In yet another day charged with arguments from the Social Policy Ministry and the Medical Association of Malta (MAM), the union has said it will issue new directives to health centre doctors if the government fails to honour the agreement reached late on Monday evening.
The first signs that another stalemate was brewing came about on Tuesday, when a spokesperson for the Social Policy Ministry said that the measure stipulated in the agreement is not dogmatic and discussions with MAM were ongoing.
Last week, MAM issued a directive to doctors who work at the Rabat, Qormi and Cospicua health centres to report for work at the other health centres, and for those who work at the Gzira health centre to report for work elsewhere in the afternoon.
The industrial action lasted just one day (Monday), since the union lifted the directive on reaching an agreement with the government that same evening.
MAM argued that because resources are overstretched, health centre doctors are often faced with verbal and sometimes even physical harassment.
The government-MAM agreement (a signed copy of which was distributed during a news conference organised by the Social Policy Ministry yesterday) stipulates, among other things, that as from Monday, government health centre doctors will be expected with the current roster: to open 24 hours at Floriana, Paola and Mosta; to man all other health centres (Cospicua, Qormi, Rabat and Gzira) between 8am and 1pm; and to man two of these health centres between 1 and 5pm as directed by the Health Division.
The agreement stipulates that health centre doctors will only provide health cover in two of the four health centres that are not open on a 24-hour basis, and as regards the manning of the two other health centres, it will be the prerogative of the Health Division to implement the measures it deems necessary.
However, during a meeting between the government and MAM yesterday morning, Social Policy Minister John Dalli gave a presentation (also given during the news conference), saying that the current complement of health centre doctors is sufficient.
He said, however, that the system could be improved by making better use of resources when they are mostly needed (possibly by reducing resources at night, which is a sensitive issue for MAM, according to Mr Dalli).
MAM officials walked out of the meeting, and during a news conference they organised later in the day, they said they only accepted to go to the meeting to listen to what the government officials had to say, not to negotiate the agreement that had been reached on Monday.
Mr Dalli, on his part, said it was not up to MAM to take decisions on policies. He said that if doctors work whenever they are needed, then there would definitely be enough doctors in the seven health centres, and no services would need to be cut down.
He accused Dr Balzan’s attitude as one that could result in suffering for the people, and said he would not accept a reduction in doctor services in health centres.
The bone of contention seems to have been caused by point four of the government-MAM agreement, which states: “The parties further agree to enter into discussions on: future changes in work practices including possible changes in the implementation of point five; and farming out of general practitioner services”. Point five is, in fact, the new schedule for health centre doctors (explained earlier).
Dr Balzan insisted however, that an agreement has been reached, and discussions on further changes would require both parties to reach a new agreement.
During yesterday’s news conference, Dr Balzan played audio clips of a public lecture held last November, in which the director of primary health care, Denis Vella Baldacchino, said that doctors are overloaded with work, are suffering high levels of occupational stress, and that 110 doctors would be required to provide a 24-hour service in health centres. Currently, there are 69.5 full time equivalents, including trainee doctors.
Dr Balzan said the union would come up with fresh industrial action should the government fail to honour Monday’s agreement, but he stopped short of specifying the type of directives that would be issued.