Updated 9am Sunday

Doctors’ union boss Martin Balzan is going to war against the government because he did not qualify for a promotion at Mater Dei Hospital, the Health Minister alleged on Saturday.

Jo Etienne Abela made the claim after Balzan said during Andrew Azzopardi’s radio show that the public sector rules were not being followed during interviews for promotions.

“In the case of a department’s deputy head, the wrong procedure was used,” Balzan said. “Civil service heads say we are right but want us to alert the Public Service Commission. It’s their job [to do so],” the union boss said.

The Public Service Commission is an independent public body tasked with staffing and discipline in the public service.

In a brief radio call-in immediately after Balzan’s intervention, the minister said Balzan had cited his own personal case as a union gripe.  

“Dr Balzan was speaking about himself," the minister said. "In 2014 he was appointed deputy head of a department following an interview. It was three-year role. From 2017 onwards, no interview was conducted. Recently, one was held and he [Balzan] did poorly. And now he is objecting."

“If a candidate does poorly in an interview, he is the one that must complain to the Public Service Commission. And Dr Balzan did so,” Abela said.

Abela said he has also offered to order an independent inquiry led by a retired judge of Balzan’s choosing into the medical post and the way it was filled.

“This isn’t an issue concerning doctors, it’s a personal one,” he said.

The minister had alluded to the personal clash last week when MAM first announced directives instructing doctors at Mater Dei Hospital’s emergency department not to refer any patients to private hospitals.

Those directives came just days after the Health Ministry said a €14 million deal to send Mater Dei patients to three private hospitals was coming into effect. The deal is intended to ease overcrowding pressures at Mater Dei.

MAM said the terms of a 2017 deal bind the government to obtain the union’s prior approval before any patients can be outsourced to the private sector.

The minister said a “core group” within the union was out to “settle personal grudges”.

The union had responded by saying the minister was resorting to “personal and very unprofessional attacks” and that it was trying to protect doctors and patients from “haphazard decisions by management”.

MAM challenges minister to give an opinion on vitals-steward debacle

In response to Abela's comments, Balzan said the union is not surprised at Abela's outbursts, which corroborates with the reasons why the MAM delegation walked out of the meeting.  

"Morality requires that signed agreements are respected if that is the standard," Balzan said.

MAM challenged the minister to publicly give his opinion on the vitals-steward debacle and lecture again on morality. 

"Currently, there is 100% support for directives by doctors in emergency and health centre doctors will all be obeying directives on Wednesday.  The MAM will deal with other issues in other sectors once this dispute is over."

'Dialogue is forgone in favour of confrontation': MAM

In a separate statement on Sunday, signed by MAM's General Secretary JP Tabone and vice-president Jeffrey Bonnici, the union said the government had "stopped listening" on health issues. 

Meetings are not held and dialogue is forgone in favour of confrontation, they added. 

The decision to issue directives to doctors was taken collectively by the MAM council on January 9 and suggesting that this was due to Dr Balzan being denied a promotion is "unserious", they added.

In medicine, industrial action is a last resort and doctors are particularly sensitive about this for historical reasons.

"The decision was taken after months of being ignored, trying to solve problems through dialogue," they said.

"When the emergency department was presented with an unworkable plan to send patients to private hospitals, MAM had no option but to issue directives. Had this plan been implemented, waiting times in the emergency department would have increased and patients would have taken even longer to be seen," MAM added.

Tabone and Bonnici said that since the last cabinet reshuffle, doctors have found it much harder to work with the government to solve problems in the health service.

"The recovery from the Vitals/Steward catastrophe is not going well. The wasted years and lack of investment are taking their toll. The flexibility and dynamism needed to address these issues while keeping stakeholders on board is missing. 

"Some health centres are crumbling, unsustainability has led to low morale and many GP resignations. Waiting times have quadrupled. More GPs are planning to leave. The Vincent Moran - Paola hub remains unopened even though it has been ready for months. Other serious issues like the medical council reform remain unaddressed."

They said the "challenges in health are too big and too urgent to waste time squabbling".

MAM, they added, was calling for "a return to serious dialogue and meaningful stakeholder consultation".