'Wrong for doctors to dictate matters'

Decisions within health centres cannot be taken by unions but by the management, Social Policy Minister John Dalli said in remarks critical of the directives issued by the doctors' union.

He said it was wrong for the Medical Association of Malta (MAM) to take matters into its own hands.

"MAM made some requests which we are studying but we will not accept to be dictated to by the association," he said in comments to the media a day after MAM issued hard-line directives which will see half of Malta's health centres remain closed from Monday.

When asked whether the authorities would be taking any legal action to ensure that the clinics are not closed, Mr Dalli said this was not an issue of legal action but dialogue.

"We have to find solutions which ensure that we get the full value from those working in clinics and hospitals," he said.

"The health service cannot revolve around the convenience of doctors who want to juggle their work in the clinic and their private practice," he said, adding that everything has to be centred around the patient.

He also insisted that health centre doctors needed to take on more responsibilities and stop sending patients to hospital for small ailments.

"You don't need to send someone to Mater Dei for a blood test," he lashed out.

MAM president Martin Balzan said that productivity was already very high, with health centre doctors seeing some 240,000 patients every year, and only few referred to hospital.

However, he continued, when there was a doubt about patients whom the doctors were not familiar with, they were sent for further investigations. "We will not take risks with patients' health," he said.

The doctors' union is also considering directing doctors at the hospital's emergency department not to see patients who are not referred unless it is a clear emergency should the department be inundated with people as a result of the clinics' closure.

"There are people who go to emergency because of a cold or a sore throat," Dr Balzan said.

Although he recognised that there was a shortage of health centre doctors, Mr Dalli said it was imperative to concentrate on the introduction of work practices which increased doctors' productivity and their contact with patients.

The MAM council issued the directives on Monday evening, under which doctors at the Qormi, Rabat and Cottonera health centres will report for work at other clinics from next Monday while the Gżira health centre will only be open half day.

The union complains that it has been calling on the authorities to concentrate human resources in fewer clinics as a short-term measure to alleviate the shortage of doctors but that no such action has been taken.

In Parliament on Monday, Mr Dalli forcefully attacked wasteful work practices in the health sector, saying that these had to be addressed so that available resources could be made better use of.

Referring to the shortage of doctors, he said this was not an issue of the government not wanting to recruit more people.

Mr Dalli said talks with MAM were still ongoing with a view to possibly averting the strike. Although MAM was one of the trade unions that least had a habit of making strike threats, such threats by all trade unions must stop because they caused intolerable harm to the well-being of those on the receiving end.

Contacted by The Times, Dr Balzan said there was still room for discussion before the directives kicked into force.