Private medical operators have requested an extension to the call for proposals on outsourcing emergency services issued by the Health Ministry, while two associations grouping family doctors warned this was a rehash of old plans which failed to yield the desired results.

The Public-Private Partnership (PPP) initiative, announced last Friday, gave private operators only eight days to apply.

Jean Claude Muscat, CEO of Saint James Hospital, said they felt the submission deadline was too short and the group had requested an extension.

When contacted, a health ministry official said that “every procurement must follow Public Procurement Regulations and I will steer away from interfering or commenting at this stage”.

A meeting between the ministry and the private operators is expected later this week.

Last Friday, ministry sources told Times of Malta there are four or five operators capable of providing the services required.

However, medical sources indicated that Saint James Capua in Sliema is the only one in Malta capable of meeting the requirements due to its qualified personnel.

“They have hired doctors who previously worked at Mater Dei’s casualty, placing them in the best possible position,” one source said.

Josie Muscat, founder of Saint James hospital, affirmed his hospital’s capability to meet the government requirements.

Writing on Facebook, he said, “Saint James today boasts a fledgling and growing emergency service able to deal with practically all cases that seek the service.”

He attributed this to significant investments in personnel and equipment, adding, “today, Saint James boasts professional doctors and nurses that provide impeccable emergency services”.

His comments came after Anthony Buttigieg, a Saint James-employed doctor criticised the Health Ministry’s request for proposals. Buttigieg warned on Saturday that the government was risking lives by forcing people to choose between private hospitals and Mater Dei for urgent care.

Another service provider, who wished to remain anonymous, expressed reluctance to submit a proposal without additional time to invest in facilities and recruit the necessary personnel.

“The major problem is finding the right personnel,” the spokesperson told Times of Malta.

The request for proposals lists services the health ministry seeks from the private sector, including treatment for uncomplicated head injuries, suturing wounds, chest infections, urinary and skin infections, stable abdominal pains, and gastroenteritis.

Muscat acknowledged that while Saint James can offer these services, it cannot treat major cardiac events and complex trauma from motor vehicle accidents.

But he described the PPP in casualty services as “a very good solution” and “the only way forward” to address the current healthcare situation.

He emphasised the importance of long-term cooperation between the government and the private sector for efficiency and cost-effectiveness, although he expected more consultation.

Other industry sources support PPP as an interim solution but criticise the government’s approach, saying private entities should have been consulted to determine the services they can safely and effectively provide.

These sources also highlighted the need to re-evaluate Malta’s healthcare system, considering the strain from the country’s overpopulation.

Mater Dei’s emergency department has faced criticism for waiting times of up to 12 hours.

Health Minister Jo Etienne Abela has said the PPP initiative aims to alleviate overcrowding and improve service quality.

Family doctors call for consultations

Late on Sunday, the  Malta College of Family Doctors and the Association of Private Family Doctors said the government's plans, announced without consultation with medical organisations, resurrected a failed similar initiative 15 years ago.

Unfortunately, the initiative had attracted semi-emergencies to the public-funded private service that would normally have been seen at health centres.

"Crucial to a proper impact of a new scheme is prior triaging by medical professionals to direct patients to their family doctor, or to the semi-emergency services in health centres, or to the emergency services in private hospitals or to the Casualty Department of Mater Dei Hospital according to the case," the associations said.

The associations urged the Department of Health to consult the relevant medical organisations to truly make this initiative the success that the country needed. 

MUMN welcomes plans

The MUMN nurses' unions welcomed the plans, saying outsourcing the emergency service was one of the best options to reduce waiting time at the hospital while easing the suffering of patients.

"From the initial stages, a consultant will be executing a triage system that will guide the patient to attend MDH or any private hospital, thus rendering the system a risk-free one," the union said. 

"The situation in the emergency department needs urgent changes since nurses and doctors working there are overburdened with the huge number of patients attending this department. However, the patients are the ones suffering the most with waiting time of approximately six hours in the waiting room with a further six hours in the emergency department as processing time," the MUMN said. 

It said the status quo was not an option.