Updated 5.20pm
The health ministry has issued an urgent call to the private sector to outsource emergency care amid pressure on the service at Mater Dei.
Private operators have just eight days to apply and must have the service available within four weeks from signing the contract.
The government said the initiative, which will operate on a 24/7 basis, will ensure the provision of publicly funded emergency services through collaboration with private operators.
The call comes after several media reports this week highlighted overcrowding at Mater Dei's emergency department, where waiting times were reported to reach up to 12 hours.
Health Minister Jo Etienne Abela said the move would ease the issue of overcrowding in the emergency department at Mater Dei Hospital.
“It will ensure the best service for patients by reducing waiting times and alleviating pressure on Mater Dei", he said.
Etienne Abela had first hinted at the involvement of the private sector in emergency care back in February in an interview with Andrew Azzopardi.
“Just as we use private sector services to slash hospital waiting lists, we could do the same to bolster emergency services,” Abela told the radio show host on RTK 103.
“The emergency room needs to expand,” he said. “Our healthcare infrastructure needs to expand.”
The move to outsource emergency care is unusual but has happened before.
In 2012, the government reached a short-lived agreement with St James Capua Hospital for the provision of emergency services at its units in Żabbar and Sliema during weekends.
Medical Association of Malta (MAM) and the Malta Union of Midwives of Nurses (MUMN) both told Times of Malta they agree with issuing a call for interest.
Martin Balzan, President of the Medical Association of Malta said: “The prices are realistic and the country is in dire need of a more efficient emergency department."
However he said MAM was not consulted and so was bound to take legal advice and may even challenge the matter in court.
“Government has not kept its word of giving us a six week advance notice before going public with such matters. We had agreed on this after Steward Health Care came to Malta for the sake of transparency," he said.
On his part, Paul Pace, MUMN President, said that the system that is being proposed is innovative and required, but “only time will tell whether it will be successful."
“The Request for Proposals lists services and procedures that are normally provided by the health centres at local level. I do not see any major issues, however the proof of the pudding is in the eating.”
What treatments will be outsourced?
Ministry sources told Times of Malta that there are “four or five services providers that are capable of providing what is required.”
This includes the treatment of uncomplicated head injuries, wounds requiring suturing, chest infections, urinary and skin infections. Individuals with stable abdominal pains and gastroenteritis will also be covered.
In its request for proposals, government said that the contract will run for a period of three months, renewable at six-month intervals for a total of two years starting from the commencement of the service.
Rates range from €30 per GP consultation to €200 per 24-hour in-patient stay. CT scans will cost the government €150.
Blood investigations, X-Rays and specialist consultations will cost €70 each. Overnight stays will be paid at the rate €50.
According to the Rfp, the rates include the initial assessment in the emergency room, specialist review and management, blood investigations, various radiological investigations with reporting, in-patient management of the case up to a maximum of 48 hours, minor or intermediate emergency procedures with a post op stay of less than 48 hours and post op care.
Costs of surgeries have been set at €425 for minor interventions and may go up to €2,394 for major orthopaedic surgeries.
The quoted fees include the provision of fully functional facilities, the services of qualified staff and supporting staff, the use of emergency, theatre and ward staff including medical doctors and supporting staff.
Any patients that return to the emergency department at MDH or PHC without managment will not be re-imbursed by the Ministry for Health and Active Ageing.
“This initiative will complement the services provided by Mater Dei, giving patients increased access to facilities and improving efficiency”, the government said in a statement on Friday.