Revise healthcare industrial relations

Nurses do more than a job. To be a good nurse, one must have love and passion for the task, a conviction that caring for others is a noble act. Nurses have to be paid for that, of course, but the commitment that is required cannot be compensated with money alone.

Nurses have rights. They include those inherent in the job, including the right not to be unduly exposed to risk and to work decent hours that, in addition to leaving them their free time, also do not tire them out unduly, and that in the interest of patients too. They work in the most sensitive of sectors but nurses enjoy freedom of association like other workers. They can join any union they like, in particular that set up specifically to protect their interest – the MUMN (Malta Union of Midwives and Nurses).

As with other public sector unions, when the MUMN takes industrial action in a trade dispute with the government, it is the public that is hit – not, as in the competitive private sector, a company’s output and profit. Essentially, the purpose of threatened or actual public sector industrial action is to bring pressure to bear on the government by mobilising public opinion against it.

Is the MUMN doing that in its dispute with the public administration? I doubt it. Leave aside the legality of the action – which requires the registration of a trade dispute not mere disagreement over issues that directly or indirectly affect the union’s members. Any action that affects public healthcare, at health centres or the state hospitals, is unlikely to attract sympathy.

That is not enough reason for the MUMN never to disagree with the government or to refrain from threatening to resort to industrial action. Rights – that concept again – have to be respected. Nevertheless, there is a moral as well as legal limit to the extent to which MUMN members should use patients and their concerned relatives to pressure the government.

The latter must not take advantage of that limit. Dates set in negotiations have to be respected. Planning has to ensure the right conditions for patients and for the medical care staff whose responsibility it is to administer to them. In this regard, the government has failed to plan the proper running of Mater Dei Hospital. That failure has been in the making for years; it did not come about overnight.

Among other things, it has resulted in a shortage of nurses, bringing about abnormal pressure on nurses who have to work undue extra hours to fill the resulting gaps. That is one of the reasons for the MUMN’s current industrial action directive. It objects to a numerus clausus for student nurses at the University. The University says, so far, no applicants for the nurses courses have been left out – Matsec results are still awaited. They are due by the end of this month.

Even so, if capacity in the University and hotel-training capacity is fully met, would it be right to try to stuff in more students, with the negative effect on quality that brings about? The short-term solution to a problem of the government’s creation can only be to employ expatriate staff.

Hospital personnel, to my mind, give essential services at all levels. To withdraw any of those services is to hurt those who require medical attention. Continued withdrawal cannot be justified even if the cause for such withdrawal were just.

The MUMN would show humaneness and perspicacity if it decided to withdraw its directives and to return to the discussions table to air its views and press for whatever action can be taken. On its part, the government has to be as responsive as circumstances permit.

On a longer term basis, it is clear that a detached review of the industrial relations structures applicable to the medical care service is required. It cannot take place in the present brittle situation. But it cannot be put off for long. It is not fair for the public to be used as both a hostage and a bargaining chip in this extremely sensitive sector.

Healthcare personnel’s rights have to continue to be recognised and protected. That can be achieved in ways that exclude healthcare staff, nurses and others putting patients’ wellbeing in danger.