The doctors' union has the power to stop "Vitals style" privatisation of the health service but it cannot stop the government from outsourcing health services, Jo Etienne Abela said on Wednesday. 

He was speaking in parliament in the context of the government's current dispute with the Medical Association of Malta over the outsourcing of emergency cases to private hospitals to ease pressure on Mater Dei Hospital. The union has said it was not consulted and has ordered its members not to refer patients from the state hospital.

The health minister tabled an agreement the two sides had signed the MAM in 2018. He explained that in terms of that deal,  "agreements like those with Vitals and later Steward" where a private company was handed core operations of the health service, could not go ahead without the written consent of the MAM. 

But the government does not need the MAM's consent in cases of outsourcing services, he said. It is only required to consult the union before an agreement takes effect. 

That, he insisted, was what the government had done.