He has nothing to declare, not even genius
Published:
June 14, 2008 at 3:30pm
Oscar Wilde is supposed to have told US customs officers on entering New York that he had nothing to declare but his genius. Joseph Muscat has nothing to declare, full stop. Check this out (thank you, Mike).
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Come on Daphne, I expected much better.
That document is not valid as it is not signed.
[Moderator – You’re right. The clerks at the European Parliament forged that document and put it on their website, for all to see, right here: http://www.europarl.europa.eu/ep-dif/28121_20-11-2007.PDF ]
Simon had quite some things to declare:
http://www.europarl.europa.eu/ep-dif/28120_20-02-2008.pdf
How about showing us David Casa declaration? Even David had nothing to declare. Forza Joseph!!
AJMA – A Anglu, J Joseph, M Muscat, A Abela
AJMA telghin fil-gvern!!!
http://www.europarl.europa.eu/ep-dif/28122_20-11-2007.pdf
DAVID CASA ALSO HAD NOTHING TO DECLARE!!
[Moderator – David Casa ain’t the leader of the opposition.]
AJMA rasi qed jghid Gonzi
Only the two lawyer MEPS declare anything – is this a sign that their legal background gives them a better picture of what constitutes a false declaration?
@Chris S – I think a more likely explanation is that no company ever sought to engage the services of Joseph Muscat as a director or similar, despite his legions of qualifications and his doctorate in economics. That is, unless he is making a false declaration.
Kindly explain what this is supposed to mean lol. I admit ignorance and ask for an explanation. Please :D
PROSIT HEJ. MELA FORGET ABOUT HAVING AN ALTERNATIVE PARTY TO RELY ON OVER THE NEXT 5 YEARS.
I RECKON AFTER HAVING SEEN WHAT THEY LANDED THEMSELVES WITH, THE MILITANT FACTIONS OF THE MLP DECIDED TO NUDGE HIM AND GIVE HIM 2 WONDERFUL DEPUTIES. YAAAAK
Nothing To declare Eh? I wonder…..
Now he can declare that he has two bookends…Tony “look what the cat dragged in” and Anglu il-polijsman. Tow deputij Lijders mustaccuni. Have just watched Xarabank. All that sweetness !! U dahk sfurzat minn kulhadd! Doesnt Peppi have anything better to do? It was an immature show. And the questions were obviously planted, untill some girl challenged Joe on abortion. It lacked depth all around. I shudder to think what we are in for.
Dear Moderator, I never mentioned any forgery.
I just said, and repeat, that that document is not valid as it is not signed.
According to joseph Muscat on Xarabank, political interference in queue jumping the waiting-list at Mater Dei is not corruption!
This is despicable, the unfairness of patients being skipped in the hospital waiting-list is justified according to MLP’s leader!
Dear Moderator as u said David Casa ain’t the leader of the opposition. All right then maybe ucan tell us were we can find Dr Gonzi declaration then!
@Lino Cert
You know what Lino Cert, that was the most despicable, obscene edition of Xarabank I have ever seen. You could sense Peppi’s feelings from beyong the screen! And that question of Mater Dei. How unfair! How despicable. Bringing in actors to ask questions. And about waiting lists in Mater Dei! Such a hypotetical non-sensical question! Why didnt Peppi, rather, bring Minister Dalli along and ask HIM what he thinks of the waiting lists?
And that picture of a dog. Using an animal’s suffering to get at the MLP leader asking him a stupid question about hunting.
God help this country. But this situation will not go on forever. Enjoy it while it lasts. Hadd wara hadd, tasal ta’ kulhadd. Even though its taking much longer than it should.
Maybe he could declare the white collar and cuffs on his striped shirt:
http://www.maltastar.com/pages/msrv/msfullart.asp?an=21892
(Kwazi qisu ha’ jaghmel il-precett!)
@ Lino Cert
Be fair!…Joseph didn’t say that the unfairness of patients being skipped is justified…he just said that it is not corruption. He said it is discrimination but not corruption. He also explained that first and foremost, we should tackle the ‘waiting list’ problem, as we say in maltese “il-barri trid taqbdu minn qrunu”!
Corruption and discrimination are both in a way or another illegal, but they are not the same. An example of corruption is that of Mistra while an example of discrimination is this one, skipping other patients!
check out his wikipedia entry, updated.. :)
Daphne,
Muscat as a person seems fine. Time will tell. Unfortunately the deputy leaders made labour move 2 steps forward with Muscat and 1 step backward with the2 deputy leaders.
Nothing personally against them, it is just that in my opinion, they should remove anyone that was in the 80’s.
@ hope
corruption in skipping waiting lists is much more serious than the Mistra corruption, because it leeds to suffering, and sometimes death, I have myself witnessed a seven year old girl needing urgent treatment for a tumour skipped in the waiting-list for an urgent intervention by the mother of a minister’s driver, who had only a minor complaint, the young girl’s mother was in despair , when I went I complained to the hospital superintendent I was told “jaqaw ghandek xi-interess?” !! I then urged the mother to seek immediate treatment for her daughter privately and paid for her myself, though i didnt even know the mother
Lino Cert said: “I have myself witnessed a seven year old girl needing urgent treatment for a tumour”
Oh come on! Patients in need of an URGENT treatment are not put on waiting lists!
@Neriku – that’s a declaration for the purposes of the European Parliament, and Lawrence Gonzi is not an MEP.
“Patients in need of an URGENT treatment are not put on waiting lists!”
yes they are, there are OUTPATIENT waiting liss, for non-urgent conditions, then there are INPATIENT waiting lists for patients needing urgent treatment, these lists are manipulated to favour certain patients over others, it is not just politicians who cheat these lists, its also relatives who work in the hospital, consultant doctors who push their private patients etc,
for the INPATIENT waiting list , sometimes even a few hours could make the difference between life and death,
I have written about such abuses several times to the authorities, with details and names , but have never as much received an acknwowledgement,
by the way, something that may not seem urgent may still be fatal, for example to a woman awaiting evaluation of a breast lump, a difference of a few months could mean the difference between an early cancer or a late one, even a child with blood in the urine (as in the case I am mentioning) , the difference of a few weeks could mean the tumour in her kidneys is caught too late and would become inoperable,
so dont underestimate the seriousness of what Joseph Muscat is suggesting, that a polician’s influence in skipping hospital waiting lists is acceptable , when it is actually one of the most serious example of corruption .
@ Lino Cert
In maltese we say “kulhadd jara tieghu” and it’s true! It sounds a little bit egoistic but that’s the way it is, whether we like it or not.
As I’ve already said, we shouldn’t discuss such cases, but we should remove the waiting lists as soon as possible. Ok, a state of the art hospital, objectively everyone agrees on this one…now we shall move on…we need an efficient service. Everybody pays taxes therefore everybody is entitled to be offered an efficient medical service when needed.
“David Casa ain’t the leader of the opposition.”
Yes, very sound argument.
Newly elected MP Agius Decelis of Mosta knows a thing or two about jumping queues. Just ask him.
Are we to assume that by virtue of their nothing to declare statement, both David Casa and Joseph Muscat are , self confessed “morti di fame”?
Cut the crap guys. Go and see a consultant in his private clinic and you will jump the queue like an olympic gold medal pole vaulter
The incident recounted here by Lino Cert (@hope)is really shocking and so as the Communications Coordinator for Health i’m kindly asking him/her to contact my office on 22992406 and forward all information about this case.
This case will be investigated seriously.
@ Amanda Mallia
re your link to maltastar
Poor GA is reduced to photo ops for the Poodle! And why on earth are they holding hands? Eh ghax Gowzef ihobbu ‘l Gorg ukoll.
“Jumping Jack”: Nepotism and beureocracy go hand and hand. Since human beings are not perfect, there is no perfect system either. Have you watched One News today? Waiting lists are never ending and I would prefer an appointment for next week rather than waiting till 2010 for an appointment! As if…. That’s not corruption. That’s what I consider “making the best of your job”. I’m sure that nurses and doctors use their jobs to help others and not for their self-interest.
I would like to take this opportunity to congratulte Tony Agius Decelis for his great success in the last election!
@Blanco
What an interesting theory you have there. So are you telling me that when Labour come to power I can look forward to a hbieb ta hbieb scenario. And should it be limited to the hospital. or should we extend it to other areas? In fact why doesn’t the cash strapped Labour Party issue a call for new members where one of the perks would be to jump the queue in all government departments.
And there I was thinking that if there was one area where Nationalist and Labour supporters could be equally agreeably scandalized was the privileges game. How wrong i was!
Using your job to help others is fine as long as you do not expect or receive compensation for helping. On the other hand if I patiently wait for my turn, while others jump the queue behind my back because they know the nurse, is just not fair.
eyesonlymalta – I’m providing the link here for those too lazy to look it up:
http://en.wikipedia.org/wiki/Joseph_Muscat
What really caught my eye first in his Wikipedia entry was this, listed under “Career”, of all things:
“1974–1992: born and raised a Catholic”
What exactly did he mean by that, especially listing it under “career”? Did he make a career out of being born? Is being a catholic a career (though in some cases it could be)? Did he cease to be a catholic after 1992? Does he usually list it on his CV?
This man is not only a twerp, he’s also either a downright ignoramus, or he’s got a problem with his English. Then again, maybe he’s both.
@Lino Cert – I think you should put your money where your mouth is, and if you really have details of waiting-list abuse, get on the phone to Amanda Ciappara right now, instead of discussing these serious things anonymously here.
@Lino Cert: When you file a report of the case you mention, do post a message here. I’d be interested to know the outcome.
@Daphne – “I think you should put your money where your mouth is, and if you really have details of waiting-list abuse, get on the phone to Amanda Ciappara right now, instead of discussing these serious things anonymously here”
Sure! Look what happened to the Ombudsman for opening his mouth! If I learnt anything in my career , I have learnt to keep my mouth shut and close one eye to abuses in the Health system. That is the only way you can survive in the system.
[Daphne – http://independent.com.mt/news.asp?newsitemid=81501 What happened to the Ombudsman? He can’t be sacked or reprimanded nor have his pay cut, you know. Oh, you mean the criticism from surgeons and the minister? If he can’t stand the heat…. I can’t say I’m overly keen on your thinking. It’s the exact same ‘peasant’ philosophy that gave rise to the Mafia in Sicily. I find it sad and strange that despite generations of progress, the Maltese approach to life remains essentially that of peasants living on the edge of survival.]
@Daphne
“It’s the exact same ‘peasant’ philosophy that gave rise to the Mafia in Sicily”
Thanks, but I would rather be a peasant than a pauper. A friend of mine got thrown out of St Luke’s for speaking out and now he’s exiled from his family. That’s the thanks you get for speaking out. Not everyone is as brave (or maybe as foolish) as you Daphne!
As to the the Ombudsman, true, he cannot be sacked or reprimanded, but he will be felled, and removed from office, mark my words. He doesn’t realise how ruthless these people are, or what Mafia he is dealing with. Or if he does, he is even braver or more foolish than yourself!
[Daphne – The Ombudsman can neither be felled nor removed. He is in precisely the same position as a judge, and for the same reasons, except that he is there for a fixed term. “I would rather be a peasant than a pauper”; peasants are usually paupers. You mean that you would rather keep quiet and compromise your principles – that’s assuming you have any – than speak out, just as long as you keep bringing in the hobz. And that is exactly what I mean about southern Mediterranean peasant culture. Part of that culture is disproportionate fear of the imagined consequences of defending your rights or defending others or basic decent behaviour. And of course, those consequences are largely fictitious today, given that no feudal lord is going to string you up by the neck after disembowelling you and raping your wife and daughters then setting fire to your hovel.]
@ Daphne
“no feudal lord is going to string you up by the neck after disembowelling you and raping your wife and daughters then setting fire to your hovel”
Weird Daphne, thats exactly what they did to my “very close” friend (except, maybe, for the “daughters” bit, should read “daughter”).
[Daphne – I must introduce you to Kevin; he likes this kind of conspiracy theory.]
It’s not a theory. It’s fact. Simple trail to follow, just link the hospital appointments -> private clinics. The association is clear. It is hardly a well kept secret. Dr Frank Portelli has talked openly about this. Spill the beans and they will quietly dispose of you. Not quite the Sicilian way, more subtle, but just as brutal. Ask my friend.
I fear the Ombudsman’s days in office are counted, I hope I am wrong. it was brave of him to speak out. And this in the defence of a foreigner in jail, the lowest of the low in patient hierarchy.
[Daphne – How many times must I repeat this? The Ombudsman can’t be removed from office. He goes when his term is up, and nothing can change that, unless he resigns or leaves this earth. “And this in defence of a foreigner in jail, the lowest of the low in patient hierarchy.” Well, the Ombudsman is there primarily to defend the lowest of the low, not the highest of the high, or anyone else who is more than capable of defending himself.]
Lino Cert
“Weird Daphne, thats exactly what they did to my “very close” friend (except, maybe, for the “daughters” bit, should read “daughter”).”
Does Amnesty International know about this? It’s your only hope.
The first question a doctor asks a new patient:”what is your profession?” In other words:”How much can you afford to pay for the maintenance of my expensive hobbies?”
[Daphne – Oh come on. Practically every GP I know charges a flat rate for clinic visits and house calls, and as for specialists, it’s the same. Try looking at it the other way round, instead of so suspiciously: if certain specialists ask what their patient does for a living (not ‘what is your profession’, given the assumption that people in professions can ‘afford it’) then maybe it’s because they charge a person less if they realise he’s can’t afford the full fee. That doesn’t mean they are charging other people more. It just means they charge a lower fee as and where they deem fit. This is a good thing, not a bad one worthy of condemnation. Nor does it mean that you and I have a divine right to a lower fee too. Only yesterday, an old friend and I were talking about just this mentality: that people here resent paying for necessities, having become accustomed to the idea of getting most necessities (school, university, clinics, hospitals, Microsoft software…) for free. We are now moving to the next level of expectation: though healthcare is free at all levels, people complain about the fees of the doctors they see privately (the underlying thinking is that despite free state healthcare, private healthcare should be almost free as well); and concerts organised by entrepreneurs should be free too, or at least cheap enough to be almost free. But then, and here’s the strange thing, the very same people will spend on the oddest things, like a hugely expensive dress for a special occasion, a phenomenally costly car to be kept in a garage, the garage itself, a film-set kitchen, a flash bathroom….]
I am repeatedly surprised, and astonished, that one has legions of health care experts in Malta. The foremost expert is of course the incumbent minister, who has the portfolio for health care and medical services.
The Times of Malta today (21 January) reports the same minister as saying that, alas, it is the Ministry for Finance, which is responsible for the miserable state of affairs, for example with reference to overdue payment for delivered medicines. Lino Cert refers to Mr.Frank Portelli but at the same time Lino Cert does not explain/discuss/debate Mr.Portelli’s ideas and contentions.
@ Ms.Caruana Galizia:
The non-existence of fixed, or guide-line, tariffs for medical services in Malta may indeed be one causative factor for the prevailing discontent.
[Daphne – Do you believe that the fees of medical professionals should be fixed by the state, even in a situation where the state provides total free health care? I don’t. There might be an argument for regulating fees in the absence of state health care for all, but not otherwise.]
[Daphne – Do you believe that the fees of medical professionals should be fixed by the state, even in a situation where the state provides total free health care? I don’t. There might be an argument for regulating fees in the absence of state health care for all, but not otherwise.]
I would be very grateful, if you could tell me how “total free health care” functions in practice.
I would also be grateful to Lino Cert, if he could tell me how the medical professionals are remunerated by the respective private hospitals.
The fees of medical professionals should be considerate and transparent, although they should not necessarily be fixed by the state, unless the medics are government employees.
I worked long enough in a system, where the fees of medical professionals were/are negotiated by competent doctors’ trade unions/corporate bodies in alignment with the total sum of money, which the medical insurance companies provided/provide.
Medical insurance alone of course amounted/amounts to 13-15% of one’s income. Premium for pension/unemployment/home nursing care was/is in addition to the 13-15%. Then come also income tax and church tax.
Moreover, specialists employed as full time staff by a hospital were/are allowed to see and manage private patients in the same hospital, which employs them. In return, the specialists are obliged, through individual contract, to reimburse to the hospital an adequate sum to cover use of equipment and personnel.
At my last appointment, we were two laboratory specialists, serving 5 regional hospitals (more beds than Mater Dei) from our own base, while at the same time providing written results/reports within 24 hours in almost all cases. We were subjected to external quality assurance, as hospitals are now certified in an analogous way to, for example, hotels.
I have hardly met, or known, competent medics, who were “poor” or “needy”. The system also allows the medics time for their respective families and/or hobbies.
Nonetheless, there also exist current (financial) problems in the system, despite the rather high rates for medical insurance, which, unfortunately, is not fully comprehensive for all cases.
@Leo Said
It’s all based on commissions, basically each referring doctor gets 10% commission on the final bill, so the GP gets 10% for referring to the physician, the physician gets 10% for sending the patient to a private hospital, the diagnostic services get their 10% of all tests, and the hospital keeps what’s left over, averaging about 50%. So the higher the final bill the more is available at each “cut”. You could look at it as a giant pyramid scheme, each doctor has to keep the patient moving into a higher cost to get his “cut”, the sucker at the end of it all is the patient who has to fork out the final bill.
[Daphne – Yes, this is the situation in some cases.]
Daphne, I know exactly what I’m saying. We have experienced what (Doctor ) Lino Cert is stating. Our family doctor referred us to a surgeon for a simple hydrocil. The surgeonn wanted to operate our four-week old first-born child for an ‘encisted hydrocil of the chord’ – that’s how he diagnosed it with his fingers.I checked on some books what this meant – nothing serious.
Thank God that our son had a nappy rash on the day he should have had his operation.
Should doctors take a commission on the branded medicine they prescribe? That’s what they are doing, here in Malta and in other countries.
[Daphne – Of course they shouldn’t take commission. If that isn’t already against the law, it should be. If a doctor accepts commission on what he prescribes, then the temptation is to prescribe where unnecessary. It has long been suspected that this is one of the reasons for the over-use of antibiotics in Malta. As for the rest of your comment: that’s why there are second opinions, and even third ones. We expect too much of doctors in terms of morality. There are crooks in the medical profession as there are in every other.]
@Daphne
“We expect too much of doctors in terms of morality”
It isn’t the doctors’ fault, but the system’s. If the system is crooked, then it doesn’t follow that the doctors who follow the system are crooks. They simply have no choice, unless they want to live like paupers. If these commissions are against the law then the fault is with the enforcers, i.e the police. It wouldn’t take a genius to walk into one of these private hospitals and confiscate one of their computers and examine their hard disk. The flow of cash is also quite easy to follow by even a junior police detective. You can even walk freely into a private hospital and stick a USB into any open PC you find and download the desktop files in less than five minutes. That’s enough evidence for a budding young detective. Maybe Xarabank can look into this. It’s pretty rampant abuse and would be childs’ play to uncover.
[Daphne – Ho hum. As I said before, I’m quite unimpressed by your southern Mediterranean naghmel minn taht to survive reasoning. A doctor doesn’t have to take commission on prescriptions to survive, and nobody is forcing him or her to take commission. You’re free to prescribe whatever you want to prescribe, refer your patient to whatever specialist or private hospital you think best, and when you’re offered something in return, just say ‘no thanks, and if you make the same offer again, I’ll report you to the police.’ ]
@Daphne
” A doctor doesn’t have to take commission on prescriptions to survive”
hmmm, let me think this over, what a dilemma, either I refuse to take commissions and survive on 20,000 euros a year , or I accept commissions and live the life with 80,000 euros a year, but live with the guilt. Hmmm, this is a real tough one Daphne. If its OK I’ll sleep over it and give you my answer tomorrow. Maybe I should warn my wife first. She may want to start looking for other schools in the vicinity.
[Daphne – I’m sorry to have to break the news to you after all your talk of corruption, but you’re corrupt and what’s worse, you don’t even know it. It isn’t a tough one for me, either – I would never dream of taking commission on medicines I’ve prescribed, if I were a doctor. It wouldn’t occur to me for one minute. And reluctance to live with the guilt has nothing to do with it. Actually, your outlook on life is so corrupt I have to draw breath: you take bribes to give your wife a nice life? To pay your kids’ school-fees? Haven’t you ever seen yourself in films, starring as some corrupt police officer taking protection money from dealers to be able to take his wife on smart holidays?]
Lino Cert: You’re hung up on wrong doing,you say it’s easy to collect evidence, and yet you don’t do anything about it. What, exactly, are you complaining about? That nobody else is doing anything about the matter? Why should they, if you won’t?
[Daphne – No, apparently he’s busy taking bribes himself, while criticising the system he’s helping to shore up. A bit like Joe Pace tal-Magic Kiosk, complaining that he was ‘forced’ to pay more than Lm600,000 in bribes to corrupt government ministers, without realising that paying that money made him corrupt too, and that by colluding in the bribery he was keeping the system going.]
Lino Cert
I don’t know if the figures you quoted are realistic or not. If they are it means you make € 60K a year from commissions. Apart from the ethical issues involved, I would imagine that such income is not declared in your income tax returns. I would further imagine that commissions are also pocketed on medicines (and other consumables?) used at Mater Dei.
Daphne , doctors are sent for two week ‘seminars’ with their families .How would you prove that doctors are being corrupted by fat cats?
BTW: I notice the silence of certain contributors.
@Daphne @Corinne
Cool it honeys, I took the right decision. And paid the price. Then I lost my job, my family, and my home.
Now I wish I kept my mouth shut like everyone else.
Like I said, collecting evidence is easy. Confiscate their computers and scour their hard discs. Take their diaries. I cannot do this myself, I’d get into trouble. You just can’t steal data anymore; it’s called “data protection”, or something. There’s only so much I can do. Only the police can pull this one off. Or maybe Peppi Azzopardi though he’s recently gone soft.
[Daphne – So you don’t take bribes. You just wish you could. Oh by the way, aren’t you the one with seven children living on a pittance and expecting assistance from the government? I’m getting confused now, but your IP is the same.]
Lino cert – It’s thanks to people like yourself – rotten to the core – that corruption and corrupt practices will never be eradicated, here or anywhere else. A doctor is supposed to put his patients’ interests before his own pocket. His own pocket should not even come into it, in fact – except, of course for what is morally due to him.
Shame on you.
Pity that with your attitude and statements you are possibly also sowing seeds of doubt in respect of doctors once considered to be honest.
@John Schembri
“doctors are sent for two week ’seminars’ with their families .How would you prove that doctors are being corrupted by fat cats?”
I have a better one for you. On one of those sponsored “all expenses paid” mega-seminar trips in Rome I was offered a “good night in town, escorted by a local lady of the night” paid for by my sponsor. I was intrigued but politely declined. Not out of moral obligation, but because I was terrified my wife would find out. I regret my decision now of course. I would readily take his offer up now given half the chance !
@Daphne
“aren’t you the one with seven children living on a pittance and expecting assistance from the government?”
yes i am, what’s your point? Are you scouring all IP addresses now? Have you anything better to do? Anyway , I finally got my full childrens allowance now. Better late than never. The old system was unjust. Can I now also get my job back? Maybe Amanda can help.
[Daphne – No, I’m not scouring IP addresses, but you mistakenly posted under your old name London Area and then repeated the same comment as Lino Cert, so obviously I looked at the IP address to make certain that it wasn’t somebody pretending to be London Area or Lino Cert, as in the case of Not Kev. My point is that I suspect you’re inventing rather a lot of stuff, an easy temptation when no one knows who you are. I always suspected that London Area’s seven children might be a piece of fiction. And I dimly remember Lino Cert claiming, some time ago, that he is working hard to make his business the best in the Mediterranean. You finally got your full children’s allowance – better late than never? The system hasn’t changed in the last few weeks.And what job do you want back? The one you were thrown out of for whistleblowing while building your business?]
@ Amanda
“Lino cert – It’s thanks to people like yourself – rotten to the core – that corruption and corrupt practices will never be eradicated, here or anywhere else”
Hang in a minute, I’m the good guy here. I’m the only one who spoke out, as far as I know. I went everywhere with my complaints, the health minister (not the current one), the hospital CEO, hospital management. I got nowhere. just shrugs of “what can I do?”. I didn’t even get acknowledgements for my letters. Other doctors would grumble among themselves, but none spoke out, as far as I know. So Amanda, why are you attacking me? I don’t get it. Like I said, I refused to play the game, and as a consequence I lost my job. And once a doctor loses his job in Malta you’re screwed because there’s nowhere else to go accept overseas. Not very easy in the days we weren’t even in the EU.
[Daphne – Oh come on, you lost your job as a doctor on the state payroll? That’s a bit hard to believe.]
Lino Cert, I asked you the particular question in the particular way because, in the pre-election time featuring the concept of whistle-blowing, I was informed, through highest sources of private hospitals, that no commissions are paid to medical professionals.
Your kind explanation is a confusing surprise.
Lino Cert
“I took the right decision. And paid the price. Then I lost my job, my family, and my home.”
It does not matter to you probably but, for what it’s worth, let me tell you that I’m not believing a word you’re saying. Among other tall tales, you claimed that a “close friend” was exiled, had his wife and daughter raped and his house burnt down because he spoke out. Then you said that you hadn’t exposed the corruption because of fear of reprisal, after which you said that you earned €60K (3 times your salary) by taking commissions. Now you’re saying that you’ve already spoken out and lost your family, etc.
[Daphne – I don’t believe him either. And it turns out he’s London Area, the one who claimed to have seven children – who are now living on the streets, one assumes, along with their mother.]
@Daphne
Yes, I only got my full children’s allowance now after I complained about the discrimination against any those children born after the first three, which was intrinsically unfair. Do you need birth certificates as proof?
I have no problem meeting you in private and giving you the documentation and proof that commissions are being paid out by certain private hospitals, if you want to write a piece on it. Conveniently enough the health department has now “lost” my complete employment file, and couldn’t trace it when I demanded a meeting to try and get my job back.
As well I have evidence of corruption in the public hospital waiting list system, as well as copies of the letters I sent to the previous ministry over the years, all unanswered, and unacknowledged. I don’t want any more hassle at this stage and would need a guarantee from yourself that you would not reveal my identity and would respect my privacy. I don’t want to be dragged into any court case either. I just want to bring down this abusive system. I am not being altruistic; let’s say I just want justice.
@Leo Said
“was informed, through highest sources of private hospitals, that no commissions are paid to medical professionals.”
Is this just cash you are talking about? What about other forms of commissions? I know of some doctors who would sell their soul for a free biro! I am sure you know these doctors too. They’re the ones queuing an hour before a conference to try and bag all the freebies; these are the relatively harmless ones, though oversubscribing of antibiotics can be harmful, even at the community level. We don’t know who is monitoring the fatter cats in the system. How are you sure that no commissions are being paid?
[Daphne – The extension of the child allowance to all children over and above the first three is not a special favour to you because you complained. It was in the Nationalist Party’s electoral programme. Unfortunately, you’ve undermined your credibility as far as I’m concerned by using two identities to create different biographies, and over and above that, I have a natural distrust of information that comes from people with an axe to grind, rather than from people who have a moral objection to a situation. I don’t doubt your claims of corruption and bribery – for yes, giving doctors commission on patient referrals and prescriptions is a form of bribery. I am very familiar with the way the system works, and have probably been so for much longer than you have.]
@Antoine Vella
I never said I earned €60K, I said that’s what you could earn from commissions alone (actually 40K commissions plus 20K basic pay). This was five years ago, I dont know what the situation is now. Regarding my talk of disembowelment, rapes and houses burning I was obviously talking metaphorically, it wasn’t a physical disembowelment, and not a physical rape, it is how one feels when losing his job and home for daring to speak out against injustice. I didnt mean it literally of course.
@Daphne “giving doctors commission on patient referrals and prescriptions is a form of bribery”
It’s more serious than that, Daphne. To me, bribery is tipping someone to rush your building permit. This is worse then that. To a prisoner with mild rectal bleeding , who may be bumped to the back of the waiting list by a corrupt doctor, a year’s delay may mean the difference between surviving a colonic tumour or metatstatic disease with no chance of cure. In this case we are not talking about simple bribery but possible manslaughter. Imagine it was your own father, or worse, one of your children, how would you feel? I bet you wouldn’t be treating it so lightly then.
[Daphne – I’m not treating it lightly at all. You may have failed to note that I was the only one to write – more than once – about the direct link between the situation you describe and Malta’s topping of the European league in antibiotic use (if not the world league).]
@Daphne: It does not really matter who Lino Cert is. What matters is that what he’s stating fits perfectly in the picture. Doctors have a strong brotherhood. Just look at how many doctors were punished by fellow doctors in the Medical Council. http://www.sahha.gov.mt/showdoc.aspx?id=87&filesource=4&file=MedCouncil_AnnualReport2007.pdf
Mater Dei was to have a new style of ward management. We were told by a doctor/minister of health “mhux qisu s-sala hallijielu nannuh ghal ghomru” (referring to the head specialist). Just watch how some of them dish out sick leave certificates as long as the skivers pay them good money.
[Daphne – I wouldn’t know about the last bit. As for the rest, I mentioned that in my column today: that Anthony Zammit and Michael Farrugia know full well that their Seven Steps will translate into One Thousand and Seven Steps in the face of entrenched work practices and obstruction from their colleagues – and probably even from themselves, given that they are part of the system.]
@ Daphne :il-qasba ma’ ccaqcaqx ghal-xejn.
MC/D/305/2007
Complaint by an insurance agency against a medical practitioner alleging that incorrect dates were given on the claim certificate of an insurer’s son, with the aim of obtaining insurance money for his patient. Evidence put forward by the insurance company to the Medical Council were verified by the Council. After detailed examination of the case, the Council found no misconduct by the medical practitioner and the case was closed. No further action was necessary.
Another case
MC/D/264
An employee reported to the Medical Council the case of a company doctor disagreeing with the diagnosis of his family doctor. The Medical Council while noting the explanation by both sides came to the conclusion that the company doctor should communicate with the patient informing him that it is his right to ask his practitioner to be present during the examination. The attention of the company doctor was drawn to the fact that he should scrupulously avoid interference with, or any remarks upon the treatment or diagnosis that has been adopted by his colleague. The Medical Council considered this warning was sufficient in the circumstances and that no further action was necessary.
And this is awaiting a decision:
MC/D/272
The Education Division raised a complaint against a medical practitioner claiming that he issued sickness certificates to an employee with the same date and consecutive numbers. The Medical Council started an inquiry and the case is still pending for a final decision.
And this points to Lino Cert’s “10 % pyramid scheme”
MC/26/2007
A complaint was raised by a foreigner who was taken ill and admitted to a private hospital instead of a state hospital. Complainant argued that in his opinion the decision was taken ‘only to extract insurance money’.
Council asked complainant several times to give further details relating to alleged abuse by the doctor.
Complainant never replied. Case was considered as closed.
[Daphne – Not very impressive, I’m afraid.]
John Schembri wrote:
[Doctors have a strong brotherhood. Just look at how many doctors were punished by fellow doctors in the Medical Council.]
There are of course elements of truth in above quote:
(strong) brotherhoods among medical doctors exist not only in Malta.
In a miniscule country as Malta, with a medical system as pertains to Malta, it is quite difficult, if not impossible, to have a totally impartial Medical Council, whose professional decisions would make recourse to civil courts superfluous.
@Daphne
1. “I have a natural distrust of information that comes from people with an axe to grind, rather than from people who have a moral objection to a situation”
What’s the difference Daphne? We all have our own axes to grind. Look at yourself and your negative experiences with the Labour Party in your formative students years. You have a truckful of axes to grind there! And who can blame you? The truth is we all form prejudices on the basis of personal experiences, even if sometimes these experiences are indirect.
2. I hope you have had a chance to see the morning breakfast debate on di-ve and the Bondiplus programme, both concerned the waiting-list abuses. Concrete live experiences were given of sufferings resulting from this abuse. I hope you will write this up one day; I look forward to seeing you tackle this problem of abuse of waiting-lists in The Malta Independent.
3. You expressed incredulity at my losing my government job as a doctor. The way it was worked out was clever. They gave me three successive “charges” for missing a single day of work after, in protest, I said I would not come into work until they resolved the abuse in the waiting-lists. They then called me in and said that unless I resign voluntarily they will put these three charges into my employment record and I would then not be able to work within any public hospital in Europe, since the first check that a European hospital does is to check your previous hospital employment record. Therefore I was left with no choice but to give in my resignation, since I could not afford to have these on my record.
Can I just point out that until then I had worked for ten years in succession with the Health Department, not missing a single day in sick leave, and not ever coming in late to work or leaving early from work, this when many of my colleagues would spend days on end not even coming in to work. Of course I have an axe to grind! Anyway this is history now, but the abuse in the waiting lists is there to this day, and I see no reason why I should not grind my axe.
It was farcical to see the MAM representative and the Health minster and shadow minister all forwarding petty excuses for their consultant colleagues’ abuse of the waiting-list problem on Bondiplus. The only honest man on the panel was Dr Frank Portelli. What he said was the full picture, the other three doctors on the panel were, to put it mildly, very generous with the facts, and very evasive.
4. The fact is there are enough doctors, and enough nurses, and enough beds in Mater Dei, to treat a population of over two million without waiting-lists. This is because of our dense population. Larger countries need relatively more consultants because the populations are more dispersed. In Malta every patient is within an hour of the hospital, therefore theoretically there should be no waiting-list at all, because the limiting factor is not “population” per consultant but “coverage” per consultant. We therefore have the HIGHEST density of doctors per square mile world-wide. If there’s any country in the world that shouldn’t have a waiting-list it is Malta. The waiting-list is totally man-made and artificial. There is only one phrase that summarises the problems of our health department, and maybe of the whole country. And, in Dr Frank Portelli’s words, that is the phrase “conflict of interest”.
All our problems can be summarised by this phrase.
5. “Conflict of interest”. I repeat: “conflict of interest”. Did you get that? Because the minister doesn’t seem to get that. And neither the MAM. And neither the shadow minister. Hang on! These are all doctors as well! There you go again. “Conflict of interest”.
The government is wasting its time employing hundreds of more nurses. Tens more doctors. More consultants. Building larger and more extravagant “state of the art” hospitals. A total waste of money and energy. Nothing will ever be solved until this blessed “conflict of interest” is resolved.
[Daphne – 1. I have no axe to grind where the Labour Party is concerned. I criticise the party and vote against it not out of revenge (which is what an axe to grind is) but because I think they’re rubbish. Given the choice between deputy leader Anglu and deputy leader Tonio, the latter wins hands down where I’m concerned because he may be a ruddy bigot but he’s not a ruddy fool. 2. I am so not interested in hospital waiting-lists. I leave that sort of thing to other people. I can’t be everywhere, all the time, writing about everything. I only write about what interests me, on the assumption that it will also interest my readers. My readers tend not to be interested in the budget, water and electricity bills and hospital waiting lists. They get enough of that dreary stuff elsewhere. 3. I would have sacked you, too. On the spot. You were an employee. Employees cannot just decide unilaterally not to turn up for work whenever they see fit, on the grounds that they are protesting about something in the system which meets with their disapproval. That is quite aside from the merits or validity of your views. If you are employed, you have to turn up every day at the appointed hour and if you don’t you face the music. Any protest action, to be legal and protect you from dismissal, must be made via your union and on its specific instruction. 4. I’m not qualified to venture an opinion on this, but others on this blog are qualified and might yet do so. 5. I agree that there is severe conflict of interest. Surgeons and consultants are being asked to work hard to eliminate or reduce waiting-lists, which effectively means that they are being asked to work hard to cut down or cut out their private business which is what keeps them financially comfortable. One or two of them may be working at the state hospital only to drum up business for their private practice. The solution? Certainly not Anthony Zammit’s and Michael Farrugia’s Seven Simple Steps for Simpletons, and especially not when they are part of the system and part of the problem.]
@Daphne
“Any protest action, to be legal and protect you from dismissal, must be made via your union and on its specific instruction”
Are you saying that , when faced by a young girl with a tumour in her kidney who has been bumped off the list by a pensioner with a sore back I’m supposed to contact my union and wait for their instructions? This the same union that is made up of these same group of consultants and also who happen to represent the same consultants who are bumping patients off their list! This, the same union that sold its junior doctors down the river, depriving them of decent salaries and decent job prospects? I don’t think so.
Don’t forget that ours is the Hippocratic oath and ours is not just any old job. There has to be a line drawn somewhere. Sometimes one just has to march towards Zejtun and face the bullets. Otherwise you lose all your dignity and respect towards yourself. So I suppose it boils down to pride. And ego. And a little girl with a tumour in her kidney.
[Daphne – Sorry, but you’re wrong. You don’t deal with wrong-doing by refusing to turn up for work – three times, on three separate days. That just looks like you needed a day off to go shopping. Protest and strike action can only be undertaken through unions when you’re an employee in a large organisation, and if your union has a vested interest, then that’s besides the point. You could have done something far more effective, like gone direct to the Department of Health to report the case, gone above their heads and reported it to the minister for health, gone to the opposition and have the case raised in parliament. But staying home in protest? I don’t think so. I find it hard to believe that a child with a tumour gets bumped off the list or bumped further down it. These are emergency cases and they are treated as emergencies. There’s no waiting-list involved for suspected malignant tumours or broken bones. Otherwise, what you’re saying is that Alfred Sant got preferential treatment because he’s Alfred Sant and that I only had my smashed wrist operated on because I’m me, because otherwise I would have been left with it to set as was.]
@ Lino Cert
What is your real problem?
What kind of employment did you have with government?
What is your speciality?
If one has to be as fair as your good self expects one to be, then, one could also silently think that my good friend Frank Portelli could also harbor “conflicts of interest”.
If I were C.E.O. of a well functioning, solvent private hospital, I would definitely refrain from dabbling in issues concerning a state hospital.
Since you care to mention Lou Bondi’s last TV programme, allow me to provide following references:
http://www.timesofmalta.com/articles/view/20090126/opinion/get-the-doctors-in-the-house
http://www.timesofmalta.com/articles/view/20090127/local/surgeons-operating-at-full-capacity
http://www.timesofmalta.com/articles/view/20090124/local/doctors-union-denies-some-consultants-not-giving-enough
http://www.timesofmalta.com/articles/view/20090123/letters/management-of-waiting-lists-1
http://www.youtube.com/watch?v=GSkqB30zioM
http://www.youtube.com/watch?v=ho7fbusox9Q
@Leo Said
“Could Lino Spiteri, a former social-democrat Minister, hint to us how high an income could be commensurate for/with consultants’ performance?”
Thanks for the links, your contributions to The Times are well thought out and insightful, and I find them very interesting.
Realistically speaking, an annual salary of 300K should be a reasonable salary for type “A” (public only) consultant contracts. I would estimate about 100 consultants would take such a contract, which contracts should be renewable and reviewed annually in order to assess performance, including teaching of junior doctors, further education etc.
I would estimate that 100 consultants earn well above this figure, probably between 600-800K annually would be average, and would probably not take this contract, but eventually their private income would start to dwindle due to patients choosing public health care rather than private, and eventually these 100 “type B” consultants would, within five years, also probably opt for this “A contract”, leaving us with a truly state of the art public-only health system, but solvent private hospitals which could probably then be bought for a song by the government and converted to community/rehabilitation hospitals.
As for Dr Frank Portelli, why he has set upon this crusade for justice I don’t know. Maybe he has his own axe to grind, or maybe he is aiming at the CEO post of Mater Dei, but whatever his motivation he is the only spokesman with some mettle on these matters.
Could I ask you, Leo, what is your own interest in our health care system?
[Daphne – As I know Frank Portelli very well, I can answer that question for you: he has no agenda, he is simply unable to keep quiet where he sees this kind of thing going on, and because he’s not a coward – ref my comment to ‘Sig Bonello’ – he uses his own name and face when speaking about the situation, even if this causes awkward situations for him. Leo Said graduated from medical school in Malta but left the country in – I believe the 1960s – and has worked overseas ever since. He lives in Germany.]
Lino Cert,
You seem to have answered a question on behalf of Lino Spiteri but you did not answer the questions which I asked you.
Indeed, I have teased my good friend Frank Portelli many a time with respect to his becoming C.E.0. at Mater Dei, a possibility which I cannot foresee at the moment. My reason is that Frank Portelli, as I know him, would never accept the present NHS setup and, although John Dalli and Lawrence Gonzi would be only too happy to have him as C.E.O., the opposition towards him would create a problem for politicians. There are already too many (influential) PN and PL medics who oppose him.
250-300K would be a commensurate income for a top consultant but this sum should consist of a basic (tariff) salary plus income from private practice. In the hospitals where I had appointments, there existed a “pyramidal” consultant system and it was only the head of department who earned in the region of 250-300k. 120k was a good average for subordinate consultants and this sum consisted of basic salary, duty benefits and remuneration for participation/help in the management of private patients.
Please refer to my description (earlier on this thread as a comment to a remark by Daphne) of the system in which I worked. As Ms.Caruana Galizia correctly pointed out to you, I matured professionally in the German system of hospital practice and I do not regret the fact.
As answer to your last question, I had practical (temporary) administrative experience at the University Clinic in Aachen after finishing theory at an academy in Berlin. This experience, of course, helped in running the department of my own speciality.
On a closing note, I personally believe that Malta has too many consultants (of equal rank) in relation to the number of hospital beds. A consultant managing a ward/firm with possibly no more than 6-10 beds cannot, should not, cherish elements of self-esteem.
Frank Portelli at the di-ve.com Breakfast Debate:
http://www.youtube.com/watch?v=m8b9YxWklgc
@ Leo Said
Frank Portelli would be the right man for the job. I am sure he would have no problem facing down and confronting the influential medics within the PN and LP. Just like any bullies I think they are cowards at heart.
However I think he would need to be offered a very high pay to compensate him for the the autonomy he would need. Possibly 500K or whereabouts, and maybe he should be offered a performance bonus. The value he would give to Mater Dei would more than outweigh the cost. I have no doubt that he would deliver. So what if he upsets a few consultants? If they fail to see the wood for the trees that would be their own problem.
[Daphne – A salary of 600K is the perfect way to undermine anyone who takes on the job before he or she even begins. Be realistic.]
Lino Cert,
I beg pardon but, at some points in your contributions, I have difficulty in understanding your English. For example, “a very high pay to compensate him for the autonomy he would need”: does that mean that Frank Portelli would be paid for enjoying autonomy?
Lino Cert, just consider a soccer team in which the field players have a legally binding work contract. The team slips into misery upon which it is usually not the field players who are sacked, but the trainer/manager. In other words, a C.E.O. at Mater Dei would not, could not, be powerful enough to combat the present consultants. Opposition to Portelli’s innovative ideas would also certainly come from the doctors’ union and from the nurses’ union and possibly/probably from other trade unions.
As Ms.Caruana Galizia advises you, be realistic!
Lino Cert’s case strengthens the theory of a strong brotherhood in the medical profession: the one who rocks the boat or does not toe the line would be ruthlessly punished. My practical suggestions for this problem are:
1) a time-roster for all employees which is planned around the hospital’s needs, which boils down to the patients’ needs;
2) professional people should not have a union, if they are unionised they become workers. Workers should punch in and punch out so everyone who is in public service should clock in and out with palm readers.
I recall one time when a doctor was sent to visit me at home by my employer, when the doctor should have been at Saint Luke’s Hospital, working there.
@Leo Said
What I meant by autonomy is that he would have the power to hire and fire, without political influence.
The unions will obviously object to such power. That’s where a new contract will come in, possibly renewable every three years depending on performance.
The only way you could entice someone with the calibre of Frank Portelli to do the job would be to compensate him adequately financially. Of course, if any of the current consultants refuse the new contract they can always stay on the old contract, but I would think a salary of 300K would entice at least half of the current consultant group to take up such a “public only” contract.
@ Lino Cert
If each full-time consultant at Mater Dei were to earn 300K, how much should junior doctors and paramedics (including nursing staff) earn? Where should/could the money come from? More taxes? A new medical insurance scheme? More national debt? Medical economics per se must be considered within the framework of national economics. A so-called autonomous hospital will still have a board of directors, and hence a C.E.O. at Mater Dei will not have unlimited power to hire and fire, as have Frank Portelli at St.Philip’s and Josie Muscat at St.James’.
Quote: “Of course, if any of the current consultants refuse the new contract they can always stay on the old contract …” – in which case, one is essentially back at square one.
p.s.: Lino Cert, you still avoid answering my three questions, namely:
What is your real problem?
What kind of employment did you have with government?
What is your speciality?
@ John Schembri
A strong brotherhood in the medical profession is not only theory but, unfortunately, silent practice. This misfortune applies not only to Malta. Professional people are workers, in most cases diligent, hard workers. It is quite licit and legitimate for professional people to have a trade union/corporate body to look after the profession’s particular interests. I beg your pardon because the “practical solutions”, which you offer, are hardly practical and/or practicable.
For blog-readers, who are interested:
Frank Portelli on Health Service in Malta:
http://www.youtube.com/watch?v=DV8y9lrqiJ4
Lino Cert, you wrote:
Are you saying that, when faced by a young girl with a tumour in her kidney who has been bumped off the list by a pensioner with a sore back I’m supposed to contact my union and wait for their instructions?
A girl with a kidney tumour would be operated upon by a urologist, paediatric surgeon or a paediatric urologist. The pensioner would have to be seen by an orthopaedic surgeon, and could be possibly operated upon by a neuro-surgeon if he’s found to have a prolapsed disc.
Now can you please explain HOW both cases could ever possibly relate to each other? You have been writing many half truths…
[Daphne – My thoughts, exactly.]
Quoting the same guy:
I have myself witnessed a seven year old girl needing urgent treatment for a tumour skipped in the waiting-list for an urgent intervention by the mother of a minister’s driver, who had only a minor complaint, the young girl’s mother was in despair. When I went I complained to the hospital superintendent I was told “jaqaw ghandek xi-interess?” !! I then urged the mother to seek immediate treatment for her daughter privately and paid for her myself, though I didn’t even know the mother.
So first it’s a pensioner, now its the mother of a minister’s driver.
And you paid for the intervention yourself?
@ K Cortis
“Now can you please explain HOW both cases could ever possibly relate to each other? You have been writing many half truths…”
Yes, they may well have been half truths: for example it may have been a young boy with a bone tumour, not a young girl with a renal tumour, and the pensioner may have had a transient ischemic attack, and not a sore back. What relevance does this have? Why do you need the exact details? It’s the principle that counts, and the principle is that patients with urgent clinical needs shouldn’t be bumped off lists because of familial connections or private motivations.
I never said it was a surgical intervention either; it may have been some other form of intervention. What difference does it make? We heard on Bondiplus how a journalist’s mother was bumped off the list for an echo-cardiogram, and then died five weeks later. Did you not sense this journalist’s regret? He probably wonders whether a contribution of a hundred euros may have bumped his own mother back into the front of the list and whether this may have saved his mother’s life. This hundred euros may have made the difference between life and death. Will we now be auctioning places in a waiting list on ebay?
It is not just the surgical waiting lists that can be manipulated. At the end of the day the hospital waiting lists were being manipulated for personal gain, to the detriment of more deserving patients.
I wouldn’t be stupid enough to give you enough information to make myself identifiable. It’s a small island and whatever the system in Mater Dei, I may need these people too. And it is perhaps a poor reflection of our health system that we are afraid of annoying these powerful people in case we need them one day and have nowhere else to go.
I remember one doctor who once upset a private hospital and they sent around a memo saying that this doctor and any of his immediate family were not to be treated at that private hospital anymore. Only in Malta! That is exactly the way hospitals in Malta treat doctors they consider as trouble. Total lack of ethics. The shoot the messenger.
In any case, I have all correspondence documented, and supported by names and dates so whenever Daphne wants, and whenever I decide to grind my axe, she can write this up and I can meet her and hand over my documentation.
[Daphne – You really have a southern Mediterranean way of thinking, not to say specifically Sicilian or southern Italian, lest I be accused once more of prejudice. You say you have principles, but then you won’t stick to them ‘because you never know who you might need’ – you know, in case some doctor you’ve reported decides to damage your guts by accident-on-purpose while you’re on the operating-table, before stitching you up again. Unbelievable – well, actually, entirely believable, because yours is the dominant attitude in Malta. That’s why so many people suspect I am ‘paid’ by somebody or something other than my newspaper to write my articles – because, hey, otherwise why would I stick my neck out? Except that in a normal country it wouldn’t be sticking your neck out. It would be a perfectly normal job, writing a newspaper column. And this blog? Oh, she must have an agenda. She must be the agent of some dark political force….if it weren’t so sad, I might laugh.
You ask why the details matter. They’re not details, but important facts. If you twist the facts, especially when you’re anonymous, you have no credibility. All sensible people who are not conspiracy theorists, idle gossips or radio-phone-in-callers know that people with tumours are rushed in for emergency operations illum qabel ghada, whatever their political beliefs, their family connections or their financial resources. All urgent procedures are treated with urgency. It all depends on how you define urgent. If it’s not going to kill you or result in your bones setting badly, then it can wait while others are attended to whose life or bones are imperilled. If you don’t want to wait, you pay. That’s what private hospitals are for and thank God we have them now. Remember when we didn’t? Then even those who could pay didn’t have anywhere else to go, and jammed up the state hospital lists even further.
You are shocked because a private hospital said it wouldn’t treat somebody who had proved to be a problem – unless, of course, this is yet another of your ‘unimportant details’ which you can enliven as you wish. Well, this might come as a surprise to you, but a private hospital is a private business, and like all other private businesses, those who own it and run it have every right to refuse to sell their services to a potentially problematic customer, or to anyone else for that matter. Businesses do it all the time, because this sort of customer is just not worth the hassle. What are you suggesting now – that a private business should be forced to treat people it doesn’t want to treat? There’s the state hospital for that.
I’m not in the slightest bit interested in who you are. This place is full of odd-balls and I really don’t need to get acquainted with another one – but thanks all the same.]
quote Lino Cert: “I wouldn’t be stupid enough to give you enough information to make myself identifiable”.
Don’t you realise that you have somehow already betrayed your identity?
As a qualified doctor, would your good self know what your good self needs urgently as judged by the tenor of your messages?
quote Daphne: “This place is full of odd-balls …. ”
What about even-balls and square-balls?
[Daphne – You ask why the details matter. They’re not details, but important facts. If you twist the facts, especially when you’re anonymous, you have no credibility. All sensible people who are not conspiracy theorists, idle gossips or radio-phone-in-callers know that people with tumours are rushed in for emergency operations illum qabel ghada, whatever their political beliefs, their family connections or their financial resources.]
Exactly. The precise details are of utmost important. I don’t imagine that the Health Department will see what Lino Cert is saying in quite the same light as he is seeing it. What he is saying is basically libellous if it proves untrue. But we all know, as he knows, that where tumours and other serious conditions are concerned, the Maltese State hospital does the right thing and treats them urgently. I admit that I am taking whatever he says with more than a pinch of salt, but you cannot go around making allegations without stating precise facts, and not if you’re not prepared to prove that what you’re saying is true.
If I remember correctly, this is the same doctor who refuted the existence of GU clinics in the UK, Malta and elsewhere, some time ago, on this very blog, when Philip Carabott’s clinic at Boffa was mentioned. I have been looking for the link but cannot find it.
[Daphne – Yes, you’re right. It’s the same one, which means that he is neither a doctor, nor a paramedic, and cannot possibly ever have worked in the state health care system. He didn’t even know that there was such a thing as a specialist in STDs.]
[Leo Said – As a qualified doctor, would your good self know what your good self needs urgently as judged by the tenor of your messages?]
Now let’s all try to guess……….
@ Daphne
“All sensible people know that people with tumours are rushed in for emergency operations illum qabel ghada, whatever their political beliefs, their family connections or their financial resources”
You’re missing the point here Daphne. How would the patient know he has a tumour in the first place if his appointment for his complaint (eg rectal bleed, pain in the hip, lumpy breast, blood in the urine etc) is delayed because they are at the end of a long waiting-list? Kids tend not to complain much anyway, a child may have a limp for months before complaining. A busy working mum may not think much of a few drops of blood in her young daughter’s urine. In addition, the first line treatment for many tumors is not surgery, especially in children, and therefore “rushing them to theatre is not an option”.
I will ignore your personal attack on myself, and also Leo Said’s vile comment (though I admit it was very well versed, I really admire his writing style!) , because they have nothing to do with the topic, and in any case I find people tend to attack the messenger when they don’t like the way a discussion is going, so I’ll these insults as a compliment.
On a final note I strongly disagree that a private hospital can turn away a patient because of political or managerial reasons, I am quite sure that is unethical, and am quite shocked you think this way. Even the most vile murderer has a right to treatment , let alone an innocent bystander who may happen to have fallen foul of a particular hospital management. Surely you haven’t thought this one through?
And Daphne, if you’re going to publish this post please spare me the insults this time, and just answer the questions.
[Daphne – Excuse me, but what insults? You’re the one insulting people – anonymously. It is impossible to insult somebody when one doesn’t know who (or what) that person is. I think you forget that (1) I live in Malta and famously make a point of using the state health service, (2) I raised three rough-and-tumble sons and spent rather a lot of time at A & E, and (3) I have an extensive network of friends, acquaintances and relatives, all of whom have had to use both private and state medical services from time to time. I am not speaking to you from Mars. You, on the other hand, swing from one set of ‘facts’ to another. One minute you’re a doctor who has been sacked for standing up for what is right (you say), the next minute you have seven children and are fighting for your right to children’s allowance (you say), and the next minute you are paying for the private medical treatment of a little girl you don’t know (you say), when only a few weeks ago you were claiming that you raised your seven children on giant packs of frozen chips. Anybody with a lump in their breast or rectal bleeding does not sit on a state hospital waiting list. This is how it works. They go to their GP, pay EUR5 for the visit (they might have to cut down on one DVD rental that week, but what the hell) and get an urgent referral note to a specialist at the state hospital or, if they prefer, to a private specialist. And it’s taken from there.]
@Daphne
“which means that he is neither a doctor, nor a paramedic, and cannot possibly ever have worked in the state health care system.”
I may not be a doctor but have worked in both the state and private health care system both in Malta and overseas so I know what I am talking about. In any case the Ombudsman has also pointed out the danger of lack of transparency in the waiting-lists, and that was based on a documented and proven case. I am sure there are many others who would never have thought of complaining to the Ombudsman.
[Daphne – That might be because they’re not non-Maltese prisoners at Corradino, and have other alternatives. What were you doing in the state and private health care system both in Malta and overseas? Pushing trolleys of food around? You can’t have been doing anything much given that you didn’t know about the STD clinic at Boffa, or who Philip Carabot is.]
“people with tumours are rushed in for emergency operations illum qabel ghada”
Having had a not-so-small tumour (which, luckily, turned out to be benign) recently detected at a private clinic, I was told by the doctor concerned that the waiting list at Mater Dei is “around “three weeks long” for a case like mine. I would have paid any price to have my operation carried out – privately – immediately.
When you are told that you have got a large growth which “could be” malignant three weeks is an eternity (especially if you have got young children), even if it is nothing when compared to other waiting-lists. Needless to say, I opted to have the operation carried out privately rather than wait.
[Daphne – The waiting-list system does not take a person’s worry or inconvenience into account, but factors in only risk to life and health. No doubt the specialist had worked out that there was a strong likelihood that the tumour was benign, hence the three-week wait. Also, you were probably insured. Given the choice between a three-week wait for an operation at the state hospital and a EUR5000 bill or more for the same operation at a private hospital, you might well have opted for the former. When I had the choice between waiting for two weeks with a smashed wrist in a temporary cast for an operation at St Luke’s or spending Lm2,000 to have the same operation and care at a private hospital the next day, I chose to wait two weeks, even though I was extremely uncomfortable. I wasn’t going to throw away a couple of thousand liri to win myself two weeks of comfort, because it took a lot longer than two weeks to earn them.]
[Lino Cert – I may not be a doctor…..]
I can’t say I’m surprised, but where does this leave your credibility? Somewhere down there, at the very bottom of the barrel. If you want to be taken seriously you just cannot go around saying half-truths and, what’s more, blatantly inventing things. To me you sound like a chap who has it in for everyone, and who is trying to get his own back by anonymously saying nasty untruths about a whole lot of people.
@ I beg to differ
I feel with you but the info, which you have provided, is too superficial to allow for proper professional comment.
@ Lino Cert
Thank you for enjoying my occasional message. On another note, my professional experience compelled me to write what I last wrote in your direction, especially as I have no other method to contact you. As you seem to have a vast all-round experience, I must surmise that you will also know what profiling is.
@Leo Said
“I must surmise that you will also know what profiling is”
Yes Leo, you may surmise so, if you so please. My internet profile is obviously very different from my real-life profile. Why should it be the same? As far as I know there are no rules and regulations controlling this forum. Anyone is free to assume any user name and any profile he or she wishes, and to say whatever he wishes.
If I got out of line at times I apologise. I especially apologise to Philip Carabot. I slipped up badly there and apologised immediately, though it seems Daphne won’t let me of the hook for that one!
@ I beg to differ
“I was told by the doctor concerned that the waiting list at Mater Dei is “around “three weeks long” for a case like mine. I would have paid any price to have my operation carried out – privately – immediately”
The big question is, can a doctor truly claim to have no conflict of interest in a case like this, where he clearly stands to gain from your fear and your ability to pay for the operation to have it done immediately? Even if everything was above board, such situations raise serious conflicts of interest. I disagree with Daphne completely on this one, your worry and concern should have been enough reason to perform the operation within a few days, and I think Daphne has shown lack of empathy in comparing this lump to her own broken wrist. With due respect , Daphne, a broken wrist never killed anyone, but breast cancer (it was a breast lump I assume) kills hundreds of women every year. What young mother wouldn’t be worried sick having to wait three weeks for what is essentially a possible death sentence! Is it fair to make this mum wait three weeks for this result?
“When you are told that you have got a large growth which “could be” malignant three weeks is an eternity (especially if you have got young children), even if it is nothing when compared to other waiting-lists. Needless to say, I opted to have the operation carried out privately rather than wait”
I would seriously doubt the accuracy of this information given to you by this doctor. If you are talking about a breast lump then certainly three weeks is excessive. Suspicious breast lumps are always seen within five days at the fast-track breast clinic at Mater Dei, even if they seem initially benign. Either this doctor gave you the wrong information, or else you may have misunderstood him. Or else he was almost 100% sure that that this growth was benign, in which case I am surprised that he would worry you for nothing. So something doesn’t quite fit here.
[Daphne – “Suspicious breast lumps are always seen within five days at the fast-track breast clinic at Mater Dei, even if they seem initially benign.” Exactly. And no – person’s feelings of worry shouldn’t be a reason to push them to the top of a waiting-list. There are people who worry about nothing, and other people who don’t worry when they really have something to worry about.]
@ Daphne
“person’s feelings of worry shouldn’t be a reason to push them to the top of a waiting-list”
Neither should a few hundred euros be a good-enough reason.
[Daphne – If you’re going to spend a few hundred euros, you might as well spend them on getting the job done privately rather than on bribing a specialist to knock you to the top of the list for a ‘free’ operation. And the same goes for the specialist: it makes more sense to take the money for a private procedure than to take the money for a bribe.]
Lino Cert – “The big question is, can a doctor truly claim to have no conflict of interest in a case like this, where he clearly stands to gain from your fear and your ability to pay for the operation to have it done immediately?”
To be fair, I was the one who insisted on having it done privately, because I wanted to get it over and done with. It was entirely my decision. Plus, I have full faith in the doctor concerned. (And yes, an adequate insurance policy too, though I would have paid whatever it took to have it done asap.)
Had it been a “lesser” case (and had I not been insured), then yes, I may have opted to wait rather than have the operation carried out privately. Under the circumstances, however, it would have taken too much out of me to wait for an unspecified period before seeing the results with my own eyes, especially since the growth itself was ignored some years back by the first doctor who examined me, despite it – apparently – being pretty clear on the x-rays.
Some may reason that the original doctor may have ignored the growth because he knew it was “nothing”; let us just say that I would not really have much faith in him again, no matter how much people would try to reassure me otherwise.
Quoting the local Braveheart:
“Yes, they may well have been half truths: for example it may have been a young boy with a bone tumour, not a young girl with a renal tumour, and the pensioner may have had a transient ischemic attack, and not a sore back. What relevance does this have? Why do you need the exact details? It’s the principle that counts, and the principle is that patients with urgent clinical needs shouldn’t be bumped off lists because of familial connections or private motivations.”
So first you say that the pensioner with lower back pain was taken care of BEFORE the girl with the renal tumour. Now you say that these may have well been half truths.
Do you realise that you have lost all of your credibility, if you ever had some? I agree with you in that the waiting list system is far less than ideal, but you don’t have to prove this by making up fictitious examples…which may represent true stories to the ignorant.
Braveheart again:
“I never said it was a surgical intervention either; it may have been some other form of intervention. What difference does it make?”
It does make a difference, dear Lino. There is a waiting list for surgical procedures, and for radiological procedures. But there is no waiting list for many other therapeutic interventions.
For example, we don’t tell the guy with an MI that he has to wait a year for his coronary angiogram to be done…we just do it.
We don’t tell the guy with a colonic carcinoma to wait a year for his staging CAT Scan – we just do it very ASAP.
So please, do not generalise…
Quoting the Brave one:
“We heard on Bondiplus how a journalist’s mother was bumped off the list for an echo-cardiogram, and then died five weeks later.”
Now can you please correlate and connect the echocardiogram that wasn’t done to her cause of death? You must be a forensic expert as well…
Quoting Lino Brave:
“You’re missing the point here Daphne. How would the patient know he has a tumour in the first place if his appointment for his complaint (eg rectal bleed, pain in the hip, lumpy breast, blood in the urine etc) is delayed because they are at the end of a long waiting-list? Kids tend not to complain much anyway, a child may have a limp for months before complaining. A busy working mum may not think much of a few drops of blood in her young daughter’s urine. In addition, the first line treatment for many tumors is not surgery, especially in children, and therefore “rushing them to theatre is not an option”.
People with a rectal bleed, pain in the hip, lumpy breast, blood in the urine – most of these come to casualty. The ones with a lumpy breast are referred to the local breast clinic – and the waiting list there is in the order of a few DAYS.
Did you know that we have a breast clinic? As a side note, I should add that the breast clinic and the STD clinic are not one and the same…
Quoting Lino:
“I may not be a doctor but have worked in both the state and private health care system both in Malta and overseas so I know what I am talking about.”
There are many people working in the heath system (state and private, Maltese and international) – these include doctors, paramedics, administrators, and cleaners.
Working in a health system does not make you an expert on how health systems work; it just makes you an expert in your job… a cleaner working the the cardiac catheterisation lab does not become a cardiologist by osmosis.
@ Leo Said:
At present the system centres around the time-table of the doctors. Some doctors start working in private clinics at six in the morning, then they arrive at MDH at nine or ten in the morning, leaving their patients waiting for hours.
Timekeeping is essential to minimise abuse. A time-table should centre around the public hospital’s needs not around the part-time doctor’s whims. One goes to work when she/he is needed.
If doctors take a solemn oath to put the interests of the patient’s health first, join a union, then they cannot call themselves professionals. The interests of the patient and those of the part-time worker doctors clash.
[Daphne – I know you’re addressing Leo, but I’ve got to say that I don’t agree with you. The laws of demand and supply are at work here. There is far more demand for doctors than there are doctors, and so the doctors can call the shots. I’ll just draw a parallel from the sector in which I work. Twenty years ago, when computer-aided design was just beginning, there were hardly any people trained to do it. Art directors and designers commanded salaries three times larger than those of their colleagues who worked in the same office doing equally demanding work, but for which there was a higher supply of workers. Over and above that, they made their own hours, were permitted to throw temper tantrums and had the keys to the building just in case they felt like working at midnight instead of midday. Now the market is saturated with kids who can do the work, even if they know more about computers than they do about aesthetics and design, and the only designers who are earning worthwhile amounts are those who have left employment and set up on their own – but they are the leaders in their field. The rest are on salaries lower than what they were 20 years ago. So who in media is earning the most now? The ones who bring in the money to keep the show on the road: the best advertising sales people.]
@I beg to differ
Sounds like its the second doctor you should lose faith in, after all it turned out the first doctor was right and you were operated on for nothing. The irony of this case is incredible, the inexperienced doctor gets the credit, and the money. The conscientious doctor becomes the villain.
Your story is not unusual at all, and very much illustrates to the type of medical system prevailing in our country, fuelled by patients’ ignorance. By the way, did the second doctor subject your lump to the mandatory triple assessment before whipping it out? Or did he go ahead on his own steam?
Perhaps, this is a good enough reason to have your lump removed in Mater Dei, at least you get three professional opinions.
Quoting John Schembri:
“If doctors take a solemn oath to put the interests of the patient’s health first, join a union, then they cannot call themselves professionals.”
Are you implying that doctors do not have the right to form a union? That doctors should put the interests of patients before their own rights as workers?
Even doctors have a life – which is worth living. And this will be the case until somebody invents reliable cyber-docs.
Furthur debate about the hospital waiting lists:
http://www.il-pjazza.com/forum/index.php?topic=2126.0
@K Cortis
I have read your posts over and over again and to be honest I cannot make head or tale of what you are trying to say. Are you being sarcastic? Or maybe trying to be funny? If so you’re making a hash of it. Please try again.
Maybe Daphne can correct your english before posting your comments,she may have some time to spare seeing she’s now lost her job spell-checking Maltastar.
[Daphne – Hmmm, maybe someone else has lost a job at Maltastar. I can understand K. Cortis perfectly well, so why can’t you?]
@ John Schembri
I refer to your last post directed at me.
Do you wish to believe that I am not acquainted with the system and its pitfalls?
@ Daphne : I agree with you about market forces, but the demand must be a natural demand not an artificial demand created by the part time workers in question.
@ K Cortis: I don’t imply. All I am saying is that one cannot serve two masters (two loyalties). As far as I know a doctor cannot deny his services to a patient who cannot pay him. With the astronomical salaries being mentioned in this blog one cannot describe doctors as workers. If they want to be in a union they have every right. But can they be considered to be professionals if they do so? And is it right to address fellow professionals with sarcastic names like “braveheart”, “lino brave” , “the brave one” etc ? I would not expect that subtle name calling from a ‘professional’.
[Daphne – The demand for doctors is natural, unless you know of some unnatural illnesses of which I am unaware. Also, the shortfall between supply and demand wasn’t created by the people who became doctors – obviously – but by people like us, who didn’t become doctors.
Your comment addressed to K Cortis: doctors are not considered professional because they are/are not unionised, or because of their low/high salaries, but because they have a professional warrant and hence, professional status.]
@K Cortis
“Even doctors have a life – which is worth living”
Classic!
How on earth did “K Cortis” sneak his/her way into our medical school? He/she can’t even string two phrases together.
We’ve really hit rock-bottom now, we’ve yellow-pack medical students as well! I don’t know why I even bother any more. Maybe we have the medical system we deserve after all.
[Daphne – K Cortis isn’t “K Cortis”. He really exists. Unlike you, he uses his real name and he’s a real doctor. Oh, but I forgot – you wouldn’t know that, would you?]
@ I beg to differ
I have read all posts again but I am afraid that I still have no idea of what your condition was, except that it was a tumour. All I can say from what I have read is that even an “examined” specialist must have enough practical experience in his/her field to interpret image changes and their respective significance.
quote: “(And yes, an adequate insurance policy too, though I would have paid whatever it took to have it done asap.) Had it been a “lesser” case (and had I not been insured), then yes, I may have opted to wait rather than have the operation carried out privately”.
Thereby, you touch one important factor, which affects the system in Malta. You make me understand that you have a private insurance. If so, what does your private insurance cover? What premium do you pay for your private insurance?
quote from Lino Cert @ K Cortis: “I have read your posts over and over again and to be honest I cannot make head or tale of what you are trying to say. Are you being sarcastic? Or maybe trying to be funny? If so you’re making a hash of it. Please try again.”
Lino Cert, I personally win the impression that K Cortis is kindly showing you how silly your good self can be. My professional experience over many years was similar to what K Cortis has written here.
Lino Brave – one word of advice – read ’em again :).
John Schembri –
The astronomical salaries mentioned here were mentioned by one person only and, I assure you, there’s nothing astronomical about the salaries doctors in government practice are receiving now. If salaries were astronomical, doctors would be tripping over each other to get themselves employed within our health system. They’re not doing this, so you can rest assured that the astronomical pay-cheques are happening elsewhere, not here – which is, incidentally, why we’re always hearing about a brain-drain rather than a brain-gain.
I cannot see why the status of a professional and membership in a union should be so mutually exclusive in your mind. Professionals can and do have their own unions. Professionals are workers too, who have their own rights which must be defended.
quote John Schembri: “All I am saying is that one cannot serve two masters (two loyalties)”.
The quote is probably the only valid thing which John Schembri has written and it is the reason behind Frank Portelli’s argument that full-time consultants at Mater Dei should spend their full time at Mater Dei as civil servants with an obligation toward the nation.
I must admit that one aspect of Frank Portelli’s crusade does trouble me. I have never officially heard how many of the consultants, who have a contract with government, also work at St. Philip’s and if so, when they are present at St. Philip’s.
Within a framework of public-private joint venture in health care, one must consider the scenario where/when a doctor has possibly simultaneous emergencies in the private sphere as well as in the public domain. What does the doctor do under the given circumstances? Which loyalty would have priority?
@ John Schembri
Professionals with exorbitant salaries are workers, i.e. they work for their remuneration. Are soccer players and soccer trainers workers? Are actors workers? Are artists workers? Would you tell Elton John and/or Robbie Williams that they do not work for their royalties?
@ John Schembri:
Do not overgeneralise. Most of the doctors aren’t consultants, but junior doctors or doctors in training. And these do not have astronomical salaries. I cannot figure out how and why being part of a union doesn’t make you professional.
On a final note – even doctors have the right to be sarcastic.
@Lino B
My command of the English language seems to have become your pet subject. I know that my English is far from perfect…but shouldn’t you try to find an answer to my comments instead of wasting time and cyberspace highlighting my personal shortcomings?
How to create an artificial demand:
1) when at his place of work, the worker serves two masters;
a) processes fewer clients per hour than at his part time job;
b) prepares his appointments and other errands concerning his part-time work;
c) discusses his part-time work with other part-time workers;
d) before being operated upon the patient is asked to occupy a bed for a whole day, while in a private hospital the patient is asked to go in the early morning and leaves in the evening;
3) the worker arrives late at work and leaves early from work (no palm readers because they are professionals). Dr Deguara once caught a few professionals red-handed but nothing serious happened.
I can think of more such tactics.
@ Dr K Cortis: one cannot serve two masters and be considered a professional. How can a worker with a woodwork factory tell a client that he can deliver the desired furniture in a few weeks time instead of waiting for his factory to deliver in a year’s time because of a tall order list?
As a worker you can understand that the employer will be furious when he gets to know that his employee is poaching the clients who go to his showroom to buy his product.
I purposely made a sweeping statement. I know that doctors earn less. Juniour doctors and doctors are just pawns in this game.
John,
1a) Nobody serves two masters – there are many doctors who have never paid MAM membership, but the same applies to MAM members.
1b) The opposite is true
1c) A doctor does not ‘prepare’ his appointments…that’s up to the pharmacy or private hospital where he/she works privately.
1d) Don’t overgeneralise – there are day cases, and there are cases which require patients to stay for more than a day. Day causes are admitted in the morning in the DCU (Day Care Unit), and discharged in the evening. This was the case when MDH started to operate – nowadays part of DCU is been used as a normal ward (as opposed to a Day Care Ward) – this is due to the shortage of acute beds in MDH.
3) Why don’t you mention the numerous instances in which on-call consultants have to come to hospital at 1am? And being paid at less than 10 EUR per hour to do so?
I know a lot of honest doctors, but I experienced the ‘modus operandi’ of many consultants and some doctors. It is good to know that many consultants are dedicated professionals. Ten euro an hour for being on call or for calling at one in the morning? One has to consider the whole package: how often is a consultant “on call”? Why are caesarian births on the increase?
Why are caesarian births on the increase?
Because most mothers-to-be think that it’s more convenient to them (thereby ignoring the fact that a CS has its own risks)…and because of the decreased risk that a CS poses to (most) complicated deliveries when compared to the older methods (eg forceps, ventouse etc).
It’s actually less than 10 euros an hour.
Some consultants are on call every day, some consultants are on call every other day, some are on call every week…there’s no general rule.