Amputees have slammed the government’s lack of consultation with them over a handover from the current prosthetist at Karin Grech Hospital, contracted by Steward Health Care, to a “temporary” clinician.

Representatives of amputees told Times of Malta they contacted the health ministry weeks after a judge, in February, nullified a controversial decision to hand over three hospitals to a consortium.

The ruling meant that Steward Health Care was to return administration of the Gozo General Hospital, St Luke’s and Karin Grech – where the Orthotics and Prosthetics Unit is housed – to the government. The government had said it was ready to immediately take over the running of the hospitals after the company “abandoned” its operations.

In March, Amputees4Amputees (A4A) asked the ministry for reassurance over a handover of the prosthetics service that is crucial for people who continuously require evaluations, modifications and new fittings of prosthetic limbs.

Amy Camilleri Zahra – an amputee for 17 years and president of A4A – told Times of Malta all the organisation was asking for was a “proper handover” and consultation with amputees over the new service provider. But it was only five months later that a meeting was set with the head of Karin Grech, and they have not yet had any feedback about that August meeting.

In November, A4A was informed the authorities were issuing a 24-hour call for a quotation for the provision of a prosthetics service for the next six months. Such clinicians are usually contracted for three years to ensure consistency in the provision of the service, A4A said.

A spokesperson for the health ministry, however, told Times of Malta that, although officials have listened to A4A’s concerns, they also warned that external pressure or interference in the tendering process risked breaching Maltese legislation. The ‘interim’ six-month contract is meant to ensure the service is not disrupted until a longer tender is allocated.

But Camilleri Zahra lamented that those in charge seemed to fail to understand that prosthetics was a long-time service: “We don’t go to OPU, get a pair of legs and never set foot there again. We establish a relationship with the prosthetist because this is a service we keep accessing for life as our residual limbs keep changing.

“This is not a tender for apertures or equipment but for a clinician. We are expected to build a rapport with a clinician for six months and then, should the actual tender be awarded to someone else, we are expected to start all over again.”

A4A deputy president Angela Cassar has similarly required the service for 18 years.

“As the sole provider in Malta, the significance of a good prosthetist at St Luke’s cannot be overstated. A successful prosthesis requires an amputee – like me – to visit a prosthetist several times until the cast and the settings are optimal. Failing to correct the process can have detrimental impacts that range from painful bruises to structural damage to the body. The repetitive visits are not just routine – they’re essential for maintaining an amputee’s autonomy.”

Camilleri Zahra and Cassar said the organisation spent months urging the authorities to ensure a “proper” issuing of a long-term tender and avoid “a six-month fix”.

Health Ministry explains procedure

Following the termination of the Steward concession earlier this year, the government extended all contracts – including at OPU – to ensure a smooth transition that would not affect service users.

“Given the substantial cost of further direct extensions and in the spirit of good governance, a Request for Quotations was issued for a six-month contract (published via the Electronic Public Procurement System).

“The interim contract would ensure the service remains uninterrupted while the five-year tender is published and awarded through an open and competitive process, as per procurement regulations.

“While various officials spoke to the A4A representatives to listen to their concerns, it was made clear to them that any external pressures or interference in the tendering process would risk breaching legislation and subjecting the tender to appeals and even possibly annulment – which would ultimately negatively impact the service-users,” the spokesperson said.

They added that while the incumbent supplier did submit his bid, this was not the most financially advantageous quote.

The company that won the interim bid has engaged a prosthetist who had already been in contact with Maltese patients as a locum replacement for the incumbent prosthetist.

“Therefore, he already has a relationship with some of the OPU patients. It is pertinent to note that, apart from this prosthetist, the OPU team is also composed of other members who are involved in the provision of prostheses – most of these are government employees and will be retained.”

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