Industrial action by health professionals raises ethical issues. However, this does not mean that it is unethical. Medical staff have a legal right to strike as any other employee in the public or private sector. The right to industrial action is also an Article 11 human right – the right to freedom of association – under the European Convention on Human Rights.
Still, like other workers whose job is focused on preventing harm or protecting the public, like firefighters and social workers, medical staff must balance their obligations to the people they serve with their own personal and long-term interests. The risks for medical professionals’ mental and physical health and well-being are real and could also affect their colleagues and families.
Undoubtedly, the industrial action taken by nurses – which has now been suspended – in all public hospitals, except the Sir Anthony Mamo Oncology Centre, caused substantial hardships to vulnerable patients, especially the elderly in need of life-saving surgery.
While the nurses’ union blames the government for forcing nurses to take action in the absence of an acceptable collective agreement renewal, the doctors’ union frets about the effect of the nurses’ action that “may be causing unnecessary risks to patient safety”.
While medical professionals have ethical responsibilities to protect and promote their patients’ welfare, they face the ethical costs of taking or not taking action.
Medical staff taking industrial action risk causing harm to patients in the short term. However, abstaining from taking action could lead to greater harm to themselves, their colleagues and patients in the longer term.
Healthcare professionals need to be pragmatic in the way they act when faced with urgent cases where patients risk deterioration of their health
The political root cause of pay stagnation for medical professionals can be traced to the underfunded healthcare system. The personal impact of pay erosion on healthcare workers is made even more dramatic due to the squandering of hundreds of millions of euros of taxpayers’ money in white elephant hospital management projects tainted with corruption.
The government must address the moral hazard caused by the mismanagement of public hospital management privatisation by showing that it is ready to treat medical staff fairly. This means offering them enhanced pay and working conditions in return for the expected work. Like most other workers who serve the public, medical professionals must not be exposed to direct financial hardships and reduced ability to make important life choices such as buying a house or having children.
The band-aid solution of importing third-country nurses adopted in the last few years to fill the staff vacancies in the public health system is not sustainable. The public health system needs more productive investment to increase capacity and employ and retain medical talent to meet the needs and reasonable expectations of a fast-growing, ageing population. This will be no easy task as the political authorities suffer from a crisis of confidence due to the way they have managed the health resources in the last few years.
Nurses are expected to vote on the government’s final proposal for a new collective agreement on Tuesday. Whatever the outcome, mediation is the best way forward to resolve such disputes and the health commissioner has offered to act as a broker between the two sides. This should be accepted if the dispute is not resolved.
The medical staff argument today is the pursuit of greater long-term collective benefit at the expense of short-term disruption.
Still, healthcare professionals need to be pragmatic in the way they act when faced with urgent cases where patients risk deterioration of their health.