The recent pronouncement by the courts on the three hospitals brought back happy memories of when I was responsible as a perit for the development and maintenance of the entire stock of the nation’s health infrastructure.
I joined the Public Works Department (PWD) as a junior engineer on a definite, but renewable, six-month employment contract in October 1973. I was posted at the Schools and Hospitals Section, which was led by the late perit Joe Consiglio and which had its office at St Luke’s Hospital.
Soon after, most of the periti at the PWD went on strike as the then prime minister, Dom Mintoff, wanted them to clock-in with the industrial staff, rather than with the clerical and administrative staff.
This action left me alone leading the Schools and Hospitals Section.
My first project was to design and build the 160-bed Children’s Hospital, today known as Karin Grech Hospital. This was an onerous task for a young architect who had just graduated from the University of Malta.
The then minister of public works, Lorry Sant, came to my help and suggested that I should try and get an electrical and mechanical consultant versed in hospital design to help me out.
Through the United Nations Development Fund, we managed to procure the services of the chief engineer from the South West Thames Health Authority. Together with him and with the small staff I had at my disposition, we managed to finish the design and start the construction work.
When Karin Grech Hospital was completed and inaugurated, Mintoff decided to have a geriatric hospital at St Luke’s Hospital in order to transfer the bedridden patients at St Vincent de Paul Hospital who needed constant medical care and attention. The only site at St Luke’s where this could be built was next to Karin Grech Hospital.
Together with my team, I designed the geriatric hospital and started its construction. When the construction was nearly completed, the then chief government medical officer (CGMO), Alfred Grech, came to my office and told me: “Vince, do you feel that we are doing the right thing, placing geriatric patients next to the children’s wards?”
I said: “Hmm, I am not sure. What are you suggesting?”
Grech replied: “We should have a maternity wing there and, thus, create a mother and child complex.”
I was enthusiastic about the idea but there was one hitch. Mintoff was so enthusiastic about his idea of having a geriatric hospital that he used to call me very frequently to his office at Castille in order to review the progress being made.
To get over this, I organised two sets of draughtsmen, one working on the plans of the geriatric hospital and the other set to develop the plans of the geriatric hospital into a maternity wing linked to St Luke’s.
Neither I nor Grech had the courage to tell Mintoff or health minister Albert Hyzler of our plans. However, Hyzler soon found out about them and gave us a severe dressing-down. General elections were soon approaching and Hyzler had decided not to contest.
The next health minister was Vincent Moran who liked the idea of the maternity wing and decided to sell the idea to the prime minister. The latter subscribed to the idea and was on board; we were ‘safe’.
The task of turning a geriatric hospital into a maternity wing was not an easy one as the latter required different layouts, electrical and mechanical services, medical gases, etc. The most difficult was to accommodate the delivery rooms.
However, when we had almost finished the project, we needed additional financial resources. We submitted a claim to the then minister of finance, Joseph Abela, who was intrigued by the project and who finally gave us the go-ahead and the needed finances.
During my term of office as engineer in charge of hospitals, we added the Central Sterile Supply Department (CSSD) next to the Mother and Child Complex; built a new boiler house; renewed and enlarged the operating theatres; added a new floor to the Outpatients Department; built a new ITU; extended the Physiotherapy Department with the addition of a hydrotherapy pool; renewed and extended the Emergency and Admitting Department; modernised the kitchen and installed new cooking equipment; modernised most of the wards and renewed their electrical and mechanical services.
These are just some of the additions and improvements carried out and through which we increased the bed capacity of St Luke’s Hospital from 640 beds (1973) to 864 beds (1989).
As a side note, years later (1995/6), I had advised the government that the new Mater Dei Hospital should have at least 1,100 inpatient beds. But when it was inaugurated in 2007, it had 825 inpatient beds.
I did not have much to do with the Gozo Hospital as this was already built when I joined the Public Works Department. However, I was involved in the planning and execution of its mental wing, which was the last addition to the hospital I know of.
The above was all done by a small but dedicated team of PWD employees and the enthusiasm and vision of the then CGMO Grech, who instilled in me the same passion he had to see major improvements in the health sector for the benefit of the patients. I dedicate this write-up to him.
Vincent Cassar spent 35 years in the public service and is a fellow of the Institute of Healthcare Engineering and Estate Management.