Updated 4pm

The doctors’ union will be “escalating” directives on Wednesday after a meeting with the government on Friday went sour.

The doctors are already at loggerheads with the government over a lack of consultation about the outsourcing of emergency services to private hospitals.

Last week, the Medical Association of Malta issued directives to its members - including ordering them to halt the transferring of patients to private hospitals - over the matter.

On Friday, MAM president Martin Balzan told Times of Malta the union had met with Health Minister Jo Etienne Abela and government negotiators and discussed the issue of understaffed health centres and emergency department.

According to the union, while the population is on the increase, the number of doctors leaving the service is also on the increase, making the situation for medical practitioners at health centres "untenable".

“We met a stone wall,” Balzan said when describing the outcome of the meeting. He added he could not yet divulge information about the directives as he needed to consult with doctors before announcing details.

Balzan said the directives were being escalated because of understaffing at health centres and the continued lack of communication from the government.

Last week, the union announced directives that ordered its members not to transfer patients to private hospitals.

These directives were called after the government announced a partnership with three private hospitals that will see the outsourcing of emergency services. The union said that it had not been consulted over the matter.

The union added that there has been progress in coming to a resolution about the outsourcing of patients, but the union still does not know what the standard operating procedure is.#

'Lots of shouting and finger-pointing' - MAM

In a statement on Friday afternoon, MAM said the meeting with the minister was "characterised by lots of shouting and finger-pointing by Abela to the extent that the MAM delegation had to leave the meeting because it was not the right attitude for professional discussion".

MAM said it was particularly concerned that the ministry had proceeded with private-sector outsourcing without obtaining MAM's written consent, which directly violated an agreement "specifically drawn up to avoid the repetition of the Vitals-Steward fraud".  

The union said it "had previously agreed to stop the strike action... with the proviso that all future outsourcing of medical services would need prior MAM written approval. This approval was never sought despite repeated MAM requests including a court protest".

MAM is urging the health ministry to:

• Honor existing agreements requiring consultation on private sector involvement
• Review the burdensome SOPs for emergency department doctors
• Engage in immediate discussions regarding GP working conditions
• Respect standard civil service  procedures with regards to appointments of doctors in senior positions