Deals are struck at the negotiation table

Nurses believe they have a bad deal when it comes to working conditions and pay-packets. They are certainly not alone, within the public service, in feeling their work is under-appreciated; but that is a subject for another day. 

Since March, nurses and midwives have been following industrial action ordered by their union, the Malta Union of Midwives and Nurses, after a breakdown in sectoral agreement talks. These actions were suspended last Thursday, pending an extraordinary general conference called by the MUMN: during which members will be asked whether they will endorse or reject government’s counter-proposals. 

This newspaper will certainly not argue against the right of workers to take industrial action; and nurses are no exception. Industrial action is, at times, a necessary measure of last resort. The whole point is to cause disruption, to eventually force intransigent employers into reaching a compromise. 

Unfortunately, however, industrial action in the healthcare system is always going to be controversial: because the ultimate sufferers are patients – people who are at their most vulnerable. 

Any action by nurses and midwives must therefore be judicious; but the management of the impacted public hospitals and clinics must not use the ongoing industrial action as an excuse, to justify shortcomings within the system. 

This is why, in the best interest of patients, both the MUMN and government need to adopt a more level-headed approach to the issue. The MUMN, for instance, must be more reasonable in its demands. Asking for nurses’ two-thirds pensions to be uncapped is an obvious no-go area. It would cause untold pressure on public finances and create discrimination among public and private sector employees. 

If anything, such a proposal should be discussed as a separate issue: as part of a broader national discussion on pensions. 

Likewise, asking for a flat overtime tax rate makes little sense: because it would create discrimination between different categories of government employees. 

Moreover, some of MUMN’s arguments are non-sequiturs. Union officials have complained that nurses and midwives lose their allowances after 15 days of sick leave. This is not a phenomenon tied to the nursing profession, but a clause that forms part of the civil service collective agreement. It applies to all public-sector employees, including teachers and LSEs.  

It is unfair to foist such an argument onto an unsuspecting public, to gain sympathy. 

Nonetheless, the union is certainly right when it argues against the current system, that sees nurses having to work 46.6 hours per week, rather than 40 hours, without those 6.6 hours being remunerated as overtime. 

But it must bear in mind that government has a duty to ensure that pay packages are sustainable, and do not end up a burden on public coffers. It is fine to argue that no such consideration was made when government signed off three state hospitals to Steward Health Care and got nothing in return. But it is wrong to stick to a position that simply disregards the need for sustainable public finances, altogether. 

MUMN is also right that the nursing profession is a crucial cog in Malta’s healthcare system and must be valued accordingly. The Health Ministry should realise that, unless the salaries and conditions of nurses and midwives improve substantially, the country will continue facing a drain of human resources.  

There is a lot of excess ‘fat’ in the government system, that could be shaved off to make up for better wages and conditions in key areas. But improvements must also be registered across the whole spectrum: with allowances that encourage people to join the nursing profession; and others that encourage existing nurses to stay. 

It is only fair, too, that government honours all the promises it made during the COVID pandemic: including that nurses would be remunerated generously, when their sectoral agreement came up for discussion. After all, we did call them our ‘heroes’ at the time. 

As for the 46-hour work week anomaly: government should fix this without delay, as it had done with the police force in 2018. Nurses should work a 40-hour week; and any additional hours worked above that must be paid at overtime rates. 

The ministry should also ditch its attempts to introduce a palm reader to record employee hours: unless this is done for all healthcare workers, including doctors and consultants. 

Above all, however, both sides must not forget that the impasse is only exacerbating the suffering of patients; who will not be understanding, when their long-awaited surgical or medical appointments get cancelled for the umpteenth time.  

Their anger is, in fact, quite justifiable; and if things get worse, both nurses and government will end up losing the public’s trust given their combined duty to ensure that Malta’s healthcare services continue running smoothly. 

Both sides, then, have an interest in putting aside their warmongering; and in getting down to work on a package that is both generous and sustainable. At the end of the day, the negotiation table is the only place where such deals can be struck.