Hospital emergency crippled as patients left waiting for hours
Patients seeking emergency care at Mater Dei Hospital have to wait for more than 12 hours as government seeks private sector help to ease pressure
Over the past 10 years, government failed to live up to its commitments to invest in Mater Dei Hospital to increase bed space. Instead it banked on the corrupt Steward hospitals deal to ease the pressure, something that never materialised. Now, Malta’s only general hospital is struggling to cope under the weight of higher demand from a population boom and a surge of COVID cases.
Mater Dei Hospital was already struggling to cope and then came a COVID surge
Mater Dei Hospital was already struggling with limited bed space but is now buckling under pressure caused by a surge of COVID cases, MaltaToday has learnt.
The situation is made more complicated by scores of social cases involving patients who do not require clinical care but have nowhere to go.
The precarious situation is having a knock-on effect on the Emergency Department where patients are experiencing lengthy waiting times that can reach 12 hours.
Several healthcare workers have told MaltaToday that COVID cases requiring hospitalisation have surged thus blocking beds in the medical wards.
The Health Ministry has confirmed that there were 66 patients with COVID recovering at Mater Dei up to Friday afternoon. However, healthcare workers said the number was much higher at the beginning of the week.
“The current strain of COVID is less severe but is very infectious and after mass events, especially over the weekend, we are seeing a surge of patients with COVID, who for some reason or another require hospitalisation,” a nurse who spoke on condition of anonymity said.
• Health Ministry seeks private sector help to ease emergency burden
• Educational campaign to direct patients to services closest to them
• Healthcare professionals, Opposition blame lack of investment, population growth
The latest group of COVID variants, collectively called FLiRT, is responsible for higher infection rates across several countries. Concerts, parties, festas and the election counting hall have all provided fertile ground for COVID infections to spread over the past month.
The situation has been described by healthcare professionals as akin to the influenza season during the winter months when hospital struggles to keep up with patients requiring treatment for chest and respiratory tract infections.
“COVID patients have to be kept isolated, which limits ward space for other patients and this creates a bed shortage in a situation where the hospital is already trying to cope with higher demand from the exponential increase in population over the past few years,” the nurse said.
A 12-hour wait in emergency
A patient who required emergency care over the past couple of weeks recounted to this newspaper the interminable time it took for him to be treated and then allocated a ward bed.
“After triage, I was in the waiting area for almost four hours before a doctor could see me and commence tests and treatment. It then took several more hours for the test results to come out and be analysed by a doctor, who eventually recommended hospitalisation. I was finally allocated a bed more than 12 hours after I first stepped into the Emergency Department,” the male patient told MaltaToday.
His story is not unique with other patients reporting lengthy waiting times also at health centres before being referred to hospital. A second nurse confirmed the deteriorating situation at health centres.
“A four to five-hour waiting time is increasingly becoming commonplace at health centres, which for many people are the first point of contact when requiring emergency care,” the nurse said.
Social cases blocking beds
Another healthcare worker told MaltaToday part of the problem at Mater Dei also stems from scores of social cases that are occupying beds because there are no alternative places for them.
“These are patients who would have been admitted for a medical condition and after being treated require rehabilitation or continuous care outside a clinical environment but have nowhere to go,” they said.
The healthcare worker noted that most of these cases concern elderly people. “It seems there are not enough places in old people’s homes to take them in,” they said.
But another medical professional insisted the situation at Mater Dei has long been coming and blamed lack of investment for the current predicament. They said the hospital did not expand in line with the population explosion of the past decade.
“The population has increased rapidly because of an influx of foreign workers and this has caused a strain on resources. To make matters worse government did not invest in the necessary infrastructure to increase beds because it banked on the Vitals deal, which failed to deliver,” the doctor said.
Government seeks private sector support to ease emergency waiting times
Meanwhile, in comments to MaltaToday, the Health Ministry said it has given directions for “seminal changes” in the assessment and flow of patients who turn up at Mater Dei’s Emergency Department in a bid to reduce waiting time.
“These will be based on first contact with a decision-making specialist who has the skills to expedite appropriate patient care expertly and expeditiously, and emergency patient care on a named-consultant model,” the ministry said.
But government will also be seeking to rope in the private sector to ease the pressure on Mater Dei’s Emergency Department.
“A request for the participation of all assets in the country - primary healthcare and private sector - that provide emergency care will be issued imminently, in order to rope in untapped resources at government’s expense,” the ministry added.
It will also be unveiling “an aggressive information and education campaign” to direct persons in need of care to the “most effective service in their vicinity”. The ministry hopes this will improve efficiency and expediency, while easing the burden on the general hospital.
Longer-term projects include the issuance of a tender document for several projects that include an extension to the Emergency Department that will see the number of treatment cubicles increase to 70 from 30, the expansion of ITU beds by 40% and the building of a 126-bed acute psychiatric unit.
“Whereas government funding for these projects is guaranteed, it is obvious that rigorous public procurement and planning regulations and timeframes must be adhered to,” the ministry said.
Meanwhile, non-clinical services, including administration have started being relocated out of Mater Dei to create space that will be converted to clinical ward areas. The ministry told MaltaToday that the first such space to be cleared will accommodate 50 new beds by the end of this year.
Opposition blames failures on population growth
Even if these measures will help ease the pressure on the public health service, the impact is unlikely to be felt immediately. A more pressing question will be whether they will be enough to cater for Malta’s growing population.
Opposition health spokesperson Adrian Delia believes that emergencies such as the current COVID surge are only making worse an already precarious situation. He blames the rapid population growth and government’s inability to plan ahead for the current predicament at Mater Dei.
“The problems being experienced now have long been coming as a result of government’s economic policy based on population growth that overwhelmed public services and infrastructure to the point that this is now impacting permanent residents in their everyday lives,” Delia told MaltaToday.
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