Maltese public sector dentists have been on strike for the last two months, with hundreds of appointments being cancelled or postponed as a result of government inaction.
The strike, which started on the 6th of August, was announced after negotiations on a pay rise for governmental dentists as well as better career progression for dentists fell through.
However, after two months of striking and no further response from the government, dentists are concerned whether the public has even realised they are on strike. After all, there are only nine Malta-based dentists involved (along with two Gozo-based dentists), and they’re worried that they will be ignored until they give up.
“The government is not taking the strike seriously at all – if they were looking out for the oral health of our population, they would have done something by now,” one dentist told Lovin Malta.
“We were promised a meeting, which was cancelled, and then we had a meeting with the Health Ministry two weeks later where we gave them our proposals and they never came back with any counter-proposals… they were very ill-prepared. They just told us they wanted us to increase their output, without telling us whether any of our proposals were accepted.”
That is when the dentists began light directives: public sector dentists in Malta and Gozo stopped planned treatments for patients with appointments
“We are only seeing people with open bleeding, sufferers of trauma, and swollen faces – people in pain are not being seen at the hospital,” said another veteran dentist. “Basically, hundreds of people are having their appointments cancelled and there has been no reaction from the government.”
“No elected lists are being carried out,” said the first dentist. “Things like extractions and check-ups are not being carried out. And anything being done currently is being done by people who are not union members, as well as a number of retired employees who had been re-engaged on a sessional basis, and are not a part of this agreement.”
Apart from re-engaging retired dentists, the government is farming out public appointments to private practices
The dentists said the government’s refusal to negotiate or instate a pay rise for public sector dentists is actually costing the government more money every day.
“We are so few in staff that the government is resorting to paying for the outsourcing of our services. Basically, the government outsources check-ups to private practices, so the check-up itself is done by a private practitioner, and the service is done in-house, somewhere like Mater Dei,” the dentist said.
They explained the method behind the government farming out work.
“The government first issues an expression of interest telling you how many patients you need to see, then you get a contract with the government and you see a number of patients and get paid for each patient seen,” the dentist said. “The government pays between €10 and €20 per check-up, depending on what X-rays are being taken.”
The striking dentists worked out just how much the outsourcing is costing the government.
“In this case, the government has issued this call where one dental surgeon sees 357 check ups in a year, and gets paid between €10 and €20 per patient,” they said. “14 dentists have taken this contract up. For these nearly 5,000 check ups, the government is paying between €50,000 to €100,000 per year.
“If we, the public dentists, had undertaken these same check-ups with our current salary, they would be done in 227 working days, and cost the government €21,000 to €26,000 in salaries. And if the government accepted our pay rise proposal, we would cost the government €38,000 to €48,000 in salaries per year – less than they are currently paying to outsource it,” they said.
The government is allegedly also flying in foreign dentists to cover the public sector dentists’ workload
“What we have heard is that foreign dentists, from Serbia, have applied to the medical council for warrants as foreign dentists to work in Malta in our place… that’s their idea of solving the problem, getting third country nationals over,” a dentist said.
“And not EU members,” they continued. “So supposedly they should not even get a warrant, but they’ve already done this with anaesthetists in hospital, where they are allowed to work supposedly under the condition that they learn medical Maltese within a year.”
“But if you go to hospital, all the anaesthetists you would find would not speak a word of Maltese, and there are a lot of Serbs working there right now,” they said.
The President of the Association of Anaesthetists has since then come out to clarify the situation within his own department.
One dentist said they knew of at least one dentist that was asked to come to Malta from abroad.
“They brought in someone a few months back, but after a short time he left,” the dentist said.
“If you are going to solve it, solve it now, not let more than eight weeks pass without responding to any proposals” – Maltese dentist
With weak responses from the government, outsourcing of their work at a higher price, targeting of foreign dentists to bring over, and no response to the original proposals of chances of career progression and a pay rise, the dentists are considering the next step to raise the standards in their profession.
“We are already very short of staff, and our proposals aim to attract more people to this line of work in the public service – and to retain the people who are attracted to the work,” the dentists said.
“What we are seeing is a lot of people resigning and no new people coming in because the conditions are below par when compared with the private sector,” they said. “Doctors are an enormous class with a union, but dentists, we are a small class, and dwindling…”
“There were seven dentistry graduates this year, and so far none of them have shown any interest in serving the public,” one dentist said
“Maybe one may come in, but they are also considering opening a private practice. Plus, in the last two months alone, three people have resigned, and one of them had been there for 10 years, so it wasn’t someone who just came in and did a six-month stint for experience… the person eventually felt forced to resign because there is no career progression at all.”
Public service dentists who do not specialise or do consultation work start at governmental pay scale eight, and can go up to pay scale seven.
With no end to the strike in sight, and more Maltese and Gozitan resigning from their positions as the conditions do not change, the dentists are still hopeful.
“We’ve never been in this situation before, where we lacked people to the point that we need to outsource. The reality is, the government may still need to outsource as our numbers have dwindled so much,” a dentist said.
“However,” they continued, “the government at the moment is paying more to outsource to private practices than it would have to pay if they raised our salaries and made becoming a public dentist more attractive. If they made the role of the public service dentist more attractive, they’d get more interest from new graduates, and more retention for those who choose this profession.”