Auditor General Charles Deguara presented the performance audit report in caption to the Speaker of the House of Representatives Anġlu Farrugia. NAO’s original 2018 study had put forward a number of recommendations intended to address the issues and concerns related to Mount Carmel Hospital (MCH) and by implication, the Mental Health Services (MHS). This follow-up study was therefore intended to assess government’s progress in implementing this Office’s related recommendations.
This review positively noted that all recommendations put forward in the NAO’s original 2018 report were accepted by MHS. More importantly, implementation, albeit to different extents, had been registered on more than half of them, including those considered by this Office as being the more critical.
NAO noted that there is clear intent by MHS to implement the former’s recommendations regarding improvements to MCH’s structural design, safety, and ambience, with refurbishments and structural works being already undertaken on more than half of the hospital’s wards. Notwithstanding, NAO remains concerned with the state of the remaining wards which, since the 2018 report, have largely remained in similar, less than desirable, condition. This Office considers that such an environment undoubtedly still impinges on the patients’ and staff’s overall wellbeing. NAO also remains concerned about the unsuccessful attempt to secure a temporary acute hospital to relocate patients from MCH, but recognises efforts undertaken so that MCH itself is rendered safer and better suited for mental health patients.
This review has also shown an improved situation regarding MCH’s security personnel however, it also highlighted the NAO’s concern about the insignificant progress registered on the recommended improvements with respect to the hospital’s CCTV systems and the management of master keys.
Improvements were also reported on MHS’s resources, with NAO noting an increase in both recurrent and capital financial allocations towards MCH between 2018 and 2022, as well as a reduction in staff shortages. While these improvements are undoubtedly commendable, this review however found that these still do not amount to what MHS considers optimal, mainly as the hospital faces significant external challenges to recruit the total required human resource complement, and due to the fact that MCH did not manage to fully utilise the funds which were allocated to it for capital projects in the past years.
The launching of a mental health strategy, and MHS’s evident accomplishment to drastically reduce the number of in-patients at MCH who do not strictly require hospitalisation in a mental health institution, was also positively noted in this review. This ties in with the significant effort which has been invested in the strengthening of MHS community services, most notably insofar as human resources (even if the ideal complements still must be reached) as well as communication between community clinics/centres and central MCH are concerned. Notwithstanding, this Office remains concerned about the evident challenges being posed on those community services which are housed in premises which are either inadequate or too small to suitably cater for mental health out-patients.
These issues, along with others, are comprehensively presented in the audit report together with this Office’s recommendations. This report, in its entirety, may be accessed through the NAO website: www.nao.gov.mt as well as on the NAO Facebook page www.facebook.com/NAOMalta.
Source: Office of the Prime Minister