to St Luke’s eventually, in the meantime, they will be relocated in a building in Swatar near Mater Dei, and the administration blocks will be turned into two new wards, allowing for 160 extra beds.

Abela said he is certain these movements will occur during summer, and the offices will be turned into wards, just as happened to the M10 ward, which was originally the canteen.

Mater Dei’s Level -1 will outsource non-clinical staff and be converted into wards for high-dependency care, compiling the most critical patients in one floor near other departments. This floor will have operation theatres, the ITU, and emergency care.

Abela said that the cleaning of medical instruments also does not have to be in Mater Dei and will be relocated within one to two years.

Day surgery, ENT (Ear, nose, throat), dental, ophthalmic and endoscopy services will also be relocated within three to five years, to St Luke’s Hospital. Abela said that government wants Mater Dei, with its limited footprint, to specialise in the treatment of inpatients.

The Medical and Nursing Schools will also relocate to St Luke’s with an estimate timeframe of three to five years, Abela said.

 The outpatient’s department, which are day services, whose place “is not in the acute hospital” is to be moved to Karin Grech, and will be replaced with the mother and child area, with specialised theatres for mothers, as well as an emergency area. This will take around four to five years, Abela said.

“Over a period of five years, we will have the space to increase Mater Dei’s capacity with 600 extra beds, a number better reflective of the current population, and the expansion of it in the future,” Abela said.

Adjacent lands for parking are being discussed, as well as other ancillary requirements such as IT hardware and software solutions, as well as a new electrical distribution plant, as one ward generates energy three times as much as any nearby commercial services.

Abela also spoke of the medium to long term plans of the expansion of the ITU, where it plans to increase its bed occupancy to 40%, to have 28 beds.

Services which were given during the Covid-19 pandemic will now give way for more services addressing the increase in population, with more plans of contingency for St Luke’s.

Abela said that these plans were discussed with Mater Dei employees as well as Cabinet, who acknowledges the important decisions which need to be implemented as soon as possible, as it is an important matter of national interest.

He said that the cost of this project is vast, and plans on how St Luke’s is to be disseminated for services are undergoing.

Abela was asked if the plans for St Luke's Hospital will be in some form privatised, to which he said that while one should not compete with the private sector, government will be proceeding with its own plans for St Luke's, and it will be led and operated by government.

Asked by The Malta Independent as to what will happen to the section of Mt Carmel which houses prisoners, during the phasing out of mental health services, Abela said that discussions with the Home Affairs Ministry, as well as the Social Policy Ministry are underway on the matter.

He said that the phasing out project is one which will take several years, but government's priority are the patients who have mental health problems who should no longer be stigmatised, in a place secluded from the mainstream health facility.

"We want one health, there is no difference between mental and physical health," Abela said. He said that the Mt Carmel building will continue to be used as a medical facility, but should no longer provide mental health services.

On a question on human resources, Abela said that this is a matter on every Health Ministers' mouths, adding that foreigners working in Malta are needed, and should be treated well, and brought to the country in an ethical way.