OPENING SPEECH BY DR LOUIS DEGUARA, MINISTER OF HEALTH, ON THE OCCASION OF "SAFE MANAGEMENT OF HEALTHCARE WASTE" SEMINAR TO BE HELD ON THURSDAY 25TH JANUARY 2001

Clinical waste has, over the past months, made the headlines several times. This is understandable. Hospitals, being treatment centres for conditions including infectious disease, have long created apprehension amongst the general public. It is therefore understandable that any issue that deals with waste from any hospital is bound to be an emotional one. It is however important that we tackle the matter in a scientific way aiming to assess the situation objectively and devise clear policies and interventions based on the latest available scientific advice. My Ministry has over the past years been highly proactive in the issues of clinical waste. In fact a number of individuals from the health department have been working continuously on a holistic approach on the management of clinical waste in our hospitals which is reaching further than just tackling the problem of St. Luke's hospital incinerator. We have consulted numerous authoritative sources both in Europe and in the US. Key officials from the Department have visited hospitals abroad to assess various waste management techniques in operation. What is equally important, we have worked hard and consulted local stakeholders to ensure that any system introduced would make sense and give good results within the local context.

This seminar marks the start of a campaign within the various entities of the Department to improve waste minimisation and particularly proper segregation between clinical and domestic type waste at ward and clinic levels. We are planning ahead for the next decade or two. It is therefore worthwhile doing things properly rather than rushing into improper decisions, which would give counter-productive results.

The Health Department has completed a comprehensive waste management plan to handle clinical waste from production to disposal. The Department also intends to have specific managerial personnel with direct responsibilities for improving segregation and transportation within the hospital as well as training of all personnel involved.

This comprehensive approach has not been limited to infectious waste. To this end we have for example avoided the easy way out of dumping cytotoxic and expired pharmaceutical products at the Maghtab landfill. Over the past years, these have been diligently stored in proper facilities. Following the recent ratification of the Basle convention, we will soon be issuing a call for interested parties to transport this waste to mainland Europe for incineration in designated facilities. We are also concious that hospitals produce large quantities of non-clinical waste. We will be looking seriously at recycling options for these types of waste, including paper and cardboard which are presently produced in large quantities in Healthcare settings.

For the general public the issue of clinical waste has often equated to the old incinerator at St. Luke's Hospital. My Ministry has long recognised the need to change this old piece of equipment. However it was also believed that this intervention could not take place until a clear direction was clarified at both national and departmental levels. The recent developments in the national waste management plan, as well as the finalisation of the Health Division policies, have now put us in a position to be able to issue a call for tenders to replace the old incinerator with a state-of-the-art clinical waste disposal plant which will be initially sited at SLH but could be transportable to the new hospital on its completion. We are optimistic that the plant will be in place and running by the end of the year. At the same time the old incinerator will be removed. The new plant will work on non-burn technology, thereby avoiding all the health hazards environmental issues that have been associated with the current incinerator. It will in effect convert potential infectious hospital waste into a harmless, unrecognisable end-product which is by far safer than household waste and which can be disposed of in a landfill.

The Division anticipates that this wise approach toward clinical waste management in the hospitals would also favour private entities and the community. We are confident that the Environmental Protection Department will, in the near future, require clinical waste management on national basis to comply with EU directives encompassing all producers of clinical waste, whether these are from government hospitals, private clinics, solitary medical and dental practitioners, and even patients in households. To this end it is our intention to make available, on a commercial basis, the soon-to-be introduced clinical waste facility to clinics, local councils, individuals, and companies who need to dispose of clinical waste. In this way, entities that produce reasonably small quantities of clinical waste will have proper facilities where to dispose of their clinical waste without having to invest in capital equipment.

I would like to conclude by wishing you all a successful seminar and look forward to your discussion as being an additional consultative tool in our efforts to improve our management of clinical waste.