Nurses would eagerly accept added duties, including assessing patients, but doctors oppose any move they believe might go against patients’ interests.

Teamwork should be in consultation with each other and not a dictatorship

There was a mixed reaction from the nurses’ and doctors’ unions on a proposal made by Parliamentary Secretary for Community Care Mario Galea, urging nurses to be entrusted with duties that were currently considered to be strictly a doctor’s responsibility.

Opening up the role of nurses would help ensure accessible and affordable good quality care and allow doctors and specialists more time to dedicate to more complicated and specialised care, he said.

But while nurses agreed with the idea, doctors said this had to be done within a medical team being led by specialised doctors.The Medical Association of Malta said it would welcome the extension of nursing duties, such as taking of blood and insertion of intravenous cannulas for drips, duties which were performed by doctors, but this had to be done within a medical team led by trained professionals to protect the patient.

“MAM would oppose measures where non-medical staff practise unsupervised. These practices are mainly introduced in remote or rural areas of third world countries, where no trained medical staff is available,” MAM general secretary Martin Balzan said.

“The Maltese patient deserves the highest level of patient care, delivered by appropriately trained medical teams, supported by competent nursing and paramedical teams.” Moreover, EU directives and Maltese criminal and civil law limited the practice of medicine to the medical profession, MAM said.

However, reacting to the proposal and the doctors’ reaction, the Malta Union of Midwives and Nurses said that in all developed countries nurses and midwives worked in clinics, which they led as independent practitioners and “assume full responsibilities as any medical doctor”.

It said the Medical Association of Malta had given a false impression when it said nurses and midwives had to fall within a medical team that had to be led by the medical profession.

MUMN said MAM’s statement clearly showed doctors’ eagerness not to lose one inch of power.

Nurses and midwives in Malta, it said, were fully qualified to do independent private practice according to their warrant.

The union said it was shameful for MAM officials to cite the interests of the patient when in actual fact, “MAM does not want nurses and midwives to affect the private practice of certain consultants,” it claimed. The Malta Union of Midwives and Nurses said it fully agreed with Mr Galea’s view that in the primary care environment, highly qualified nurses could take the initiative, just as their counterparts did in other countries, and start offering services which were nonexistent in Malta’s health service.

All European countries, for example, had adopted the family health nurse in the community with great success in reducing admissions to acute hospitals.

“We feel that while nurses and doctors should work as a team in certain areas, these teams do not need necessarily to be doctor-led. Teamwork should be in consultation with each other and not a dictatorship,” it said.