Updated 8am

A judge has watered down the nursing union’s planned industrial action, ordering it to withdraw directives he deemed detrimental to the wellbeing of patients.

Action ordered by the Malta Union of Midwives and Nurses can go ahead except for directives which could place patients’ health at risk, judge Robert Mangion ruled on Friday. He also disallowed any action that was to be taken by nurses working at St Vincent De Paul facility for the elderly and Karin Grech Rehabilitation Hospital. 

However, at Mater Dei Hospital, the nurses’ action will mean that only four of the 12 operating theatres currently in use during the virus pandemic can be used. 

“The court believes that while the right of industrial action should be respected and this should not be hampered in any way, at the same time it believes that when it comes to actions affecting essential services, such a right has its limitations especially in the midst of the COVID-19 pandemic,” judge Mangion said.

Reacting on Saturday, the MUMN Council said the ruling was a "great victory" as it authorised it to undertake industrial action. 

"MUMN expects that the sectoral agreement is to be discussed if the Health Division wants to prevent further industrial actions allowed by the same decree," the union said.

Friday's judgment partly upheld an application for an injunction against the union’s widespread action filed by the health authorities. 

The hospital’s emergency department clinical chairman had warned the actions would bring the hospital to a halt. The judge had temporarily upheld a request to ban the action because of its impact on the health service. Friday’s judgment was final. 

The MUMN is in dispute with the government over wages and allowances. Nurses are disputing what they say is a €2,000 to €5,000 annual discrepancy between their wage and that of other healthcare workers. 

The court did not delve into financial issues, limiting its judgment to the long list of directives issued by the union and ruling which could go ahead and which could not. 

“While the right to industrial action must be respected, the court must act with caution and attention to ensure that patients’ lives and health are not jeopardised,” Mr Justice Mangion said. 

“In these circumstances, the court must distinguish between what can, at face value, endanger patients’ lives and their health and those that would only cause inconvenience but which would not endanger lives. 

“For an injunction to be issued, it is not sufficient to prevent an inconvenience, difficulty, discomfort or concern. Needless to say, industrial action without any form of impact would be a useless action,” he added. 

Directives forbidden

He partially accepted the health authorities’ claim that certain directives, such as stopping communication between nurses and other health service providers, would have impacted the standard of care received by the patient. 

To this end, the judge disallowed directives for nurses not to call for bed cleaning to be done. He also dropped union orders for its members not to give handovers to other hospitals or homes and not to refer patients to allied professionals for treatment. Such actions, the judge said, could endanger the patients’ health. 

Other directives to be ignored are not to report any faults in the ward and not to coordinate with any other ward or other hospital personnel. 

Among other directives disallowed are not to inform doctors about blood samples or swabs that need to be taken, including for COVID-19, and not to accompany patients to the doctor’s room. 

“The court is of the opinion that delays in communication or coordination may endanger the patient’s health.” If in any case, the health of a patient is endangered, nurses and midwives must assist that patient “with agility without taking any of the directives into account,” the judge ruled.

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