No institution gives so much national heartache as Mater Dei Hospital. Yes, ARMS Ltd and Arriva have caused untold inconvenience on a national scale but problems associated with the health service cut deeper in the psyche of the individual as they may immediately translate themselves into physical suffering.
Waiting for months on end to have an operation at the State hospital, ending up in a corridor until space is found in wards and finding medicine out of stock are problems that have been defying solutions for years.
Now the Government has appointed John Dalli as a hospital tsar as it attempts to come to grips with the complex set of problems that have bedevilled the national hospital.
The appointment was made too early given the convoluted case he is involved in since he was forced to resign as European Commissioner only last October. Meanwhile, his re-emergence in the local limelight on the side of a government party that he had once fought against is more than a touch ironic and it will be interesting to see how he interacts with the new Health Minister, Godfrey Farrugia.
But it cannot be denied that Mr Dalli can bring experience in this field to a government that has been suffering a distinct lack of it. Thus, from that point of view it may stand to benefit. However, there is no doubting that the situation at the hospital is a hard nut to crack.
Long waiting times is a problem many State hospitals face all over the world. Some, like Saint Goran’s in Sweden, have tackled the issue through a partnership with private business, spearheading, successfully, lean management techniques.
Thinking on such lines in the face of such bad service the country has had through ARMS and Arriva is not even remotely on the cards and Mr Dalli would have to be realistic and admit that the way ahead is tough and fraught with problems of bureaucracy that may take far more time for him to unravel than he might have ever thought possible.
As Social Policy Minister four years ago, Mr Dalli had pledged what he then called a revolution at the national hospital.
He had challenged the way surgeons and consultants worked. He is now at the helm again, and will probably find that the situation has not changed much since then.
Financially, the challenge is formidable and Joseph Muscat did not mince words on the state of play. He said the health sector was decaying from the inside. His Government, he noted, found no plan for the way forward but solely management by crisis.
The greatest irony of all is that, when it comes to care, the service is generally considered to be of the highest quality. And whereas in its election programme the party in government said it believed in involving private hospitals in the equation for a solution, one of the first acts of the new Health Minister was the axing of an arrangement for the provision of an emergency service at a Zabbar hospital. According to the minister, no money had been allocated for the service.
Making the health service run efficiently may well be the first step leading to serious thinking about ensuring that it becomes sustainable.
However, whether it will be possible to get this particular house in order remains to be seen.