The Health Division believes a union directive affecting nursing aides, care workers and health assistants will negatively impact the most vulnerable groups.

The General Workers' Union notified the Health Division yesterday it had issued a work-to-rule directive in connection with the workers' salaries.

The union said it wanted an immediate solution to the disparity in the salaries of workers in various grades who performed the same work and had the same responsibilities.

While the health authorities are insisting that this was the result of an agreement reached years ago, the GWU is maintaining the agreement mentioned is no longer valid because of amendments to the Employment and Industrial Relations Act.

The union's decision to take industrial action came shortly after the government sanctioned a Lm195 yearly allowance to care workers.

A spokesman for the Health Division told The Times the union's directive had basically reduced the workers' duties to serving dinners and doing some reception work. Health Centre doctors had to examine patients without access to medical records.

"As a result of these actions, patients and the elderly are not being assisted out of bed," he said.

"They are causing patients unnecessary suffering. These issues are resolved around a table, not through such ways."

In a statement last night, the Health Ministry said the workers would still be paid their full salaries. The government has notified the GWU it was prepared to meet and discuss the issue next week.