Doctors complain of shortages at emergency department

Hospital doctors yesterday flanked Medical Association of Malta officials who complained about a shortage of staff at St Luke's Hospital's accident and emergency department.

The bone of contention lies in the fact that instead of getting off duty doctors to work at the casualty section, the authorities were taking doctors from wards to fill the gaps at the accident and emergency department, MAM president Stephen Fava said.

Dr Fava and MAM general secretary Martin Balzan stressed that this was not the answer and could actually put patients' lives at risk.

Dr Balzan told The Times last week that the doctors in question were not sufficiently experienced, the level of supervision at casualty was inadequate and the other departments also had staff shortage problems.

"Emergencies happen not only at the emergency department but even in wards. Taking doctors from wards would put patients' lives at risk," Dr Fava said.

Dr Balzan said the government preferred to let patients suffer instead of paying a few hundred liri to get extra doctors from other sections to work at the accident and emergency department when they are off duty.

Dr Fava explained that doctors were leaving because working conditions in Malta were not attractive, causing a brain drain.

Dr Balzan said that as soon as doctors gained enough experience to be able to work on their own, they were being lost to hospitals abroad. While the number of patients was increasing, the number of doctors was on the whole decreasing. The situation had long been deteriorating and had now reached a point where patients were suffering.

Dr Fava said even though the emergency department operated on a triage system, there were still times when people waited for a long time.

Contacted yesterday a spokesman for St Luke's, Boffa and Mater Dei hospitals said waiting times at the department were the result of "erratic patterns of demand on the services".

"The demand is not constant, so while shifts are structured to mirror the demand pattern, it is not always possible to have a perfect fit," he said.

Dr Fava said the health authorities accepted the fact that there was a shortage of doctors at casualty and also accepted that the full complement should be 40 but there were only 30 doctors currently working.

The hospitals' spokesman said it was acknowledged that over the years the demand for the accident and emergency department services had increased and that was why the hospital management proposed to increase the number of doctors at the section at specific times, using both doctors on duty and those who were not.

He said this was the subject of talks with the MAM but despite its initial agreement the association had decided to withdraw this agreement and issue directives to doctors not to move from the department they work in to the accident and emergency unit "even if for just a short period of time (four hours)".

"These four hours were precisely the period when the backlog at the accident and emergency department accumulated, resulting in long waiting times," he explained.

The spokesman said the complement of 40, mentioned by the MAM, was still being evaluated by the management.

"One must keep in mind that the possibility of deploying 10 additional doctors is dependant on having more house officers (graduating doctors)," he said.

Asked whether doctors could be taken from health centres, Dr Balzan said these were more understaffed than hospital, having only half the complement.

The MAM has directed doctors to work to rule and not to accept to be moved from a ward to the casualty department. Dr Fava said there were no plans at present to step up the action.