Outgoing GHA chief hails progress but says healthcare must continue evolving or risk decline 

Healthcare must evolve and develop with global trends “or it goes backwards”, the GHA’s outgoing Director General, Kevin McGee, said, as he praised the organisation he has led for the past two years and said it “stands with the very best”. 

Mr McGee, who is due to step down from the post in the coming weeks for personal reasons, was addressing a well-attended GHA public meeting in City Hall on Thursday evening. 

A seasoned healthcare manager who had served for four decades in the NHS before coming to Gibraltar, Mr McGee offered those present a snapshot of his views on the GHA and how healthcare must evolve at a time of transformation driven by global recruitment pressures and fast-paced technological development. 

“I am immensely proud of the services that we deliver within the GHA,” he said.  

“We don't get everything right, and I will be the first to admit that, but nor does any healthcare system anywhere in the world.” 

“Healthcare is about choices.” 

“Healthcare is never black or it's white, it's always a shade of something in the middle and we always have to make decisions.” 

“But be it the frontline services that are delivered on a day-to-day basis; be it the waiting lists that we have, which are very low in comparison to international standards; be it access to primary care.” 

“Any of the markers that you choose to judge a healthcare system against, Gibraltar stands with the very best and I think we should be really proud of that.” 

Mr McGee cited the new services that were being repatriated and developed by the GHA, from the catheterisation laboratory to the new oncology service and the work on community mental health services. 

“All of these are examples of investment, innovation and forward thinking that's going on in the delivery of healthcare across Gibraltar,” he said. 

Mr McGee was clear though of the need for constant improvement, including ensuring the training and development of a local workforce against the backdrop of increased global demand for healthcare professionals. 

Mr McGee said every healthcare service in the world was facing pressure in recruiting staff. 

He praised the “remarkable work” done with the University of Gibraltar in recent years, noting that the GHA was currently employing 16 additional nurses who had completed their training in Gibraltar. 

“That's the workforce not just of now, but of the future,” he said. 

“And it's really important that we continue to grow that workforce and invest in local people.” 

At the same, the GHA would always need to recruit externally, “it’s the nature of healthcare”, and it was important too to ensure Gibraltar can continue to attract “the best staff”. 

“The one truism I know about healthcare is it can never be static,” Mr McGee said. 

Healthcare in Gibraltar was “fundamentally different” to 30 years ago and will be undergo drastic change again over the next three decades. 

“Healthcare cannot be static,” Mr McGee added.  

“Healthcare either evolves and develops or it goes backwards.” 

Another challenge faced by Gibraltar is that, while the GHA has strong links with UK and Spanish hospitals, in a crisis “we can only rely on ourselves”. 

“That means we have jeopardy, and that means we have to think about the structure of the services that we offer, and how we make those services resilient and fit for anything that will come our way,” he said. 

“That carries risks in its own right, and there's additional costs that have to be incurred as a consequence.” 

Ultimately, it means the GHA must be ready to deliver not only its day-to-day services, but also to respond to any crisis situation. 

The GHA must also be ready to embrace major changes in global healthcare, from genomics and artificial intelligence to digital records and the globalisation of the workforce, that were fundamentally transforming how services are delivered. 

Health Minister Gemma Arias Vasquez also addressed the meeting and spoke of her passion for improving healthcare services in Gibraltar, rooted in a personal experience as a parent. 

She outlined various initiatives under way in the GHA, from the development of new life-saving services – she highlighted the cath lab and the new oncology suite that will open by the end of November as key examples – to sharp reductions in waiting times for surgery, from 23 weeks on average in 2022 to nine weeks now, and in orthopaedics, down from 40 weeks to seven weeks. 

And she said too that the change was driven largely by patient input, including a patient feedback survey on the PCC which is currently being reviewed and whose results will be published in due course. 

“In the last two years, we have begun to put the GHA on a stronger, fairer and more modern path,” she said.  

“Reform is not easy, believe me. It's hard work.” 

“It means often having to have difficult conversations.” 

“It means saying to people that things must change.” 

“It means listening to patients who feel the system has not worked for them.” 

“But I do genuinely believe that real reform is happening in the GHA.”  

“I genuinely believe that the GHA has the potential of becoming a groundbreaking institution, which leaves the NHS in its wake on waiting times.” 

The meeting also heard presentations from Dr Roger Moore, a consultant cardiologist at the GHA who outlined the importance of the cath lab in providing rapid emergency intervention that critically saved time in emergencies and, in the past week alone, had treated five heart attack patients. 

Dr Helen Carter, the Director of Public Health, delivered a presentation on the GHA’s screening programmes and how these were being developed, highlighting the importance of early diagnosis and intervention in ensuring good outcomes.