Doctors fear that fewer operations will be held

A Mater Dei Hospital circular sent to doctors with new instructions on how to manage theatre workloads would result in fewer operations being carried out, the president of the Medical Association of Malta, Martin Balzan, warned.

I’m not averse to changing work practices but you have to look at the bigger picture

He was categorical, saying that “the solution cannot consist in cutting the number of operations”. He criticised the government for not having consulted with the MAM before issuing the circular.

The circular informs doctors, among other things, that “postponed or cancelled procedures due to a lack of ITU beds must be undertaken within the same month”.

A Health Ministry spokesman denied that the circular’s intention was to reduce the number of operations, saying that it sought to better organise hospital workloads for all parties concerned.

Issued last Sunday, the instructions were presented by way of appeasing the Malta Union of Midwives and Nurses, Dr Balzan said. The MUMN had threatened industrial action if working conditions in operating theatres were not improved by the end of the month,

Dr Balzan felt the nurses’ union had jumped the gun when it made such a threat, seeing as 250 new nurses were set to enter the workforce in June. The influx was likely to ease several workload issues.

He argued that operating theatre workloads were intense, with the number of operations at Mater Dei increasing by some 10 per cent year-on-year. He used this figure – as well as Mater Dei’s average patient stay of 6.3 days, low by EU standards – to bat away government charges of doctors’ inflexibility.

“I’m not averse to changing work practices but you have to look at the bigger picture. Doctors and consultants have worked extremely hard over the past years.”

Health Minister Joe Cassar told The Sunday Times some weeks ago that doctors’ and nurses’ aversion to changing their work practices were to blame for bed shortage issues at Mater Dei.

It was a charge which union representatives for both professions refuted, with MUMN president Paul Pace saying the existing hospital was “just too small”.

There was no silver bullet to resolving bed shortages, Dr Balzan contended, arguing that although a lack of beds manifested itself in Mater Dei, problems lay elsewhere.

“The truth is we lack community services for the elderly. Although we’ve increased bed supply over the years, we haven’t managed to match demand,” he said. “The problem’s been coming since the 1980s but politicians only think in the short-term,” he sighed.

Resolving shortage issues was only possible in the long-term – “we’re talking 2020” – and would require accurate, long-term projections concerning bed demand.

Dr Balzan excoriated the government for its decision, as part of public expenditure cuts, to reduce the number of doctors at health centres.

Deriding the decision as “misplaced austerity”, Dr Balzan argued it was contradictory to first announce plans to better equip health centres only to then cut down on their medical staff.

But as spats between the MUMN, the MAM, the government and Mater Dei management continue , Dr Balzan was eager to reassure the public that medical care would not be impinged.

“This is a trade union matter: within hospital, doctors, nurses and management are all working together with absolutely no problems at all.”