Health Minister Jo Etienne Abela described as “lies” claims that the Medical Association of Malta (MAM) was not consulted or aware of the outsourcing of the treatment of emergency services.

“It is a lie that I personally met with MAM once this year (2024), it is a lie and I stand by it in court,” Abela told journalists on Monday. 

On Saturday, the Medical Association of Malta declared an industrial dispute and ordered its members to follow established procedures and refrain from participating in patient transfers to private hospitals without prior approval. 

The directives came 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. 

MAM president Martin Balzan previously told Times of Malta that the association was not consulted and that the union was “completely in the dark” on how the partnership was to work.

Speaking to journalists, Abela said that after his first meeting with MAM on 27 February last year, another meeting took place on 15 May. The next day, Abela attended a meeting with all Mater Dei staff to discuss the emergency services reform. 

“Anyone who says they did not know that this was going to happen, it’s a lie,” Abela said. “There is the truth and then there are lies.”

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. 

He noted how private hospitals in the UK cannot cope with the influx of patients, and how the UK government has employed nurses to treat patients in hospital corridors. 

 “The Maltese government does not want this, and that is why we allocated €14 million to outsource,” he said.

“I cannot have €14 million in the bank and leave patients in corridors, or else in the theatre recovery, where in the morning I was meant to carry out operations.”

How will the process work?

Abela also elaborated on how patients will be treated at private hospitals. 

He said all patients would be first assessed at Mater Dei's emergency department.

He said patients with "not complicated" or "non-complex" conditions will be sent to DaVinci, Saint James Hospital or St Thomas. 

“We are not inventing the wheel here, we are just saying there should be a process where patients with non-complex diseases can receive appropriate care in private hospitals," he said.

"What has changed this year is that we have a cash pot we can use to alleviate suffering.”

'Poor definition' of discussion

In a reply to the minister’s comment, MAM’s president Martin Balzan said Abela has a “poor definition” of discussion, stating there were no “meaningful discussions” between the ministry and the union.

Balzan noted how five meetings took place between 27 February and 12 November of last year, but “no discussion took place”. 

On 12 November, an impromptu meeting was held after MAM informed members that the minister was legally obliged to obtain written consent from MAM before any public-private partnership.

“This was mostly composed of a shout-out by the Minister where he denied that MAM claims that IVF PPP in private was costing five times the international market rate and he threatened a libel case,” the statement read, noting how the meeting mainly was regarding IVF procedures. 

The union defended their directives impacting the emergency services and said they held discussions with the Permanent Secretary for “People and Management” and said it was Mater Dei’s management who was at fault, as working conditions were changed without prior notice on Friday afternoon. 

“No union will accept changes in working conditions which expose its member to serious legal risks before prior agreement, and this is completely in line with industrial disputes.”