The significant increase in the number of operations is creating new bottlenecks, but postponing operations that aren’t too urgent is no solution, the doctors’ union, the Medical Association of Malta, said yesterday.
Reacting to a circular that the Mater Dei Hospital management sent to doctors on Sunday (which he said supported the postponement of operations), MAM president Martin Balzan said the union should have been consulted before the circular was issued.
“An agreement was reached on Saturday, but we were left out. This is not right. MUMN is trying to impose matters on the hospital management,” he said, adding that the government probably issued the circular as a means of staving off industrial action by the Malta Union of Midwives and Nurses.
“I would like to make it clear that we have very good relations with nurses. This is a trade union matter,” said Dr Balzan.
He went on to say that the pressure on nurses is real, but the solution is not to reduce the number of operations. Doctors aren’t ready to cancel operations, especially if they involve urgent cases and cancer cases, he insisted.
Asked to comment, Health Minister Joe Cassar said, however, that the circular in question was about internal policy as a means of improving the planning process for operations. He said there didn’t need to be consultation with the unions since it wasn’t something that affected working conditions.
Among other things, the circular states that, “For those planned major variant surgeries requiring an ITU bed post operatively, a clear confirmation must be submitted whether at ITU bed has been booked and confirmed as available. Postponed or cancelled procedures due to a lack of ITU beds must be undertaken within the SAME month. This also holds for cancelled and postponed procedures due to time running out (over runs) at the theatres.” [sic]
Dr Cassar explained that certain operations are already postponed when beds aren’t available, and the policy is simply making things clear.
Dr Balzan explained that the government tackled the waiting lists issue by trying to increase the number of operations, which have increased significant over the last four to five years.
Of course, the work load of operating theatre nurses has increased a great deal, said the MAM president, adding that the solution isn’t to postpone operations, but to increase the number of staff in theatres.
“About 250 new nurses are expected to have completed their degree course in the coming months, so some of them can certainly work in operating theatres – naturally by first being given on-the-job training. Operating theatres are high priority areas when it comes to human resources.”
MAM secretary general Gordon Caruana Dingli, a surgeon at Mater Dei Hospital, explained that there are three types of operations – emergency cases, cases of people that need to undergo surgery as soon as possible, such as cancer patients, and others on the waiting lists (such as cases of hernia).
While the demand for operations has been on the increase, the number of operations carried out has also increased, said Mr Caruana Dingli.
“There has been an annual increase of five to 10% over the last five years, but this has also created new bottlenecks. At the same time, it doesn’t make sense to postpone cancer operations, for instance.
“We have a lot of respect for theatre nurses, who go the extra mile to ensure that patients get the best service possible. It is clear that they do want more operations to be carried out.”
Dr Balzan, on his part, went on to rebut statements made by the Malta Union of Midwives and Nurses regarding consultants not working on Sundays. He said there are consultants who work from 8am till 2.30pm between Monday and Saturday, and others who work from till 4pm between Monday and Friday. He said consultants actually went in for work on Sunday when there was a crisis and didn’t get paid extra.
He was critical of the fact that the government is equipping health centres better (with X-ray machines for instance), but at the same time reducing the number of doctors as part of the €200,000 cost-cutting exercise in health centres.
Talking about the bed shortage problem, the MAM president said the demand for geriatric services is bigger than the supply. He said the solution to the bed shortage problem is long-term planning on three levels – infrastructure, human resources and financing.