The president of the Medical Association of Malta (MAM), Martin Balzan, said that the union has been in talks with the Health Ministry for the past year to create both financial and non-financial incentives which would attract more people to choose a career in casualty to address the "chronic medical understaffing".

The Malta Independent on Sunday reached out to Balzan to discuss the situation at Mater Dei Hospital's Emergency department, where a 55-year-old man died last Tuesday after being told to wait despite having complained of chest pains. A magisterial inquiry has been launched into the case and an independent inquiry is looking into the procedures adopted in the Emergency department.

Without speaking about the merits of the case, Balzan highlighted that there are not enough "casualty" doctors in the department to cope with the country's increasing demand.

These are doctors who work in the hospital department where people, who are hurt in accidents or suddenly become ill go for urgent treatment, and are trained specially to deal with such incidents.

"Casualty is not a popular career choice as it is very intensive, and requires dedication," Balzan said, pointing out that this issue prevails all around the world, not just in Malta.

Balzan reiterated that there are not enough doctors in casualty, and the MAM has spent the past year working with the Health Ministry to create both financial and non-financial incentives that would attract more people to the job.

"And if no Maltese candidates show interest, we will need to hire foreigners if necessary," Balzan said.

In discussions with the Health Minister and the chief Medical officer of Mater Dei, Balzan said that the aim is to bring in more casualty doctors to address the "chronic medical understaffing".

He said that while he does not represent nurses, there is also a shortage of many other healthcare professionals such as nurses, radiographers and more. This problem is all across the board, Balzan said.

"Infrastructure is insufficient, medical staff is insufficient, however, the quality and training of doctors is excellent," Balzan pointed out.

He said that the doctors working at the Casualty department are very dedicated, as it involves extremely hard work.

Balzan said that since the opening of Mater Dei Hospital in 2007, two things have occurred.

He stated that the life expectancy of Maltese people has increased thanks to advancements in modern medicine. Balzan said that women's life expectancy, in the last 16 years, has increased by around 84.5%, and men's life expectancy increased by almost 83%.

"People are living longer, but as a consequence of living longer, they tend to have more diseases or chronic illnesses," Balzan said.

He continued that the ageing population in Malta has resulted into the country being a "victim of its own success".

Additionally, Balzan said that Malta's population has also drastically increased to over 550,000, which is affecting the whole healthcare system.

"Over the last years, the demand has increased exponentially. Investment in infrastructure has not matched and was last done when the Sir Anthony Mamo Oncology Centre and the Emergency wards at Mater Dei were opened," he said.

Balzan said that 11 years ago, these were coping with the existing demand. Since then, there has been zero investment in the sector, and what was supposed to be done was "stolen".

He said that the main hospital is not big enough from an infrastructure point of view for all services, however, nor is the emergency casualty department, which is a more pressing issue.

Asked if the results from the inquiry into the case would lead to any changes in the sector, Balzan said while he did not know, the MAM has identified the systemic problems in the sector with the Ministry.

He said that understaffing and infrastructural problems fall under the Health Ministry's remit, and it is the Ministry that must solve these issues.

Besides increase in demand and the population, there are also things which government as a whole must deal with.

On the lost time in which investment was meant to be made in the three hospitals, which were under Steward Healthcare for the past decade, where the existing hospitals were set for renovation and investment, Balzan said that "everybody is a victim of that situation".

"If there is a queue, there is a queue for everyone. The waiting list is for every citizen and tourist in Malta," Balzan said. He added that once money went "down the drain", everybody ended up suffering, and if someone is sick, or has a life-threatening illness, it becomes dangerous.