Most of us think of hospitals and shudder. Unless you live in the US, in which case may be getting red under the collar because Obama is trying to introduce health care, EU-style.
One thing Malta has always prided itself on is a free health service. This country has a long legacy of hospitaliers, dating from the Knights right through to the current crop of surgeons with a world class reputation. And yet, for my generation, the public hospital meant the crumbling St Luke’s Hospital in Gwardamangia. When the new hospital project was first mooted, in the early nineties, there were many who perceived it as a white elephant. The history of Mater Dei is fraught with controversy and the usual Mediterranean soap opera of mismanagement and spiralling budgets. And yet, the teaching hospital opened in June 2007 and now sits there, next to the University, with a total floor area of 232,000m² and approximately 8,000 rooms, 25 operating theatres and more expansion on the way in the shape of a cancer ward.
I spent the best part of Wednesday as a patient at Mater Dei. It was a scheduled operation, with a pre-op appointment last week and the operation this week at the ‘Day Care Centre’. Now I’ve experienced some of the work cycles of the hospital first hand, here are some off the cuff observations:
1. The appointment system is nothing short of shambolic. On arrival, you are sucked into a vortex of queues, shrugs, flapping orderlies and organised chaos. It takes four hours to get through a sequence that eventually leads to a cardiologist; an x-ray specialist; the blood sampling unit and then back to a doctor who took my blood pressure and briefed me on what to expect during my operation. Most of the four hours were spent waiting for something to happen. There’s a great opportunity for some time management guru to re-engineer the entire appointment system. Gathering everyone in a cramped waiting room at the same time for hours on end is just daft.
2. You have to ASK for information, otherwise you will be treated as another in a herd of people blindly going from ‘a’ to ‘b’ – and in Mater Dei’s case, that involves navigating down floors and through long corridors.
3. When you do get to see a specialist, the monitoring is thorough. Quality time at each stage of the pit stop.
4. The equipment is new and shiny. The toilets are clean! There are TVs in the waiting room.
5. It’s all about how you communicate with your customers. Clear information at hand and online to enable people to manage expectations about how long they have to wait, what the process involves. Put up some videos on YouTube, treat people like the curious, scared beings that they are when they become patients and you’ll get positive payback.
6. If I’d been in the US, how much would my four hours of monitoring have cost?
1. There’s another long queue to register at 7.30 am. Almost an hour and a half before I actually get called.
2. Once you’re inside the ward, things change quickly. Where pre-op staff are too busy to explain, here the nurses are friendly, understand that people are apprehensive at best when they get hand-tagged and get their knots tangled when putting on their gowns. The bed is comfortable, the linen sparkling white.
3. It’s the first time I remember being wheeled anywhere in my life. The nurses crack jokes on the way to the operating theatre. The lift doors have that clunk of expensive equipment.
4. You’re now in a professional, quiet human chain. The anaesthetists take over, one is a trainee. We talk about adrenalin. The last thing I remember is someone patting my shoulder and saying ‘Good luck, my friend.’ I come round in a recovery room, and immediately feel people around me, making sure that I am OK. It’s like being 7 years old again and your mother is checking up on you and making comforting clucking noises.
5. Back in the ward, nurses fiddle with your drip, get you a glass of water, tell you someone called earlier to see how you were doing. You’re told to rest. Outside, the radio is playing. It blends well with the constant phone calls.
6. A doctor shows up after the drip is removed. We chat about the various attributes of pain-killers. She knows half my family. If Mater Dei need someone for those information videos, they don’t have to hire talent: she’s already there, in-house, with perfect 21st century Euro-Maltese panache and great bed-side manner to go with the new equipment.
7. It’s taken me precisely 8 hours to complete my operation and get released.
Mater Dei is a totally Maltese experience. If someone had to do an ethnography study on how we really tick, as a nation, they should start with our national hospital.
Despite the whirring technology, the shiny huge halls and corridors, the air-conditioning in every part of the structure, there is something familiar about the place that banishes your fears once you are actually inside the patient system. No matter who you are, you know that you are in good hands, that people are giving you the best care they can. Maybe it’s because of our size. Or it’s that eclectic mix of familiarity and neighbourliness, which no attempt at formality and efficiency and management systems can ever quite overcome.
Mater Dei has something that other national health services can only dream of. It’s wonderfully human.