A number of operations were cancelled last night and more may have to be cancelled as a result of directive by the Malta Union of Midwives and Nurses to theatre nurses.

The directive was issued following John Dalli's report on the situation at Mater Dei Hospital.

"The union has already issued a directive to theatre nurses not to work unless there are three nurses available for major operations, as is  international practice.

"Nurses are fed up of appeasing the situation and instead of gratitude they received opprobrium," union president Paul Pace said this morning.

Theatre nurses, he said, were so angry that Health Minister Godfrey Farrugia had to go and speak to them this morning.

Addressing a news conference, he said the MUMN will not discuss change based on John Dalli’s report on Mater Dei Hospital unless the former health minister withdrew the allegations against nurses or proved them.

Mr Dalli wrote that trade unions had excessive leverage in collective agreement talks and some work practices needed to be changed. He said personnel were not properly monitored, some workers decided what their own job description was, and clocked off when they liked. He also complained of excessive number of shifts.

Mr Pace said "the MUMN will not participate in any committee, board or meeting on this report, not even with the Prime Minister".

Mr Pace warned the Prime Minister that what Mr Dalli was recommending was a head-on collision with the trade unions. "I do not think this is the Prime Minister's wish but if the government will seek confrontation, the MUMN is ready for it in all public hospitals," he warned.

The report, Mr Pace said, was “cowardly” and nurses were red in the face in anger.

The union, Mr Pace said, was not bothered that it was described as militant and vociferous.

“They are labels that do not bother us because we prefer to be vocal when addressing the suffering of patients caused by lack of bed space,” he said.

Mr Pace said the MUMN had expected the report to take a real snapshot that provided solutions to the problems it had been flagging for years.

But “the snapshot was based on Mr Dalli's convenience, it was unreal... It was a shoot-out not a snap shot.”

The report failed to address the lack of bed space, lengthy waiting times at the accident and emergency department and patients in corridors.

“The report tarnished the reputation of past and present management, the payroll team, nurses and all those who work at hospital.

“It is a report full of generalisations that lumps everyone in the same basket,” he complained.

Mr Pace said the report also hit out at the civil service and urged the complete privatisation of the hospital service through the Foundation of Medical Services.

Collective agreements

On collective agreements, he noted that Mr Dalli implied in his report that the two agreements signed in the past years were the cause of the financial problems and suggested they should be revisited.

The first agreement, Mr Pace said, was signed in October 2007 and discussions on it had started three years earlier.

It was concluded five months before the election and created flexibility that allowed more nurses to join the public service and expand the services offered.

The second agreement, signed in February - a month before the election - was based on a document the union presented the government two years before.

“It created specialisations and encouraged training. Today, our wages, apart from Bulgaria and Romania, are the lowest in Europe... They were not agreements that made us rich but agreements that gave nurses dignity... The agreement was only signed in February because of the political turbulence that characterised last year... The union did not use any electoral leverage, he insisted.

Lack of punch clocks

On Mr Dalli’s comments regarding the lack of punch clocks, Mr Pace said these angered nurses because the impression that they entered and left the building at whim had been given.

“Nurses sign in or use palm readers but telephone calls are also made at random to check on the presence of nurses in wards. Management performed spot checks at 2am to check on attendance and no disciplinary measure had ever been taken against a nurse or midwife for absenteeism.

Mr Dalli, however, seemed to have ignored these systems when he gave the impression that the hospital was a free-for-all.

What he did not mention were the long hours nurses put in to cover up for lack of staff or leave cancellation on the day, Mr Pace said.

Rosters

Mr Pace referred to Mr Dalli's claim that there were more than 500 rosters and that these were aimed to promote overtime and said that wards worked on a single roster based on day-day-night.

In critical wards, such as the ITU, rosters were based on a day-night-rest-off basis because they required more people to be manned.

The implication, he said, was that Mr Dalli wanted to remove family-friendly measures. But at least 55 per cent of the nursing work force was of child-rearing age.

“Does the Prime Minister want to take on board the recommendation and remove these family-friendly measures?

Operating theatres

Mr Pace said the report pointed out that nurses left midway through an operation because of different shift patterns.

But both in 2012 and in 2009, the MUMN asked the hospital to stick to the policy of conducting operations in two batches because they were overlapping.

Nurses in operating theatres, he said, were insulted by the comments in their regard, after all the sacrifices they made to ensure operations ran smoothly

And although nurses gave hand-overs just as consultants and aestheticisms did, Mr Dalli only targeted nurses.

No operation list was ever cancelled because of nurses, he said adding that "none of the theatre nurses are sitting pretty".