Beds at Mater Dei hospital
link to The Times
Sunday, 9th December 2007
Beds at Mater Dei Hospital
Emanuel Abela, Director of Information, Valletta.
Reference is made to the article 'Concern over lack of hospital beds' (The Sunday Times, December 2).
Nowhere in the world is acute hospital bed requirement of countries measured in "beds per consultant". Bed numbers are the subject of a complex analysis of population needs in accordance with disease patterns in the country, matched with the age of the population and taking into account the organisation of the health system.
The hospital bed requirements for rarer diseases such as blood diseases can never be the same as beds required for cardiac or diabetic patients.
Hospital bed needs never reflect maximum possible seasonal bed requirements, but look at performance and forecasts according to practice reforms.
It is pertinent to point out that there were extensive consultations on the number of beds at Mater Dei Hospital during the discussions on the medical brief with consultants and clinical staff. These bed numbers had also with them changes in practice which were clearly spelt out in the unit briefs and policies.
The number of beds at Mater Dei Hospital is equal to that at St Luke's Hospital. On migration of services this bed number is being supported by 93 new rehabilitation beds and 62 new intermediate care beds within Karin Grech Hospital under Zammit Clapp Hospital management.
This should provide a stronger buffer than what was available in past winters with a few provisos: avoidance of unnecessary admissions by strengthening specialist numbers at the Casualty Department, more active involvement of specialists in geriatrics, regular in-patient follow-ups with a view to early discharge, and ensuring that medical admissions are made by more senior members of the medical team.
These necessary reforms were recently resisted by certain consultants, hopefully not the same ones now advising the Medical Association of Malta (MAM) about bed numbers per consultant.
The bed numbers in surgical wards have been substantially strengthened by the new day care unit. Rather than admitting patients to wards, patients are cared for in a separate area within the hospital, leaving additional beds in acute hospital wards for more elective cases to be performed.
All hospitals have winter crisis plans. St Luke's Hospital had one in the past and so has Mater Dei. The plan at St Luke's did have curtailment of elective surgery and takeover of surgical beds; in agreement between hospital management and both unions that overcrowding burden should be equally distributed.
With the collaboration of all staff, with implementation of patient management reforms highlighted above and with appropriate use of available resources, takeover of surgical beds can hopefully be avoided.
Following the recent agreements signed with MAM and the Malta Union of Midwives and Nurses (MUMN), Government has set in motion the administrative machinery to implement its side of the agreements.
MAM and MUMN should now be advising their members to concentrate on the obligations that staff have towards the public in terms of these agreements: work plans, performance assessment and appraisal and placing the patient at the centre of the service they offer.