Health Minister Jo Etienne Abela has said that the Paola Regional Hub contractor had made 'outrageous' requests to the government.

The hub, officially called the Vincent Moran regional health hub, has faced delays and is not yet open, despite the planning permit having been granted back in 2017. Once operational, it will serve as a health centre where, among other things, surgeries could also be performed by surgeons and specialists. A termination notice had been sent to the contractor responsible for the regional hub project by the Ministry for Health in September.

There is ongoing litigation between the health authorities and the consortium that won the tender - Ergon-Technoline JV.

In an interview with this media house, Abela said that both the structure and the equipment are all there and ready, but government is waiting for the pending compliance certification in order for it to start operating.

He said certification is needed, however, government will not be "held at ransom" on what is due to the taxpayer.

"The Foundation for Medical Services (FMS) scrupulously went by the contract. The project should have been delivered by the previous contractor two years ago, and it was not. That is the end result, for me, and for the patient," Abela said, explaining that the contractor made "outrageous" requests to government.

"You cannot have an almostready project, and then start asking government for €6 million, then €14 million, then €24 million over and above the original price in a matter of days," Abela said.

He continued that the FMS, the Ministry, and government could never have agreed to such terms.

"Let me be clear, this was not a clash with the contractor over some small sum. Here, we are talking about an almost 100% variation in the tender value," Abela said, adding that this was not a compromise the government was willing to make.

Abela continued that there is an ongoing arbitration process, and government and FMS want it to conclude, and whatever is due to the contractor will be upheld by right.

The minister said that he wants the service to start operating as soon as possible, but could not give a definite time frame. "We are awaiting compliance certification, and as soon as I receive technical reports giving the go-ahead for safe delivery of healthcare, I can assure you, we will open immediately. We will not procrastinate more than necessary," Abela said.

Any investment in workforce must translate into excellent patient care

Discussing relationships with prominent medical professional unions like the Medical Association of Malta and the Malta Union for Midwives and Nurses (MUMN), Abela recognized the inevitability of clashes but emphasized the shared goal of patient care.

"I am usually extremely moderate and non-confrontational, but that does not mean that clashes will not occur," he stated. He affirmed his commitment to ensuring fair conditions for healthcare workers while maintaining high standards of service delivery.

"Government is the executive, and our employees receive salaries to provide excellent service," Abela noted, highlighting the importance of transparency and collaboration with unions.

He acknowledged that while clashes are natural, they should be minimized by focusing on shared interests.

Abela continued that government works very well with the two unions, as well as UHM - Voice of the Workers and the General Workers' Union (GWU), and when there are national matters, he asks all unions to each have a representative at the table, at the same time, in the interest of transparency.

Abela said that by and large, the extra remuneration the Ministry offers translates into good patient care, but government must be vigilant and wants to ensure any investment in the workforce is translated into better service to patients.

A medical professional within the emergency department interviewed by The Malta Independent on Sunday had said that the same department was not consulted on the outsourcing of emergency services to the private sector, saying that it was never explained to them directly by the Minister.

Asked about this, Abela said that this is untrue and a "complete fallacy." He said that while he did not speak to each and every emergency physician, the Emergency department has its own Chairman and Deputy Chairman, who have the responsibility to communicate government plans to its employees.

"In April, I also gave an hour-long lecture taking comments and questions in the central auditorium of Mater Dei, and everyone was invited. There were important questions that were asked and we rethought certain issues," Abela said.

Ambulances to collaborate with CPD

Abela also addressed the need for improved ambulance services and emergency responders, noting that the training of 54 new responders had recently concluded.

"We would like emergency responders in Malta and Gozo to share and be flexible in their working hours," he said, promoting inter-island collaboration in emergency response.

Abela said that future tenders will require more ambulances, and government is also in the process of starting training for more emergency responders.

On top of that, Abela said that he has spoken to Home Affairs Minister Byron Camilleri recently to discuss the possibility of a strategy where emergency responders are in better dialogue with the Civil Protection Department.

"They have similar aims to their job, and it would make sense to enhance the pool of emergency respondents in every way possible," Abela said.

Abela affirmed that government wants these hubs, in coordination with other entities. "It is a question of making the system work better together," Abela said, adding that this strategy will cost money, but will benefit patients.

Mental Health Unit tender document has been submitted

Abela confirmed ongoing plans for a mental health unit, stating that a tender document has been submitted to the Department of Contracts.

This EU-funded project, costing in the region of €35 million, aims to integrate physical and mental health services, combating stigma in mental healthcare, which he said even pervades the medical profession.

Abela pointed out that mental health is stigmatized, even by medical professionals, as it is "ingrained" in their minds that psychiatrists and surgeons/physicians are a "different breed." He was made aware of this after speaking to mental health professionals.

Abela said that the best way forward is to have the acute mental health services in one unit.

Asked to clarify whether this will be a hospital or a unit, Abela said that this will be a fully-fledged unit which will be part of Mater Dei in the new area on top of which the MAU wards were created.

The unit will be extremely close to the emergency department, the extension of which, in addition to the acute psychiatric unit, will be one project, Abela said. He thanked the FMS for moving on with it "in record-time".

Regarding healthcare for thirdcountry nationals (TCNs), Abela said that government issued a legal notice this year mandating private medical insurance for the first year of residence for TCNs.

"If they had to use our system for free, that would be endangering the sustainability of the system," he cautioned. While he could not provide a specific figure for outstanding bills owed by TCNs, he emphasized the importance of safeguarding the healthcare system's viability.

Addressing concerns about data management, Abela acknowledged the need for a consolidated health database.

He said that the cases that were brought to the Ministry's attention had taken place due to human error in inputting data. Abela said that these things happen and will happen again.

"It does not mean we do not try to make the system better. Yes, we want a digital system and to do away with paperwork, and we are going to invest heavily in a new system," Abela said, adding that that was why the Ministry introduced another security check, meaning they also ask for the patients' date of birth.

"Two security checks are already better than one," Abela said, adding that one has to alert the hospital of the changes, and that affecting the changes is equally important.