Unions consider action on bed shortage

Three medical unions are considering industrial action at Mater Dei Hospital over the bed shortage problem which they feel has reached a critical point.

Independently of each other, the Medical Association of Malta (MAM), which represents doctors, the Malta Union of Midwives and Nurses (MUMN) and the Emergency Nurses’ Union (ENU) said they were tired of the situation and were looking at possible industrial action as a measure of last resort.

Two of the unions did not give details of the action they would take, if any, while the MUMN said it might issue directives connected to day surgery if the bed shortage there was not solved by Monday.

The three unions were asked for their reactions to the bed remodelling exercise proposed by the government. They were practically unanimous in their reactions: the exercise was a waste of time since the causes were already known and immediate action was needed.

The general view was that shortage of beds was causing undue stress on their members and stripping patients of their dignity.

Earlier this week, Health Minister Joseph Cassar said an exercise would be carried out at Mater Dei Hospital to establish how each bed was being used and to consider in which areas the number of beds could be increased.

The state hospital has been plagued with the problem ever since it opened its doors to the public three years ago. With 850 beds, it has less bed-space than the previous St Luke’s Hospital.

MAM’s president Martin Balzan and ENU president John Zammit both said the “unacceptable” situation was pushing them to consider industrial action.

MUMN president Paul Pace said the union would have no choice but to issue directives to its members if the bed shortage at the day surgery ward was not solved by Monday.

The “obvious” action to be taken by the union would include directing nurses to handle only that number of patients equivalent to the number of beds left available for day surgery.

“The bed situation has gone from bad to worse,” he said. Apart from the problems in four corridor areas — area two in the casualty department, the paediatric corridor, holding bay and discharge lounge — where patients were nursed on stretchers, only 14 out of 65 beds in the day surgery unit were used for the intended purpose. The bulk of the area was being allocated to patients after they had been seen in the casualty department.

He said the bed remodelling exercise only made sense if there were beds left to move around – which was not the case. Remodelling only offered a temporary “short-term patch work” as the problem was much more deep-rooted.

One of the main issues, he maintained, was the lack of geriatric services in the community and lack of legislation protecting the elderly from being abandoned in hospital by relatives, where they blocked beds. Then there was the lack of palliative care, for people with incurable illnesses.

Even if these issues were tackled, there were still not enough beds to cater for the needs of the population, he said. As a long-term solution, there needed to be a proper study of the country’s needs.

“The bed situation at Mater Dei is untenable. It’s unacceptable that you have 70 per cent of emergency patients in corridors...The association will be meeting next week and may have to act... industrial action could be taken,” Dr Balzan said.

Mr Zammit, representing emergency nurses, said his union had recommended turning an area, used for staff uniforms, into an area for people awaiting beds.

“The staff and patients are suffering... we can no longer exclude issuing directives as we are overworked,” he said, adding he would wait for the outcome of a recent meeting with management.

“They can do the remodelling exercise but we know what the problems are... We don’t have time to waste... the union is willing to help,” he said.

In a statement, the Health Ministry said it was shameful that the MUMN would resort to industrial action, to the detriment of patients, when it knew the hospital management was trying to address the bed shortage situation.

Questions sent about the unions’ reactions to the bed remodelling exercise remained unanswered by the time of going to print.