Louis Deguara signed 2007 collective agreement despite disagreeing with it

According to former Health Minister Louis Deguara, the Ministry of Health did not agree with the final draft of a 2007 collective agreement signed with doctors.

In a comment to The Times, Deguara said the final agreement was considered to be flawed and never agreed to the final draft but still signed it after being forced to do so from “Orders from above”.

Deguara is most likely referring to the Prime Minister’s Chief of Staff, Edgar Galea Curmi as having been the one to given the ‘orders’ to sign the final agreement.

Prime Minister Lawrence Gonzi had, at the time, described the collective agreement as a ‘milestone’ and it was signed four months prior to the general election of 2008.

Migration from St Luke’s Hospital to Mater Dei Hospital had not yet begun back in March 2007, and agreement with doctors on working conditions were far from concluded but Deguara told MaltaToday that discussions were ongoing with many unions who looking to increase their remuneration.

“All unions have signed a collective agreement except the doctors’ union, so it was wise… to start discussions with the doctors… which are being held with the Office of the Prime Minister, and not the Health Division, because they are not about work conditions but about remuneration, and that’s not our remit,” Deguara had said.

Mater Dei opened in 2007 prior to the general elections in 2008 and a €1.7 million direct order was issued to a security company to continue the services previously provided to Skanska, the Swedish firm entrusted with the construction of the hospital.

The total expense of direct orders, erroneous invoicing and cost of reducing Mater Dei Parking Fees amounted to just over €4.1 million by 2009.

In 2009, the Auditor General said that the government was not securing value-for-money contracts but Gonzi defended his actions.

A number of consultants work until 1pm at the MDH as a result of this agreement but Deguara had told MaltaToday in 2007 that this was one of the major issues discussed prior to signing the agreement.

“One of the issues we discussed was that the new hospital cannot just operate in the morning. We can double the output and the capacity, and if we really want to go for medical tourism, then obviously we need to make this hospital work, not just till 2pm, but all day long,” Deguara said.  

The government recently proposed that doctors and consultants should work afternoon shifts so as to keep the Outpatients’ Department open until just after 5pm.

But this was not the first time that this suggestion was made, as Deguara had clearly pointed out to MaltaToday. “The problem with consultants remains that while nurses work on a shift basis, consultants do not. Now, if you want to increase turnover of patients and cut down on waiting lists, reduce queues and attract medical tourism, the hospital has to function for much longer periods especially in the evenings.”

Health Minister Joe Cassar said the bed shortage problem at Mater Dei was the result of unsuitable work practices and could be improved by the uptake of afternoon shifts by consultants.

The Medical Association of Malta (MAM) said that this could be possible but the government would need to make it more financially attractive.

However, proposals were made to pay consultants better overtime rates for the uptake of later shifts but nurses insisted the same should be considered for them.

Nurses union chief Paul Pace hit back at Cassar saying he had failed to understand the fundamental problem regarding bed shortages and said consultants should be made available until 6pm but doubted anything would be done in the face of elections round the corner.

More soon….