Bed capacity at St Bernard’s Hospital: A Government exercise in silencing the truth behind the numbers  

By Joelle Ladislaus 

Minister Arias Vasquez’s Gibraltar Chronicle opinion piece on bed capacity at St Bernard’s Hospital was nothing short of stunning. When a Minister relies on the statement that she has the figures and her opposition counterpart does not to make a point, it demonstrates exactly what the GSD have been saying for years, that there is no transparency under the current Government. Regardless of whether the GSLP leadership changes, the practices will remain the same; a leopard can’t change its spots. If I don’t have the figures as to bed capacity at St. Bernard’s Hospital, it is because the Minister withholds information because I’ve asked for clarification on countless occasions and the answers that we get don’t reflect the everyday reality that patients and staff are experiencing.  

The accusation that I am refusing to engage with Minister Arias Vasquez is a red herring designed to draw the focus away from the real issues of bed capacity at the hospital. I have not, and would not refuse to engage constructively, where I draw the line is in being drawn into political stunts which are set up for photo opportunities and self- congratulatory press releases.  

Minister Arias-Vasquez can’t present herself as believing in a different style of collaborative politics but withhold information from the Opposition. She can’t have it both ways.  

The same goes for her assertion that she has a “plan.” One can be forgiven for being sceptical as to whether there is such a plan given how directionless and piecemeal the Government’s approach has been.  

After all the so-called “gamechanger” that is presented as a real difference for bed capacity at St Bernard’s was not planned at all. Up until very recently the Government were insisting that the Rooke facility which was the product of its China joint-venture would be sold and not used by the GHA at all. So much for planning. This has been a white elephant that the GHA has been forced to occupy because otherwise it would not just have been an expensive flop but an empty one too.  

But if there is a plan for the GHA, for its future and bed capacity let us see it rather than have vague “trust in me” statements.  

And is the solution to bed capacity issues really as easy as saying that they will move some 70 80 patients to Rooke? We know that the Rooke facility will be full immediately on opening and that there is a long waiting-list. That may provide a temporary solution, but what happens when there are elderly acute admissions who then develop other issues requiring long-term care and cannot go home or when other persons needing long-term care present at the hospital? Won’t free beds be filled up again? To compound things the GHA has announced its intention to use some of the freed-up space for clinical spaces, and the Minister has confirmed that there will be a loss of some acute adult beds as a result. So, the problem may be exacerbated in the future and not as “resolved” as the Minister’s spin would have us believe. Where is the so-called plan on bed capacity?  

If there is to be a holistic solution that reality must be grappled with. The debate on how there can be an expansion of services for the growing elderly population is for another article, but this is a reality that looms large for St Bernard’s bed management. It is also a reality that the Government have had a long time in office to prepare for this.  

According to the Minister, St Bernard’s Hospital has 146 adult beds, not including maternity and paediatrics, but it is more complicated than that because the available beds also need to be staffed, in areas of the hospital which are appropriate and available when needed. For example, there are 13 beds in the Critical Care Unit, but those beds are, as the name suggests, for critically ill patients. Similarly, including the beds in the day surgery unit as part of the overall figure does not give an accurate reflection of the available number of beds because the whole purpose of the day surgery unit is for patients to be discharged that same day and not to remain open and functioning as a ward outside of clinical hours.  

Further, it’s a fact that the number of acute hospital beds at St Bernard’s Hospital has changed very little over the course of the past 15 years. I accept that the approach to healthcare has changed during that time and that medical advances and the day surgery unit mean that a percentage of patients will be discharged sooner. However, minimising the impact that increases in population have, as this Government does, is totally unrealistic.  

It’s part of the current Government’s style to manipulate what has been said to suit their narrative, and Minister Arias Vasquez is no different. What the GSD has said is that consideration should be given to retaining the beds that will be freed up at St Bernard’s Hospital after patients have transferred to Rooke, rather than converting those spaces into clinical space and thereby reducing the number of acute adult beds available at the hospital. This should be the case, at least until the expanded provision of elderly care is properly addressed because otherwise this unresolved issue will eventually rebound on a St Bernard’s which will no longer have any beds to solve it with.  

The reality is that we have received and continue to receive reports from service users that they or their family members are being admitted into A & E for lack of beds or that they have had elective surgeries cancelled due to bed shortages. These are not isolated incidents, they are persistent and span over the past few years, which is why we have raised the issue of bed capacity and will continue to do so.  

When the GSD raised concerns about the elderly long-stay patients who were moved into the maternity ward last month for lack of beds, Minister Arias Vasquez complained that it was not a question for politicians to become involved in. That did not seem to apply to her when she said in Parliament in November 2024 that “the action plan when wards are at capacity is to move patients to other clinical areas or other GHA facilities. There are wards, for example maternity and Rainbow Ward, which cannot be used. Obviously, you cannot mix adults and children, so there are certain wards that cannot be used for these purposes, but the plans which the GHA has in place do allow for patient movement around different wards.”  

What GHA staff deserve is to have the problems which they face daily, and which make their jobs so much harder, recognised and addressed. They deserve to be listened to and provided with adequate resources so that they can carry out their jobs safely. The public has had enough of this Government manipulating reality and keeping them in the dark about things that impact their daily lives. Transparency and accountability would go a longer way than silencing the truth behind people’s lived experiences. 

Joelle Ladislaus is a GSD MP and Shadow Minister for Health and Justice.