Updated 7 pm with Ministry statement 

The doctors' union on Wednesday welcomed the conclusions of a magisterial inquiry into a man's sudden death while awaiting hospital treatment, but said the government should acknowledge that patients were waiting for hours for services owing to under-investment in the health infrastructure.

The inquiry by Magistrate Joe Mifsud concluded that medical staff who treated former policeman Stephen Mangion were not guilty of any wrongdoing, Health Minister Jo Etienne Abela said later that these professionals had faced a barrage of public anger when they had done all they could to save his life. 

The Medical Association said the doctors had done their best – despite a failure of systems due to lack of infrastructure.

"The MAM is very satisfied that the enquiring magistrate found that doctors and indeed all other health care professionals performed their duties in an ethical and professional way," the union said.

It was true however that patients had to wait for unacceptable periods of time for all government services as €400 million of investment had gone down the drain, and virtually zero investment had been made in infrastructure in the last 11 years, the union said. The minister had to be honest and admit this publicly and apologise to patients for this situation not blame those who did their best for patients in such unfortunate circumstances, the union said.

Its reference to €400 million was the sum paid by the government to Vitals/Steward to run three public hospitals in a deal later annulled by the courts because of fraud. 

Referring to other comments by the minister during a press conference on Tuesday, the union said it was disappointed that the health ministry had not discussed outsourcing of services with it. It pointed out that people in Malta paid €10,000 for an IVF procedure, when most centres in the European Union charged under €2000. 

The union said it had refrained from publicly alarming the public about the sad decision taken by the health ministry for a ward specifically designed for critical patients needing ventilation to be closed and for patients to be placed in hospital wards which were not equipped for such patients. It said that since these critically ill patients were in danger of dying, respiratory physicians had written to the State Advocate to protest the ministry's decision.  

The union said it was always ready for discussion but would not be a scapegoat for the government’s failure to sufficiently invest in the health infrastructure.

MAM obstinance obstructing reform - Health Ministry 

In a statement later on Wednesday the Health Ministry denied the claims made by the MAM, saying that the association has been “obstructing” attempts at reform with a “confrontational and negative attitude”. 

The ministry said it was “devious” to suggest that the ministerial inquiry somehow undermines the medical profession. 

“It is high time that doctors, patients and society at large are made aware of the obstructive stance that MAM has persistently adopted in MAM-Government interactions. This stance has reached levels that are affecting the transformation of Healthcare Services and society’s expectations of delivery of care,” they said. 

The ministry listed a number of reforms they say the MAM has “opposed, obstructed or slowed down”, which included: 

•  Assessment by first senior medical contact in the emergency departments;
• Consultant assignation to emergency patients
• The replenishment of Emergency Doctors at the Gozo General Hospital Casualty
• The outsourcing to the private sector of emergency services for non-life threatening conditions to allow the Emergency Department to concentrate on life-threatening conditions
• The transformation of Mater Dei level -1 floor into a “hot-floor” that will obviate corridor wards that the Government deems not patient-worthy
• The establishment of a medical high-dependency unit in the newly appointed M10
• The setting up of an ambulatory care hospital in St Luke’s, to relocate day care facilities, dental surgery, ophthalmology, and dermatology out of Mater Dei
• The setting up of an out-patients clinic facility in Karin Grech Hospital
• Investment in a large state-of-the-art Mother and Child Unit in the current out-patient block at Mater Dei Hospital 
• The integration of mental health into physical health;
• The inclusion of patient advocacy representatives on medical regulatory/disciplinary bodies
• The development of acute psychiatric services in Mater Dei Hospital 
• Relocation of non-invasive ventilation services to a new suggested site
• Re-emergence of plastic surgery as a sub-speciality with its own dedicated ward
• The immediate provision of 6-month outsourced IVF services to allow enlargement and refurbishment of the Mater Dei ART clinic
• Investment in extra twilight CT and MR scan sessions to provide a 24/7, 7-day a week radiology service at Mater Dei and Gozo General Hospitals, paid on a per-case basis, to address and abolish current waiting lists
• Resistance to unit sub-specialising e.g. gastroenterology department to, amongst other things, address out-patient waiting lists of close to 6000 patients.

The ministry said it nonetheless remains open to constructive discussion as it continued to hold with other trade unions.