The government has rejected claims by the Medical Association of Malta (MAM) that new point-of-care testing machines were introduced at health centres without prior consultation, insisting that discussions with doctors began in 2024, a statement issued by the Health Ministry said.

The statement follows an ongoing dispute between the government and MAM over the introduction of the equipment, which has led to industrial directives and disagreements over union representatives' access to health centres.

On Thursday, MAM called for the removal of the new testing equipment from health centres, arguing that the machines are more suited to acute and emergency care than routine primary healthcare.

The union also raised concerns about the consultation process, claiming that doctors had only been informed of the changes after the government had committed to procurement contracts worth more than €4.5 million.

MAM expressed concern that the introduction of the equipment could delay treatment for patients with serious conditions and increase waiting times at health centres.

The union also alleged that its representatives had faced difficulties accessing health centres to meet members, including an incident at Mosta Health Centre on 1 October when a doctor was reportedly escorted out by security officers.

MAM has filed a judicial protest over the conduct of Primary Health Care management and called for the equipment to be removed and training suspended pending a resolution of the dispute.

In its response, the Health Ministry rejected the union's claims that point-of-care testing had been introduced without consultation, saying engagement with doctors had begun as early as 2024.

The Ministry said doctors had been given the opportunity to contribute to the procurement process, while general practitioners had also participated in developing the relevant clinical practice guidelines.

It added that a senior doctor from Primary Health Care had served on the Point-of-Care Testing Committee, which was responsible for overseeing the process.

"Disagreement with the outcome or implementation of a government initiative cannot be interpreted as the absence of consultation whatsoever," the Ministry said.

The statement said that discussions with MAM had been regular and continuous, with the union only communicating its substantive disagreement with the introduction of the equipment in late August 2026.

The Ministry said Primary Health Care management had made clear that doctors would not be obliged to use the machines and that their use would remain subject to individual clinical discretion.

Despite this, MAM registered a pre-advice of industrial action and subsequently issued directives that came into effect on 15 September.

Under those directives, doctors were instructed "not to use, calibrate, provide or receive training in relation to any Point-of-Care Test machines, until further notice".

The government said it had responded by inviting MAM to discussions on several occasions, both formally and informally, in accordance with the Public Service Collective Agreement.

The Ministry also defended its investment in the testing equipment, saying the machines were intended to improve the delivery of primary healthcare by providing rapid test results and allowing doctors to make more informed decisions during consultations.

It said that the equipment can help identify serious conditions such as heart failure and blood clots, as well as support the early detection of heart attacks and the rapid transfer of patients requiring emergency hospital treatment.

The tests can also assess infection and inflammation, helping doctors determine when antibiotics are appropriate, while checking kidney function and electrolyte levels, particularly in dehydrated patients or those experiencing complications from other medical conditions.

Other uses include detecting anaemia, assessing bleeding risks and potentially monitoring blood clotting through INR testing.

The Ministry said the equipment could reduce unnecessary referrals to hospital emergency departments when patients could safely be treated within the community, while ensuring that those requiring urgent assessment were referred without delay.

It said that point-of-care testing would ultimately provide patients with quicker results, earlier treatment and access to appropriate care closer to home.

Turning to the disagreement over union access to health centres, the Ministry said MAM representatives had visited Primary Health Care premises without obtaining prior authorisation after the industrial directives came into force.

The government rejected suggestions that union representatives were being prevented from meeting members at their workplaces, maintaining that such meetings were permitted provided authorisation was requested beforehand.

It said meetings should take place during employees' breaks and outside clinical areas to safeguard patient privacy, safety and continuity of care.

The Ministry also said that while it recognised employees' right to follow lawful union directives, it had a responsibility to protect staff from undue pressure or interference by union representatives, particularly employees who were not union members or who chose not to follow the directives.

The government said it remained available for constructive discussions with MAM, while maintaining its commitment to modernising healthcare services, protecting employees' rights and ensuring uninterrupted patient care.