Tensions flared at Mater Dei Hospital on Monday morning as patients argued over their turn to have their blood drawn at the Phlebotomy & ACC outpatient unit where some had been queuing since 5am.

Patients turned up before sunrise to ensure they got their blood drawn by phlebotomists, who are limiting the number of patients they see each day in line with industrial action that has now been dragging on for over six months.

This tension is a regular morning scene, according to several people who work in the area and as documented in footage seen by Times of Malta showing people arguing over their spot in the queue.

Times of Malta also visited the hospital. By 6am there were about 15 people quietly sitting on the blue chairs that line the corridor outside the unit.

The sun was barely up. The silence was only broken when a new person arrived and asked “who is last”, to take their rightful spot in the queue.

By 7am the number of people had more than doubled.

The bickering started when a couple arrived and stood by the unit’s door without asking who was last in the line.

Elderly people, many of whom had waited in the queue several times to get their blood drawn in the past months, started looking at each other.

“Look at them they are standing by the door. There is no way they will skip me. I woke up at 4am to get here early enough,” one elderly woman said.

“I get all jittery before I have to come here,” she added.

The strangers started talking, united in their cause that no one should jump the queue.

“They are only taking 30 patients every day... they will close the door at 9am latest,” another woman said.

Just before 7.30am a security officer opened the door and asked patients to queue in order of arrival. Several loud arguments followed as people disagreed over who had arrived before who. Patiently, security staff tried to restore order.

“You should have been here last week... the situation was much worse,” one man shouted for all to hear.

Then, just after 8am came the announcement: “Only those patients on warfarin (a blood thinner) will be seen. The others can leave as there is the strike,” the security officer said.

By this time there were just a handful of people apart from the warfarin patients. Some complained loudly but were asked to leave by security staff who explained that this was beyond their control.

One woman who was turned away told Times of Malta how she was recently hospitalised for blood clots and had been given an appointment to get her blood drawn.

“I walked all the way from Birkirkara to come here this morning. They should have told us if there was an issue.

“It’s only 8am. Now I need to wait to be given another appointment,” she said clutching at her hospital documents – the evidence of her appointment that never happened.

Phlebotomists, who are healthcare workers and who draw patients’ blood, have been obeying directives issued by the Malta Union of Midwives and Nurses in a dispute over a sectoral agreement. The previous agreement lapsed in January 2021 and directives were ordered in September that year.

Last week, Health Minister Chris Fearne urged phlebotomists to resume their duties saying the dispute has been solved. But MUMN head Paul Pace denied this was the case, saying the government and the union had not had a meeting for months - a claim the ministry denied. 

A health ministry spokesperson said a meeting between the two sides on Monday was inconclusive “as MUMN put forward new requests, additional to what had already been agreed to”.

The union said that it had put the government's proposal to a vote of phlebotomists, who rejected it.  A main issue is that the current agreement and proposals allow for workers covered in the same sectoral agreement, and who do the same job, to have different wages, it told Times of Malta. 

What are the directives' instructions?

Phlebotomists have been told to limit the number of patients they see every day. The issue centres around their pay package and a request to be provided with training courses to be able to advance in their career, according to the union.

The industrial action stretches across Mater Dei Hospital, Karin Grech Hospital and health centres. Each phlebotomist is only drawing blood from five patients a day. All urgent cases, including oncology patients and patients on warfarin, are seen to.

At Mater Dei, the action has had a ripple effect across the whole hospital with doctors having to step in to draw patients’ blood over and above their busy caseload.

A house officer spoke about how chaotic the situation was in the medical wards where doctors relied on each other to draw blood for patients.

“We are talking about people who are hospitalised so, while they might not be emergencies, they are acute and their blood test can determine their medication and recovery,” the house officer said.

“It is more stressful waiting to see if the patients will have their blood drawn by a phlebotomist. Might as well do it yourself,” she said.