Health Minister Chris Fearne shows more respect to doctors than he does to nurses, the president of the Malta Union of Midwives and Nurses, Paul Pace, said.

Malta is the only European Union country whose government has taken the nurses’ union to court on more than one occasion, he said in an interview with The Malta Independent on Sunday.

Meeting at the MUMN headquarters office, lit by a temporary lighting system and an open window due to the bureaucratic processes of granting the facility only a temporary electrical supply, Pace opened up about the daily battles he has to endure due to the lack of communication with the Health Ministry, as he put it.

It was only recently, he charged, that the Health Minister resorted to legal action to stop the industrial action being carried out by MUMN and its members. He lost, Pace said.

The industrial action, according to Pace, consisted of limiting the services provided by nurses according to the staff available at any given time. This means, for example, that certain services which were available in a ward with 40 nurses, were cut in half when only 20 nurses were available to work the shifts.

Pace called this a practice “which is found in every hospital around the world. It is not an ideal situation but the services offered at Mater Dei and other hospitals do not depend on how many beds are available. Patients are not sacks of potatoes which can just be placed in a bed, and that’s it. They have needs and services which requires staff”.

According to Pace, Fearne has the mentality to increase the services proportionally to the amount of beds available, irrespective of the nursing workforce. “He keeps on pushing patients into our hospitals and health services without any consideration to how the service will be offered.”

“Fearne respects his colleagues who are surgeons and doctors; doctors see patients with appointments 10 to 15 a day max, and irrespective to how long the waiting list is, they stick to those numbers,” Pace said. It is not the same with nurses.

Pace went on to compare nurses who are overworked because of staff shortages and doctors who have appointments and stick to their times. “When it comes to nurses there is no respect. Picture this, a nurse on her own in a ward trying to cope with the patients and there are an extra five beds, somehow those beds will be filled but the nurse still remains on her own.”

Another problem which nurses have to face is the management of the wards. “In the case of wards filling up, nurses have to figure out solutions on how to accept more patients, not the management. These are the factors which cause stress and burnout on the job.”

It was due to these reasons that Pace, in his capacity as MUMN president, issued the directives to limit the services offered by the nurses. In response to this, Fearne and the government took the union to court requesting that the directives be stopped.

The court however ruled that the action taken by the MUMN was perfectly legal.

Pace said that Fearne, in his seven years as Health Minister, has yet to invest in a capital project in the health sector. “Opening health centres, which were already open or just refurbished, is not a proper investment. No new wards built, no northern hub, no new Mount Carmel and so on,” Pace said.

Pace said that “whenever MUMN highlights the issues which need to be tackled, we are slapped on the wrist. We are the only country in the European Union where the government takes the nurses’ union to court”, he said.

“In the next general meeting of the Nurses and Midwives Union of all Europe we have a big story to tell on how our government takes us to court on more than one occasion.”

 

Playing the devil’s advocate

The industrial action limiting the services nurses can provide only prompts the question as to why these actions are taken if they are only going to add to the problems and lack of services found at Mater Dei.

Pace replied that the shortage of nurses has been ongoing for years. “The ministry had a lot of opportunities to intervene and do as it should in order to prevent the escalation to this stage, but they didn't take any notice.”

Industrial action is always the last resort when it comes to getting the union’s message across. “For years Fearne has shrugged the problem off and in seven years I never received a single email from him to discuss the problem.”

Pace then explained that the situation went from not so bad, to bad, to worse and so on. “Nurses were taken to court; nurses were accused of being criminals, taken in front of disciplinary hearings due to not being able to cope with the workload and so on. All this time we were ignored.”

“Fearne has to realise that the services at Mater Dei are not given by the hospital, but by the nurses,” Pace said. At least ministers like Joe Etienne Abela (responsible for the elderly) noticed the shortage at St Vincent De Paul and decided not to open certain wards and services due to the small complement of nurses working there, he added.

Due to the shortage of nurses, the current nurses are having their vacation leave affected as relief nurses could not be brought in to replace them, according to Pace. “Nurses are resorting to working each other’s shifts as a form of debt in order to be able to take vacation leave.”

“With Fearne we have come to a situation where social dialogue does not exist. Even the judge told us to discuss, we have put ourselves forward on many occasions but we were ignored.”

With regards to the opening of the new health centre in Paola, Pace asked “who will fill the nurses’ positions? From where will he get the nurses?”

 

The way forward according to MUMN

Pace stressed the importance of proper and clear communication between the Union and the Ministry in order to improve the working conditions of nurses and midwives.

The improvement of working conditions is a worldwide thing since in the nursing profession, the employing competitors are not only the government and the private sector but the international community.

“When countries, like the United Kingdom, realised that they had a nursing problem, instead of taking their nurses to court and accusing them of falling short of their duties and so on, they made the profession more attractive in order to ‘steal’ nurses from the international community.”

Pace said that this issue had to be handled by the government years ago. “With the conditions currently in place one has to be crazy to go into nursing – it is a fulfilling profession but not with the current conditions.”

“Nowadays, and rightly so, youths are attracted to higher paying jobs and with less responsibilities. Communication channels have to be opened again and proper discussions tackling the issue directly are needed,” he added.