“These (sick-leave) certificates are meant for people to get social benefits. Why is it that despite recent media reports about abuse of these certificates, the police failed to investigate as though everything has been forgiven? What do you think Chris Fearne?”

This was disgraced family doctor and former Labour MP Silvio Grixti throwing down the gauntlet to Deputy Prime Minister Chris Fearne.

Grixti’s Facebook post is short but devastating. It’s an open threat to Fearne. Grixti is an insider. He was kept on as consultant at the Office of the Prime Minister until well after his forced resignation. Robert Abela continued to protect him for months after Abela realised the scandal would eventually leak out. Abela covered up for him, keeping mum until Times of Malta eventually uncovered the massive scam Grixti allegedly orchestrated.

Grixti is only now starting to feel the pressure. He’s been interrogated by the police for a second time. Like a cornered rat, he’s now lashing out. He’s making it clear he won’t go down alone. He will bring down others with him. That public sneaky question to Fearne is laden with an ominous threat. Grixti knows something about Fearne – and he’s letting Fearne know he will use it if he has to.

Grixti’s cryptic post was referring to the strange case of shadow health minister Stephen Spiteri. In 2017, Lovin Malta accused Spiteri of issuing false medical certificates for a fee of €5 without even bothering to see patients. They published a telephone conversation with a pharmacist at Spiteri’s clinic in Kalkara.

When the pharmacist was asked by the caller how he could get a sick-leave certificate, she replied: “send somebody, they can write your details on a paper, and you can pick it (the certificate) up tomorrow”. “What time will he (Spiteri) be there,” the caller asked. “At 10 am but he never finishes them (the certificates) at that time because he’ll have many (to sign).”

When the Medical Council started disciplinary procedures against Spiteri, he filed a constitutional case claiming his right to a fair hearing had been breached. In June 2023, the court decided that the Medical Council’s multiple functions – from investigation, to prosecution, to passing judgement and issuing penalties – breached Spiteri’s rights.

The Medical Council did not appeal the sentence. That was almost five months ago. Since then, the nation’s Medical Council, the only regulatory body of the medical profession tasked with protecting patients, has completely ceased to function.

Prior to the court judgment, the council had the power to sanction doctors, impose fines, suspend registration and even erase a doctor’s name from the register.

After the judgment, the Medical Council has been rendered completely toothless. So toothless that when Grixti was called by the council to explain his role in the disability benefits scandal, he gave the council a two-fingered salute and just ignored it.

In response to the council’s request for comments, Grixti replied, through his lawyers, “since nothing has changed in the composition and operations of the Medical Council since this judgment, I am opting to ignore the Medical Council’s request”. And there was nothing the council could do about it.

Silvio Grixti is making it clear he won’t go down alone- Kevin Cassar

The primary role of the Medical Council is to protect all citizens from rogue doctors who practise unprofessionally, unethically or even dangerously. That protection has been dismantled since last June. It is the minister of health’s responsibility to ensure patients are protected. Yet, months later, Fearne has done nothing.

The council didn’t appeal the court’s decision despite the fact that the state advocate declared that Spiteri’s challenge had no legal basis. Our Labour government found time to present legislation to allow 16-year-olds to become mayors but couldn’t be bothered to enact legislation to enable the Medical Council to function.

Who benefits from the Medical Council’s castration? Spiteri and Grixti. The council didn’t appeal the judgment in Spiteri’s constitutional case. And Spiteri’s disciplinary procedures ground to a halt.

Had the council found Spiteri guilty, he would lose his shadow health portfolio. His very parliamentary seat would be at risk. Even worse, he would probably be suspended by the council, losing his right to practise medicine and with it his main source of income.

Fearne failed to enact legislation to revive the Medical Council, ensuring Spiteri’s and Grixti’s continued protection. Meanwhile, the shadow health minister has not asked a single parliamentary question since the last election. Some of his fellow MPs tabled 500, even 600 PQs. Spiteri has barely uttered a single word after the devastating appeals court sentence over the Vitals concession.

Spiteri, the PN’s spokesperson on health, should be taking  Fearne to task over the catastrophic catalogue of errors in the health sector. He should be challenging Fearne over the abysmal conditions patients have had to endure in underground corridors, hospital canteens and medical school libraries.

He should be objecting to the long list of chronically out-of-stock essential items. He should be badgering his medical colleagues for information about the true state of Malta’s health service. He should be denouncing Fearne for his failure to build the long-promised mental health hospital, the outpatients block at Mater Dei Hospital, the mother-and-child hospital.

Spiteri should be pointing out how Fearne stood next to Ram Tumuluri ramming lies down our throats. He should be reminding us how Fearne stood up for Steward as the “real deal”.

Instead, there is complete silence from Spiteri in parliament. Fearne goes unquestioned and unchallenged. That’s a gift for Fearne and for Labour.

So, while Spiteri benefits from Fearne’s inaction, Fearne benefits from Spiteri’s silence. And piggy-backing on Labour’s demolition of the Medical Council is the shameless Grixti.

Grixti is right: “The police failed to investigate as though everything has been forgiven.” The police failed their duty, again.

Meanwhile, the Medical Council can’t carry out its responsibilities. And Labour keeps lying – the institutions are working.

No, they’re not.

Kevin Cassar is a professor of surgery.