Patients at public hospitals can expect delays to medical appointments and testing as of Friday, after more than 1,300 healthcare workers were ordered into industrial action. 

Union Ħaddiema Magħqudin issued more than 400 directives to its members across the healthcare service, saying that it was doing so because the government was “dragging its feet” when negotiating collective agreements.

The directives, which came into effect on Friday morning, will affect various departments and sectors, from emergency ambulance responders to radiographers, dental hygienists, physiotherapists and social workers. 

Many of the directives make exceptions for accident and emergency cases, general emergency procedures and cases which require life-supporting monitoring such as dysphagic patients. Duties are to be carried out only if necessary.

What are the directives?

Emergency responders will drive ambulances or other vehicles but will not carry out any other duties.

Radiographers will not take up elective cases or recurring patients on their second or third appointments, and have also been told not to help patients to change into gowns.

People seeking to schedule appointments with radiographers at Gozo General Hospital will also be affected, as professionals there have been instructed to not answer phone calls or emails from patients.

Biomedical scientists have been told not to process testing requests at Mater Dei hospital and Gozo General Hospital. 

Some departments, such as the angiography suite, will close at 2.30pm. Elective cases such as angioplasties and embolizations will not be accepted. 

Internal departmental communication will be crippled as radiographers and other professionals across all hospitals, including Karin Grech Hospital, Mount Carmel hospital, Saint Vincent de Paul as well as primary healthcare centres have been told to ignore internal emails except for emergency cases. 

Speech language pathologists will not answer calls, attend any meetings or run any student training sessions. They will also refuse to see patients unless in-person referrals are given for new cases.

Active ageing and community care professionals will be refusing new cases and will not be giving out routine treatments in the community. Those working in a residential setting will see a maximum of seven cases a day and refer the rest to Mater Dei's accident and emergency department.

Orthotic and prosthetic specialists will refuse to see new cases unless the patient is assessed as being at a high risk due to conditions such as diabetes or neuropathy.

Occupational therapists at Mater Dei will not accept follow-up sessions nor fill out reports related to patients.

Community mental health workers based at Mount Carmel will not be sending statistics nor following up on cases, and will not send information packs to service users.

Physiotherapists will not answer calls, emails or honour outpatients appointments at both Mount Carmel and Mater Dei.

Audiologists will not be meeting new paediatric cases for hearing aid fittings nor perform repairs, and they will not be conducting screening unless it is for newborns.

Dental hygienists at Mater Dei and Gozo General hospitals will not see more than one patient a day except for patients who are deemed at higher risk or have complications which exclude them from the directives.

All Karin Grech and Gozo hospital employees will not contact caregivers, relatives or significant others and will not carry out any administrative duties.

Social workers will not attend home visits nor carry out initial assessments. 

Union slams 'irresponsible' government

Announcing the directives, UĦM CEO Josef Vella trashed the government for “dragging its feet” on collective agreements that the union had been trying to flesh out for years.

He said that the union is considering further escalating the directives.

Vella also questioned the government’s decisions to enter into management agreements with Vitals Global Healthcare and then Steward Health Care, arguing that “we do not need foreign companies to manage local workforces.”

“For some reasons, the government has not kept its word and does not want to implement what had been agreed upon in writing,” Vella said.

“1,200 professionals are losing out on thousands of euros they are owed. As a union, we can never accept collective agreements not being respected,” he added.

Emergency ambulance responders had also won the right to a collective agreement in January 2019, with proposals being submitted in July of the same year, he said. 

The union boss warned the government to “stick to its commitments,” adding that “it is disgraceful to have a situation in which social dialogue has fallen to these kinds of lows.”

Vella went on to make a case about the contracts government signed with Steward Healthcare, adding that professionals employed by these entities should have their payroll and rights funded and taken care of by the government.

“We called for the government to level the playing field and give these workers equal pay for equal work with other professionals in the same field. 

“Government was given a chance to honour this agreement by January of this year, and to this day we have heard absolutely nothing from them,” Vella said.

PN offers to mediate

The Nationalist Party, via its employment spokesperson Jason Azzopardi, offered to step in as a mediator to resolve the “unprecedented industrial dispute”.

“The government cannot keep dragging its feet for years to negotiate a collective agreement for its workers which then end up expiring,” Azzopardi said, saying the government was "generous with its inner circles and miserly with its workers."

He said the PN was offering to mediate the dispute, which he blamed on the Labour government being "indifferent, insensitive and arrogant" and unwilling to honour "its own written obligations."

See the full list of directives in the PDF below.