Updated: MAM writes to PM, warns of 'major industrial action'
(Adds comments by Frank Portelli that patients have to come before politics)
The Medical Association (MAM) has written to the Prime Minister warning that it has been "inevitably pushed to order major industrial actions" in the health sector.
The warning was made days after half of Malta’s health centres remained unmanned by doctors for a day following a dispute about the shortage of doctors in the government clinics.
The dispute between the MAM and the government reached new heights on Thursday when association officials walked out of a meeting with Social Policy Minister John Dalli. Mr Dalli had presented the doctors’ representatives with options to keep all health centres open, including at night, using the present complement of 69 doctors.
This was interpreted by the MAM as the government going back on the agreement reached on Monday, which stated that the Gżira health centre would no longer operate during the night and that health centre doctors would only man two out of the Gżira, Qormi, Rabat and Cospicua clinics in the afternoon.
In its letter, the association said that last Monday it signed a formal agreement with the Ministry for Health and Social Policy which was not being honoured, with the result that trust and the fiduciary relationship between employer, employee and trade unions was being undermined. As a consequence this was fomenting militancy amongst trade unions in the health sector.
"Is this now formal government policy or is this just the policy of this particular ministry not to recognise signed formal agreements, and re‐attempt to renegotiate them after they have been signed and sealed?" the association asked.
It pointed out that the collective agreement for government employees clearly stated that for work schedules to be altered there was a mandatory six month period of discussions. On Thursday, Social Policy Minister John Dalli threatened MAM members at health centre that he would change their work schedule as from next Monday and publicly chastised MAM for upholding its member’s rights, the association said. Was this deviation from the government collective agreement a new government policy or something particular to the health ministry?
It said Mr Dalli has also publicly declared that an agreement had been reached with the St. James group of hospitals to deliver primary health services. As this contract would run into millions of euros, why was a tender not issued by the director of contracts? Was this part of official government policy to issue such large contracts without a tender or had there been a change in government regulation?
The MAM said that since the declaration of an industrial dispute, its members had faced an unprecedented wave on intimidation.
"Doctors obeying directives have received what was interpreted as an intimidatory letter from the director of primary health care. Furthermore members have been threatened by the ministry that they may be locked out of their place of work, and primary care farmed out to the private sector. MAM is now informed that the GP training scheme may be liquidated. Is intimidation now part of the Government of Malta’s industrial relations, or is it something specific to the health ministry?
The MAM said that the Maltese people expected public replies to these questions in the interest of safeguarding democratic principles.
MAM President Martin Balzan said he hoped this letter would serve as an eye opener to "whoever has abandoned democratic values, and the commitment to legality".
The MAM is expected to adopt directives for industrial action at an extraordinary general meeting called for next Tuesday evening.
PATIENTS BEFORE POLITICS - PORTELLI
In a statement, Nationalist EP candidate Frank Portelli expressed cocnern over the escalation of the dispute.
"Major Industrial action is a threat to the patients' health and cannot be justified before all other avenues have been exploited. We as doctors should put patients before politics – and we doctors should show compassion to our patients at all times - or risk being labelled as mercenaries and not as true professionals," Dr Portelli said.
He added that he expected that the MAM would do its duty and exploit all possible avenues to reach an honourable settlement with the government through discussion.
Solutions would not be achieved by major industrial action on the eve of an election and any threat to start major industrial action was likely to be interpreted as a political move, he said.
"The Prime Minister Dr Gonzi has already expressed publicly that his Government is ready to achieve a compromise solution through discussions with the Medical Association. I therefore encourage MAM to go back to the discussion table and seek a just solution," Dr Portelli said.
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R. Bueja
May 25th 2009, 09:18
Naive Francesca Abela forgot about how many strikes used to be in the 80's. Have it not crossed your mind that maybe, just maybe, this government is so decadent that with his laissez faire is threatening to destroy what we maltese people have been paying for with our taxes for decades, i.e. our health? And to add insult to injury, Gonzi comes out to say that we will begin to pay for it. Paying for services that, due to short of staff thanks to his government, we are not getting!
R Axisa
May 23rd 2009, 17:11
It's true that the welfare of the patients should come first, and I agree. But how I wish the same was said, possibly by the very same people who are saying this now, way back in 1978 during the doctors' strike, which continued for weeks and months!!!! - irrespective of the reason why the strike is all and was all about.
carmel zammit
May 23rd 2009, 15:30
@j feneck listen chap the management is made up of doctors and nurses mostly and they know their own cries and who are you to tell the doctors get out imagine just 10 minutes withot doctors and nurses what if you go sick as all humans do even gps are in mam so think before youwrite as you might need a doctor JUST NOW
carmel zammit
May 23rd 2009, 15:20
what the blinkers are you thinking.do youimagine that if you need medical aid you are not going to get it ?what do you think our doctots and nurses are?inhuman? you can walk out in a factory or an office but you cannot refuse somebody treatment?even if the hospital is full up nobody was ever sent home without being treated or admitted BUT doctors and paramedics are human and feel the burn out much more than other workers in haste and confusion only the patient suffers a wrong diagnosis makes a bad prognosis .all will be settled
M.Bezzina
May 23rd 2009, 15:15
@Francesca Abela
Ma nahsibx li it tobba u nurses jistrajkjaw mill ewwel laqgha mux ekk!!Nimmagina li ilhom isiru diskussjoniet bhall meta in nurses kienu qalu li xi 7snin ilu li andhom nuqqas kbir u jigi Dr.Deguara u jeghidlek li memx bzonn !!Ara issa x gara!!Kemm se tibqa tiddiskuti jekk jaqa f widnejn torox??
Tahseb li l'stikes jsiru ghalxejn?Jew fiz zmien l MLP kienu gustifikati li tistrajka?
@J Farrugia
Every person doctors, nurses, Chefs, drivers what else pay taxes!!!I always agree to discuss but I think the limit is over !!Yes I believe history is repeating itself because in my opinion when a government (sia PL& sia PN) accedes the 10yrs in power ARROGANCE takes its place!!This happened when MLP was in power 1980s and the PN is doing the same!!
A BEzzina
May 23rd 2009, 15:07
This business about paying all their studies is a load of rubbish. My son is a medical student and I can assure you all he gets is 86 euros a month. I have relative in the engineering course who get double that and nobody rubs their nose in it like you do doctors. When a doctor graduates and before he gets his warrant he will have to work far more than 40 hours a week and his pay is absolutely ridiculous.
g.c.Forte
May 23rd 2009, 14:48
" PATIENTS COMES BEFORE POLITICS" Is this coming from the same people that in the year 1977,took part in the famous "DOCTORS STRIKE", when the labour was in government ? Does POLITICS CAME BEFORE THE PATIENTS in 1977? I have lost my mother at the age of 49 because of that strike, it was the same year that letter bombs were sent to Doctors that did not strike. I am a labourite, and I urge the government to do the same, like the labour government did and bring doctors from Pakistan and other countries. The doctors should always remember that while they were studing medicine to become Doctors,we the common citizens were paying and still paying taxes to cover their stipends.( when I was young I did not have that privilage).
J. Debono
May 23rd 2009, 14:45
@ Frank Portelli
Dear Dr. Portelli. If you read the newspapers, you will find that there is an agreement signed between the two parties.
All MAM is asking, is for the Government to honour it first, and discuss after.
No one can pretend that MAM will enter into discussions with the Ministry of Health, who does not honour an agreement signed by both parties.
You of all people - as a medical doctor and as a candidate for the EP - should understand that the basis of all discussions is TRUST. Let the Minister of Health be trustworthy, and MAM will enter discussions.
Adrian Cachia
May 23rd 2009, 14:19
Trying to grab some votes Dr. Portelli???
Braden Sammut
May 23rd 2009, 13:29
Minghajr ma nnehhu d-drittijiet tal-haddiema u l-unions li jirraprezentawhom nahseb li l-unions ghandhom ikunu sensittivi ghall-htigijiet tan-nies. Ma nafx ezattament meta bdiet il-kwistjoni pero tul l-istorja ta' pajjizna kull gvern iffaccja tgheddid minn unions lejliet xi elezzjoni jew ohra.
Jehtieg li verament insahhu mhux biss is-servizz moghti lill-pazjenti imma l-ewwel u qabel kollox it-tmexxija tas-servizz specjalment fl-isptarijiet. Ma jistax ikun li jkollna gisem tajjeb imma bla ras. Kultant inhoss li f'pajjizna naqset hafna d-dixxiplina f'certi setturi pubblici li jistghu jkunu l-kawza tat-tgergir (kultant gustifikat) u l-apatija tan-nies u nfieq zejjed.
Hawn min ra kazijiet fejn tmur go klinika tal-gvern, ikun hemm 3 tobba imma wiehed biss jara l-pazjenti?
Jew, tmur l-ispizerija tal-Gvern u tigri xi haga simili?
Ma rridx ninfama lil dawn in-nies imma nixtieq nara jekk din il-percezzjoni ta' certi nies hix minnha.
KCaruana
May 23rd 2009, 13:16
Well done MAM! After years of complaints by doctors about poor working conditions and the helter-skelter way human resources are managed, finally doctor's rights are being voiced.
@JFarrugia-not only doctors get educated for free so don't single them out! Anzi doctors are one of the very few professionals that come out of university and actually give their service back to the state. Go barking up someone else's tree! And yes - that's what doctors are doing: getting out. Why do you think the maltese healthcare system is in this situation?! Coz the maltese government doesn't give a fig about it's doctors. Laqwa li jahdmu it-tobba u nisfruttawhom. Great attitude!
Wake up Malta: Doctors are human beings too and want to have time to meet friends, create and actually enjoy a family. We're not work-machines and deserve to be given the opportunity to progress in our careers, have protected working times, natural breaks and a fair salary.
Does the public even know that a junior doctor (i.e. non-consultant) can work anything from 80-120 hours a week? In which other profession does this happen?!
Thanks MAM for putting doctors first and saying stop to all the government's breaches in the collective agreement.
Leo Said
May 23rd 2009, 13:05
A doctors' strike is of course always a disadvantage for many patients.
Considering the status quo in Malta, doctors' strikes in Malta are licit, if not imperative. Two main reasons would be that (1) patients be made aware that excellence in medical care cannot be a freebie and that NI contributions in Malta are far from adequate to sustain an excellent service and (2) that government, regardless of political colour, wakes up to its responsibilities re health care and re administration of health care services.
Moreover, private hospitals should per se keep out of any industrial dispute between MAM and government.
Galea. L
May 23rd 2009, 12:59
Francesca Abela
"In my opinion Doctors and Nurses should NEVER resort to strike action."
You can only say this if YOU are a Doctor or a Nurse so that you will feel what they are feeling Francesca. Strikes are the order of the day during Gonzi's government because of his incompetence and sweeping all the problems under the carpet hoping that they will go away. At least the PN governments are now getting a taste of their own medicine that they fed the people and the Labour Government when PL was in power.
J Farrugia
No Farrugia. NO ONE orders pilots to work more than the hours established by international regulations because they have the responsibility of the crew and passengers.
The same cannot be done to Doctors and Nurses because they also have the responsibility of their patients.
If Gonzi is so incompetent that although warned years before that there are not enough Doctors and Nurses and as usual he sweeped the problem under the carpet, then GONZI is to blame for the dire situation we are in.
GONZI and no one else.
Francesca Abela
May 23rd 2009, 12:56
C. Cilia - No it is not Dr. Gonzi's legacy at all. More likely it seems to be that some Unions wake up during NP governments. I am also seeing a pattern - the minute a Union comes to an agreement with government on certain issues, another Union makes other claims. What exactly are they trying to do - can they not hold on until the worldwide economic situation is back to normal - or is there a hidden agenda ? Think of the country first for a change.
Jeremy J Camilleri
May 23rd 2009, 12:53
J Farrugia is living in cukoo land.
WHy does he make such senseless statements?
Otherwise get out?
Lets hope that the MD's don't read these blogs and take his advice.....I;m SURE that they don't have other alternatives.....
A Borg
May 23rd 2009, 12:43
@ all those lashing out to the MAM directive.
if doctors want to get out, believe me they can as in UK a simple GP has a wage of
75,000 sterling per annum plus benefits. so please, a bit of respect for people who
work excessive hours (and btw that affects their performance and makes them liable
to making mistakes) and get paid peanuts in return.
not everybody spends 5 years in one of the hardest courses only to be ordered around.
nobody seems to ever grumble about anybody else getting free education and then not giving anything back. so please, be serious. everybody wants remuneration, so don't
demand that doctors work as volunteers :/ lawyers, accountants, teachers do not as far
as i'm concerned.
they want more humane conditions in order to offer a better service. greedy government
can dish out millions in futile projects which fo termendously over budget but not to employ
any extra doctors...
J. Debono
May 23rd 2009, 12:28
@J. Farrugia
"AND OBEYING ALL ORDERS GIVEN BY MANAGEMENT. Otherwise, GET OUT."
This is exactly the problem, doctors are getting out - either to private work or abroad! Then what about free health services promised before elections?
What the argument is all about, is, that it is high time that the government will do something to keep the doctors from getting out.
MAM has asked for nothing. It simply stated that there is not enough doctors to man all Health Centres. The Ministry of Health signed an agreement to close one Health centre from 5pm till 8am leaving 3 open Health Centres (adequate for Malta's size and population), and be responsible to man two Health Centres from 1pm - 5pm - (for a total of 7 open Health Centres).
What it is now asking, is for the Ministry of Health to HONOUR the agreement.
To man a Health Centre by only one doctor as the Minister of Health wants is reckless to say the least . Patients are not numbers, and it is true that sometimes nights are quiet, but if two emergencies (to say the least) occur simultaneously, who of the two patients will volunteer to wait!!!!
A Farrugia
May 23rd 2009, 12:20
The Government got it all wrong in the health sector....lack of staff at Mater dei, lack of staff at the Local health centres, expensive medicines, unavailability of medicines from hospital, the shelving of the pharmacy of your choice due to incompetence and mismanagement, breast screening programme shelved due to lack of funds, never ending waiting lists. John Dalli was quite right in saying a year ago that the National Health Service in Malta was in a state of neglect but one is right to ask what actions did he take during the last 12 months.
walter caruana
May 23rd 2009, 12:02
MAM is claiming that its members are being intimidated. I think it is the other way round because MAM has been openly threatening any doctors who give their service to the public against the inhuman directives given by the union
Claudine Cassar
May 23rd 2009, 12:02
@J Farrugia
@Francesca Abela
It seems to me that you have not read the article, and all the previous articles on the topic. MAM IS putting the patient first - they are not asking for more money, or better conditions for their members. What they ARE asking for is an adequate number of doctors to man the primary healthcare system properly.
What will hurt the patient is the termination of the GP training scheme in order to deploy trainees in the health centre. If I need to see a doctor, I want a properly trained one, not a trainee! And if you had the slightest modicum of sense, so would you.
Joseph Sammut
May 23rd 2009, 11:56
I have to agree with Mr. J. Farrugia. Facts are there for everyone to see, if one wants to see them.
How can these things be left to happen either by Government or Unions?
The way I see it, the more head strong MAM is, the more rotten the apple is.
Josephine Galea
May 23rd 2009, 11:50
In its letter to the Prime Minister, Doctor Martin Balzan queried whether intimidation is now part of the Government of Malta's industrial relations, or is it something specific to the health ministry. He wrote that the Maltese people expected public replies to these questions in the interest of safeguarding democratic principles. MAM President Martin balzan said he hoped the letter would serve as an eye opener to "whoever has abandoned democratioc values, and the commitment to legality". These extremely serious accusations are made by MAM, a Union affiliated to CMTU and not by TONY ZARB of the GWU.
R.Zammit
May 23rd 2009, 11:47
This issue is partly resolvable by getting newly graduated doctors to commit (bank bond) to Government service for 10 years following their free and actually remunerated university training. Same should be done with other University/MCAST graduates.
This will get young doctors to give back something to the Government and the community, and give a slightly better service to the otherwise utterly and dismally slipshod treatment one gets on our NHS. We are producing dozens of doctors annually and at least the Government's own health services will be manned
This bond, for the suggested number of years is already in practise in other sectors. Furthermore their bond should prohibit them from private practise also, thus commiting themselves exclusively to the NHS.
C.Zarb
May 23rd 2009, 11:41
@ Mr Farrugia
You may not have noticed but doctors pay taxes too. Yet do not worry too much about doctors, since their value is recognised both at the private sector and abroad. If things get worse they will simply leave for better conditions abroad (something that is happening right now). I don't know how Malta would fare without them though.
Randolph De Battista
May 23rd 2009, 11:39
I say shame on all the readers who are condemning MAM for standing up for the rights of its members! Why are we the only country in Europe where citizens lambast workers simply for defending their rights?
No worker strikes just for the fun of it, especially professionals whose work controls the lives of many.
The question I ask is, are all these unions at fault and the government on the good track? Or maybe vice versa?
Anthony Paris
May 23rd 2009, 10:36
Is history repeating itself?
C Cilia
May 23rd 2009, 10:08
This is the Gonzi's legacy - strikes all year round. Tghid il unions kollha ghandhom zball u gonzi biss jaf x'inu jaghmel??
Francesca Abela
May 23rd 2009, 09:41
Thank you MAM for always putting the welfare of the patients first! Shame on you. In my opinion Doctors and Nurses should NEVER resort to strike action. Keep on meeting with government and stay put until a solution is found to the benefit of all concerned.
J Farrugia
May 23rd 2009, 09:22
No dear MAM the Maltese people want the doctors to give their services to the nation for which they are being paid for out of our taxes. They are to work according to what the management orders if you are its employees, and not the other way round. You order the management what to do otherwise you strike. Doctors are there to serve after the people of malta have paid all your studies with you giving nothing in return. This cannot go on. If you are employed by the Hospital then you have to abide according to conscience, if you have one, with all the rules and regulations binding you to the employment contract. AND OBEYING ALL ORDERS GIVEN BY MANAGEMENT. Otherwise, GET OUT.
M. R. Borg
May 23rd 2009, 09:21
Dr Gonzi! this is alarming! Think it's time for a change in Management and a change in Ministry in the Public Health .... and in the country's interest!!