Issue link: https://maltatoday.uberflip.com/i/294639
maltatoday, SUNDAY, 13 APRIL 2014 13 Interview medicines. "Again, the writing is on the wall, and has been there for years. Admittedly there are logistical complications in this issue. We are an island; other countries have the luxury of overland supply routes, and can arrange for speedy deliveries in case of an emergency. In Malta this is not so easy; you have to rely on ship- ping schedules, and so on." But again, it all boils down to pre- vailing work practices. "Our propos- al is for government, when issuing a tender, to give the contract to two suppliers on a 50/50 basis, not just one. This way, if one supplier cannot meet the demand, government will at least have a fall-back position." As things stand, however, govern- ment is at the mercy of a single sup- plier who, for various reasons, may sometimes fail to meet an order on time. "Why limit oneself to only one? Why not rely on more suppliers? It's easy, other hospitals do it…" He answers his own question. "Ob- viously, suppliers don't like it. They want to have exclusivity. But we are not here to make suppliers happy. We are here to see to the needs of patients…." The picture that emerges from Paul Pace's complaints seems to be one of successive governments some- how unable to bring to heel certain lobby-groups that have an interest in retaining the status quo; in this case, the consultants' lobby and that of the pharmaceutical distributors and sup- pliers. At the same time, this suggests that both these lobbies exert consid- erable influence over both parties. How realistic is this scenario? Pace shrugs. "The consultants are a powerful lobby," he says simply. "To give you an example: why was the John Hopkins report never pub- lished? I would have thought inves- tigative journalists would be onto something like that in a flash…" The report was commissioned by the Nationalist government and completed in 2012. Undertaken by a leading American medical centre, it is understood to point towards serious management problems and political interference in the decision- making process. Both PN and Labour governments have however refused to publish it, citing confidentiality clauses. "One of the things the Hopkins report stated was that Mater Dei consultants were part-time," Pace observes. "Clearly there was some- thing in this report that the consult- ants didn't like. So it was never made public…" Another indication of the lobby's strength is the reluctance of govern- ments to ever cross it, even to their own exorbitant cost. "Joe Cassar was too scared of them to do anything about the situation. And the PN paid a high political price for this. It took all the flak, but never managed to solve the problems at Mater Dei. They preferred to take criticism from the Opposition… and from the MUMN!" he adds with an- other laugh. "Our view has however remained the same no matter who is in gov- ernment. If work practices need to change, let's do it tomorrow. We don't need more taskforces. Cassar knew what needed to be done; but he never had the courage to do it. As for Godfrey Farrugia, he always was a consultants' lapdog. Always took their advice, even if it never got us anywhere. And he made matters worse by empowering consultants more…" Is this why Farrugia was removed in the cabinet reshuffle? Pace re- fers the question to Joseph Muscat. "Why was he removed? I don't know. The Prime Minister might have had his own personal reasons. I'm the last person to know. I'm sure it wasn't just because of MUMN…." Pace doesn't hide the fact that his union agrees with the decision, though he points out how he had desisted from criticising the belea- guered health minister before he stood down. "This is why I walked out of a recent radio programme. There was a strong rumour that Godfrey was on his way out at the time, and I was challenged to criti- cise him on air. But it's like the last two months of election campaign. Better to keep quiet. For me to blurt out these things then, with Godfrey already on his way out, was not ideal. Now, however, I can…." He laughs again. "That's why they call me vociferous, I suppose. That's why they always accuse me of being in cahoots with the Opposition, no matter who is in government. That's why they say I 'have an agenda'. It's because I always speak my mind. If the problem is this, I will say it is this…" Meanwhile Farrugia has been re- placed by energy minister Konrad Mizzi, with Chris Fearne as parlia- mentary secretary. What change in approach does the MUMN envisage under the new minister? "It is too early to say. I would like to think there is light at the end of the tunnel. Mizzi took a managerial approach to energy issues, and it is a management approach that is need- ed here too. From our initial meet- ings the prospects look good. Both Mizzi and Fearne have indicated that they will take our considerations on board. One thing is certain, however. Labour can't afford to go to an elec- tion in four years' time with the same problems still in place. Like I said, people aren't stupid. They know what the problems are. And they will know if they have been solved or not…" Successive healthcare reforms have ignored the real problems at Mater Dei and other hospitals. Paul Pace, president of the Malta Union of Midwives and Nurses, argues that the time has come to confront the real issues for a change PHOTOGRAPHY BY RAY ATTARD The elephant in the operating room