Updated 4.15pm with ministry's statement
The doctors' union has ordered doctors to stop transferring patients to private hospitals, amid an industrial dispute stemming from a "bed crisis" at Mater Dei Hospital.
The Medical Association of Malta (MAM) said it had declared an industrial dispute due to "mismanagement" and a new private hospitals' outsourcing agreement, according to an email sent to the Health Ministry on Saturday.
The email, seen by Times of Malta, orders members of the union to follow established procedures and refrain from participating in patient transfers to private hospitals without prior approval.
Health Minister Jo Etienne Abela reacted with anger to the directives, implying the union was issuing directives due to "personal grudges". Saint James Hospital, Malta's largest private healthcare group, also expressed concern at the MAM measures.
The union instructions come just two days after the Health Ministry unveiled a new partnership with three private hospitals to outsource emergency services in a bid to ease waiting times at Mater Dei hospital.
"Medical practitioners shall not advise or otherwise participate in transfers to private hospitals and admit all patients to Mater Dei," the MAM email read.
The MAM said that, as a result of the "chaos", the management is violating signed agreements, by making private decisions without consulting with the union.
'Relationship with minister is very bad'
When contacted, MAM president Martin Balzan said the association was not consulted about the outsourcing of emergency services to three private hospitals to ease waiting times.
"To have any private partnership, the government needs our written consent. We do not have that,” Balzan said.
In response to questions, the Health Ministry said it had discussed the plan with the doctor's union on "a number of occasions, starting in February 2024". It also accused the union of having issued directives irregularly, without having declared an industrial dispute first.
MAM boss Balzan said doctors' job was to decide on patient treatment, not on whether or not a patient should be transferred to a private facility.
The ministry said transfers to private hospitals required the consent of both senior clinicians and patients themselves, with the aim of easing pressures on clinicians at Mater Dei and speeding up healthcare for patients.
Balzan said the union and minister were on bad terms.
“The relationship with this minister is very bad. By and large, he does not respect agreements... he doesn’t talk to us.”
Balzan said that doctors were being expected to bear responsibility for a system not discussed or negotiated with their union.
In a later statement, the union said it was "completely in the dark on how the proposed partnership is going to work" and had no written documentation to work with.
It cited concerns about "patient safety", without elaborating.
The union also pointed out how there have been numerous irregularities with regard to the appointment of people in senior management positions, which goes against the collective agreement signed between the union and the government.
Many health centre general practitioners have resigned due to bad working conditions, the union added.
"The services are overstretched and waiting times are unacceptably long."
Health Minister:
Health Minister Jo Etienne Abela responded on Facebook, saying MAM was resorting to directives to resolve "personal grudges".
The union had also sought to block other health-related initiatives in the past, he said.
“This heartless act confirms that for this core group within the MAM, lies and personal grudges come first and not the patient. For them it doesn’t matter if someone remains on a stretcher in a corridor or if their operation gets cancelled," he said.
Mater Dei at breaking point
Tensions between the MAM and the government concern a decision to involve the private sector in providing state-covered emergency services.
In July 2024, the minister issued an urgent call to the private sector to outsource emergency care as Mater Dei could not keep up with the high demand.
In May 2024, Health Minister Jo Etienne Abela pledged to include measures that will see an increase in beds a drive to reduce waiting times at the emergency department and the relocation of some services.
He said his aim is to increase Mater Dei’s bed spaces by 600 beds from 1,200 bed spaces.