Patients requiring emergency surgery are at times made to wait because there are not enough nursing staff to man Mater Dei's emergency theatres, The Sunday Times has learnt.
A surgeon who spoke on condition of anonymity said: "It is unheard of not to have an emergency theatre available. There are times when a patient who needs to be operated upon urgently has to wait for hours because the emergency theatre is not functioning."
He said there were patients who risked losing a limb, or even dying, if they were not operated upon immediately.
"We regularly book patients for emergency surgery in the morning and have to wait until elective operations are finished, sometimes late in the evening," he said.
He said it was only when an operation was a clear-cut emergency that elective surgery was stopped, adding to the already-long waiting lists.
"Why should a patient who is awaiting surgery to have an abscess removed, and is in extreme pain, have to wait for hours for his operation, if not more than a day, because we do not have enough staff to operate more theatres?"
When contacted, a spokesman for the Health Parliamentary Secretary said that all acute emergency operations were carried out at once.
The spokesman said this happened "irrespective of which day of the week it happens or at which hour", adding that no planned or elective operations had been cancelled this year due to staff shortages.
However, the surgeon said: "There are surgeons who only operate in the afternoon because there is not enough available theatre time in the morning. Others only have one slot a week. They are desperate to work more."
He blamed the problem on an acute shortage of theatre nurses. And there is no sign of respite since the nurses' union opposes the introduction of theatre technicians, a new breed of paramedics who could help cut the waiting lists for operations.
When contacted, president of the Association of Surgeons of Malta Gordon Caruana Dingli said: "At the moment, emergencies are performed in the late afternoon and evenings, after planned surgery is completed. It is a good idea to have a designated emergency theatre that can be used in the mornings...
"At present, when there is a severe emergency, planned surgery lists can be stopped to allow the staff to be used for emergency cases," he said, adding that the standard of theatre nurses was very high and problems arose not because of their capability but because of a shortage of manpower.
However, he said, while an increase in theatre nurses would allow more operations to be carried out, this would probably result in another bottleneck due to a shortage of beds in the day care unit, surgical wards and nursing staff in wards.