The Medical Association of Malta said is very concerned at the way that the Health Centres have been allowed to deteriorate. Failure to address outstanding issues, continued uncertainty and disruption of leave has led to low morale, an exodus of young specialists and unacceptably long waiting times for sick patients, MAM said in a letter to the health department.

The service has been stretched beyond its limit and can only continue to cope in its current form if downgraded or reformed, it added.

The MAM council has declared an industrial dispute which will, should resolution fail, be followed by wide spread, effective industrial action.

The following issues remain outstanding:

1) An opaque and disorganised vacation leave system in the Mosta health centre resulting in doctors being denied their leave and losing it.

2) Fewer GPs assigned to front line services than the safe minimum, in spite of increasing workloads (less than listed in the collective agreement)

3) Intimidation and insecurity for part time, reduced hours and contract for service doctors

4) Very long waiting times for patients as sick patients are told to wait in the same queue as patients who need paperwork. All ‘cold’ cases should be given an appointment. While MAM supports Schedule V rights given to GPs this should be strictly by appointment.

5) Crowd control problems in the Floriana Health Centre, where unsupervised patients in the waiting area are disturbing consultations and getting into fights. The relocation of the waiting room seems to be main reason for this problem.

6) Complex tasks being assigned to very junior doctors

7) Inadequate facilities for doctors

8) Lack of consultation and uncertainty on the Kirkop Health Centre and changes to prescribing practices.

MAM said it is requesting an urgent meeting to address these issues.