The motivations behind the latest round of MUMN directives can be crystallised with the most peculiar of reasons. In essence, a pretty good but long overdue sectoral agreement was signed for the allied health professionals, a class of healthcare workers within the public service. They include physiotherapists, podiatrists, speech language pathologists, dieticians and optometrists.
As a minimum, they follow a four-year degree course for entry into their profession and are on a national level regulated by the same council. A patient visits these practitioners for a diagnosis, treatment and management plan for a particular ailment falling within their scope of practice. They all enjoy autonomy and independent practice.
Whereas such news is normally received positively, the nursing union appeared to have none of this. The agreement was simply too good for them to sit idle. They proceeded with steadfast directives running in excess of 100 individual instructions to members and which, according to senior health authorities, if left unabated would bring Mater Dei Hospital to a standstill.
Given that our healthcare system was already struggling due to COVID-19, the government had to file an application for a warrant of prohibitory injunction to stop the directives in their tracks. The MUMN was irked. Ironically, this judicial tactic was used against the government by the MUMN itself in September 2020 to stop the former from signing the sectoral agreement for the allied health professionals with the UĦM. The agreement was eventually signed but it proved to be the tipping point for the nursing union.
The MUMN claim that when they signed their own agreement they were not offered the same conditions offered to these workers two years down the line. At the time, the MUMN signed a sectoral agreement willingly and voluntarily, binding the parties for the term 2018- 2022. Sectoral agreements are fully fledged contracts between the parties, so the MUMN’s actions to compel the government into submission and to renegotiate an agreement that is still binding is draconian, to say the least.
Collective and sectoral agreements are created to ascertain industrial peace for defined periods of time. Re-opening a sectoral agreement midway through the validity period will create a dangerous precedent and undermines its need. Why sign agreements for specific terms when, throughout its term, a contracting party may bully its way into revision?
The focus of unions operating in healthcare must shift to wider duties- Christian Ellul
Not only does the MUMN’s actions tread on illegitimacy but the argument they used in court to justify their action appears to be flawed. The MUMN embarked on a comparative argument, stating that allied health professionals in the same grade as nurses enjoy better allowances and a take-home-pay that is substantially higher.
The union should clarify what it means by the ‘same grades’. The public service speaks of scales and classes but not grades and, to this end, nurses are a separate class of workers than the allied health professionals.
The MUMN also speaks of work of equal value. How can we objectively measure the value of each healthcare professional to determine which are equal?
Moreover, the disparity in pay alleged by the MUMN is attenuated if one had to cite the relevant timelines. In fact, an attractive package was signed by the MUMN and has been in force since 2018, two years prior to any package worthy of acceptance was offered to allied health professionals. In fact, up until December 2020, the allied health professionals continued to benefit from a take-home pay reflecting an agreement dating back to 2013. Nurses have been benefitting from better conditions years before allied health professionals got the chance to.
Needless to say, if the MUMN wants the package of nurses to be on a par with other healthcare professionals, what’s the scope of having different classes and different sectoral agreements?
Of course, people privy to industrial negotiations are fully aware of the benefits of having different classes. These classes exist for the purposes of tailoring agreements according to the needs of each category of workers and, hence, cannot be identical. Wage packages must reflect the responsibilities, obligations, requirements and structure of each class. Pecuniary increases cannot be merely justified because other professions are paid more.
The perception out there is that the role of trade unions is merely to get better wages for their members. I disagree. The focus of unions operating in healthcare must shift to wider duties. These unions should actively participate in the development of bespoke career progression paths and then tailor an attractive and motivating renumeration package around those paths. This will not only advance the footing of the professions involved but directly advance healthcare delivery.
Comparative exercises serve no purpose in pursuit of such aims. They create friction between different professions at a time when our efforts should be that of promoting inter-disciplinary collaboration, not damaging it.
Christian Ellul is a podiatrist and law graduate.