Doctors declare industrial dispute

The Medical Association of Malta has declared an industrial dispute over the administration of intravenous (IV) medication and hinted at the need to issue directives to its members if patient safety were compromised.

The doctors' association accused the Malta Union of Midwives and Nurses with failing to provide a number of nurses for the continued delivery of essential emergency services as required by law.

The root of the issue was overcrowding in hospital, something on which both the MAM and the MUMN agreed.

Nurses stopped administering IV medication to patients over a month ago on the instructions of the MUMN in order to put pressure on the authorities to solve the staff shortage and overcrowding in hospital. Doctors had to administer the medication themselves.

When contacted, a spokesman for the Health Division said the division was trying to solve the current situation.

The division also hoped that the MAM would not resort to any actions through which patients would suffer, the spokesman added.

On its part, the MUMN insisted that intravenous medication fell in the line of duties of doctors and not nurses.

The MAM said it noted with regret that nurses were still being directed not to give IV medication to seriously ill patients.

Unfortunately, the MAM said, the MUMN had failed to ensure a continued delivery of essential and emergency services as required by law while the Health Division to date had failed to enforce the Employment and Industrial Relations Act, to protect patients from such dangerous omissions, resulting from the discontinuation of an essential service.

The emergency medical service provided by doctors was now greatly strained, as doctors, already overburdened by the overcrowding problem, now had to take on additional work usually done by a much larger number of nurses, it said.

The MAM added that this was detrimental to patient care and could potentially have serious consequences, especially if a number of emergencies arose at the same time.

For this reason, the MAM gave notice of industrial dispute saying it may need to issue directives to its members if patient safety was compromised.

MAM also reserved the right to take any legal action it deemed fit.

It also noted that members of staff who were on the essential services list were not protected by the Employment and Industrial Relations Act from disciplinary action, civil action for damages and criminal prosecution for negligence if they caused an interruption in the delivery of essential services.

The MAM said it hoped that "a situation of legality and safety" in the hospital would return as soon as possible.

But MUMN president Rudolph Cini accused the MAM of trying to mislead the public and reserved the right to take legal action.

Whatever the MAM said, intravenous medication was an extended role to the nurses' duties, Mr Cini reiterated.

"Nurses would not be failing in their duties if they did not administer intravenous medication even if they are not following industrial action because this kind of medication was not included in their duties," Mr Cini said.

The MUMN was convinced it was acting within the parameters of the law.

If the MAM declared a dispute, this was with the employer because the MUMN was not involved in any dispute with the medical profession, he added.

Mr Cini said IV medication to patients in the present circumstances of staff shortage and overcrowding was too risky.