Updated - Adds MUMN reaction - The Medical Association (MAM) said today that doctors would not be held responsible for harm which could be caused to patients following an MUMN directive for nurses not to prepare covering letters for the provision of certain medicines in the hospital wards.

MAM General Secretary Martin Balzan defended the use of the covering letters procedure and said his union was taking legal advice over the directive by the nurses’ union.

He also strongly denied a claim made in the MUMN statement yesterday that doctors often did not know what they were signing for when the nurses asked them to sign the covering letters.

Covering letters, he explained, were issued for the provision, by the hospital pharmacy, of expensive medicines and treatments often administered intravenously to seriously ill patients.

The purpose of the covering letter was for better control of the use of antibiotics in line with the antibiotics policy, and also to have financial control. Similar procedures also existed in other hospitals.

He said the MAM was taking legal advice because action which could obstruct the provision of medicine could give grounds for claims for civil damages by the patients. Not giving medicine was morally wrong and such an omission could even lead to manslaughter, a criminal offence.

“If there are consequences from the nuses’ industrial action, doctors cannot be held responsible and we are therefore already taking legal advice,” Dr Balzan said.

He warned that the insurance cover which medical staff enjoyed only applied when proper administrative procedures were followed.

The MUMN directive comes into force on November 1. The MUMN said on Saturday the covering letters were useless pieces of paper which complicated bureaucracy.

See MUMN statement on http://www.timesofmalta.com/articles/view/20141018/local/mumn-tells-nurses-not-to-file-covering-letters-for-medicines.540202

MUMN REACTION

MUMN president Paul Pace in a reaction to the comments by the MAM, insisted that the filling in of the covering letters was the doctors’ responsibility. Nurses were legally bound to administer drugs available in their ward and could not administer drugs that were not covered by a covering letter – required for the pharmacy to release the drug.

Currently nurses had to constantly chase doctors to fill in these covering letters. This chasing around would stop on November 1 which meant that, if doctors failed to fill in the letters, as was their duty, nurses would not be able to obtain the medicine from the pharmacy and would not be in a position to administer it to patients.

The union never said it would stop giving treatment to patients, Mr Pace insisted.

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