Malta does not have public healthcare

The notion that we have ‘free’ healthcare services for Maltese people is a lie we tell ourselves to feel better about how badly our state is failing.

Like the rest of the country, I was left aghast when I read about the case of Stephen Mangion. Mangion is the retired police officer who died at Mater Dei Hospital’s A&E department while desperately seeking urgent medical attention.

I will refrain from talking about the specifics of the case because I do not wish to speculate about details which are yet to be confirmed beyond any reasonable doubt. What emerges clearly from the outset is the fact that Mangion first visited Floriana’s Health Centre and then proceeded to the general hospital in a private vehicle rather than an ambulance. In the A&E department, Mangion complained of chest pains while waiting to be seen by a doctor before collapsing shortly after.

I will, however, make it a point to state what should be obvious, but isn’t, for a whole host of reasons. I will repeat it over and over and over – healthcare in Malta is no longer within reach of the average citizen. The hospitals concession case is the biggest betrayal of all because it cuts to the core of our own survival and well-being. Those hospitals could be saving more lives at the moment. Instead, they’ve been left to rot after decades of service with no significant investment in sight.

The most infuriating aspect of it all is that they knew that investment was going to be very sorely needed. The real evil genius of the hospitals concession is that the Labour government capitalised on the general public’s understanding that one main hospital wasn’t going to be enough to cater to Malta’s growing population. The heart of that pitch was based on a need that had already been diagnosed. They did the same for Electrogas – they also knew that we needed to upgrade our power station, and they knew people would vote for them if they promised them lower electricity bills and an overall better service.

They saw these crucial infrastructural needs not as a great endeavour to be embarked upon in the name of our country’s prosperity and security, but as an opportunity to take literally everyone for a ride and line their own pockets instead. Mangion’s blood isn’t on the hands of the overworked, underpaid nurses and doctors manning Mater Dei’s A&E. It’s on the hands of the members of Cabinet who, to this day, refuse to outright admit their guilt in the most fraudulent concession we’ve ever seen.

Mangion’s case is not an isolated one. As always, in the rush of falling over each other to report a story without adequate verification, key details from the initial reports about how Mangion died are now seemingly being disproven. Regardless, the point is that though the idea of a man dying in the waiting room of an A&E department while complaining of chest pains may sound like an exceptionally bad scenario, it isn’t.

Think about it for a minute. State hospitals and regional clinics have been drowning for years. The COVID pandemic created a massive treatment backlog. There has been constant strain on the human resources which form the backbone of our healthcare service, largely through the government’s dogged refusals to adequately raise wages and provide a competitive package to nurses and consultants who were defecting to private healthcare in droves.

Which brings me to my next point. Due to the catastrophic lack of investment in Karin Grech Rehabilitation Hospital, Gozo General Hospital, and St Luke’s Hospital, whoever needs specialised services from those hospitals will likely think twice about whether it would be even worth it. The same applies for Mater Dei Hospital, where although the facilities are far less decrepit, the fact that most people know it will take far too long to be treated properly means that the same level of doubt will creep up.

If you are covered by private medical insurance, you will thank your lucky stars that you can afford to get treated at a private hospital, safe in the knowledge that you will be treated in a matter of days rather than months or even years. If you aren’t, you are forced to depend on an overburdened, understaffed hospital that is running out of corridors to leave patients on stretchers in.

I feel confident drawing these conclusions because I just experienced this whole thought process myself, though obviously to a far lesser degree than what Stephen Mangion and his family and friends just went through. In fact, this is not a comparison, but an expansion of the argument that enables a wider perspective.

As you may know, a bike accident last week resulted in me being hospitalised and treated for severe soft tissue damage in my left knee. Given that I was picked up by an ambulance right off the tarmac a few minutes after I fell off my bike, I was immediately admitted to Mater Dei Hospital. Everyone wearing a hospital uniform was madly hoofing it from one room to the next – presumably, because the department was clearly overloaded – so I was unceremoniously shoved into the corridor to wait for further treatment.

I spent an hour and a half waiting for someone to bring me some kind of painkillers while I waited. I only got some water when my mother showed up and bought me some. I asked three different nurses to help me out, and none of them came through until a very worried parent showed up. Again, this is not an indictment of the individuals who were on shift that day, but a representation of just how fucked up things get in an overwhelmed hospital.

Two hours after being admitted, I was finally taken to the medical imaging department for an X-ray. Since my knee was the size of a tennis ball by then, it was difficult to tell whether there were any minor fractures, though they could see that I did not have any broken bones or major cracks in the bone. The doctor who oversaw all this was very professional and did his level best to make do with what he had at hand, and he took the time to carefully examine me as much as he could.

However, the fact is that he was not in a position to treat me accordingly. I needed a proper knee brace to keep the structure in place while it heals, and was instead given a makeshift bandage and was told to go buy a brace myself. I bought one that later turned out not to be what I needed, because the equipment I actually needed was not available. I was prescribed painkillers and provided with crutches, and off I went.

A week later, I was in so much pain that I was left with no option but to readmit myself to hospital. I had to call my parents to pick me up at two in the morning because I couldn’t even move. As delirious as I was, I immediately realised that it would have been pointless to go to a state hospital. I knew I would need an MRI scan to properly assess the damage in my knee, and I knew that the waiting list for that kind of scan is months-long.

The only other option was to go to a private hospital. The only reason I could consider that option is because my parents paid for health insurance which I otherwise could not afford. Within the same morning, I was seen by a talented orthopaedic surgeon who could immediately tell that the problem was far more severe than the X-ray could have possibly pictured. He drained my knee, ordered an MRI scan for the following morning, booked me for urgent surgery, and went out of his way to ensure that I got a proper medical brace, all within the space of 72 hours.

In simpler terms, the state’s healthcare system was not in a position to treat me, in the same way it was not in a position to treat Mangion before he collapsed. There is so much that the system cannot deal with that everything starts falling through, irrespective of whether you are in a life or death situation, whether you need the kind of intervention I needed after that accident, or even something as simple as a consultation with a GP.

Who knows how many people out there had to make the same call I did? I’m almost sure that every one of you can think of at least one person with a similar story, or perhaps even experienced it yourselves. Who knows how much harm could have been prevented if the state’s hospital system was regularly maintained and upgraded according to the country’s evolving needs over the years?

We will never know, because a couple dozen assholes wanted to enrich themselves at everyone else’s expense and are still resisting every reasonable attempt at holding them accountable.

We’ve been robbed so blind we cannot even see just how delusional it is to say that we still have free healthcare in this country. If it’s not within reach when you need it, it’s not free. It’s subject to chance, insurance policies, and financial security.

‘Despicable’ doesn’t even cut it anymore.