Nurses’ union wants employers to pay

Malta’s nurses’ union has asked the government and private operator Healthmark to cover new costs that third-country national nurses will face under the budget measures.

That is not a symbolic complaint. It is a request directed at the two employers the union says depend most heavily on those workers, and it goes straight to a pressure point the budget largely sidestepped: who absorbs the bill when the state adds costs to a workforce the health system already struggles to replace.

MUMN president Paul Pace said he had contacted the health ministry and Healthmark and wanted discussions to start on maintaining benefits that affected staff stand to lose, particularly free childcare. He also argued that nurses should be exempt from the new annual €400 infrastructure fee and have transport costs covered.

The budget measures announced for third-country nationals include that €400 yearly fee, about €1,000 a year for the use of a private car, and charges for public transport and childcare. Those last two services are free for citizens and long-term residents. Pace’s position is that, if the government insists on imposing those costs, the employers relying on these workers should pay them instead.

There is an awkwardness here that the union is plainly exploiting. The prime minister suggested employers should step in for services used by third-country workers. In the public health sector, the employer is the state itself. The government is therefore not just setting the new charges; it is being asked to compensate for them out of another pocket.

Pace said 40% of nurses at Mater Dei Hospital are third-country nationals. He put the share at 60% at St Vincent de Paul and Mount Carmel, 85% at Karin Grech Rehabilitation Hospital and 95% in the private sector. He added that the proportions are even higher for care workers. Those figures, if accurate, describe a system that has long since moved past supplementary foreign recruitment and into structural dependence.

That is why the union’s warning matters. Pace said hospitals in the UK and Ireland offer higher wages, while Malta remained competitive partly because of benefits such as free childcare and free public transport. Remove those advantages, his argument goes, and Malta is left asking imported staff to pay more for less.

He tied that risk to the government’s own expansion plans, citing intentions to enlarge the emergency department and build a 250-bed hospital near St Vincent de Paul. Buildings are easy to announce. Staffing them is the unglamorous part where policy usually meets arithmetic.

Healthmark did not commit to a specific measure but indicated it may step in. In a reply to Times of Malta, the company said it recognised that many of its employees would face added financial burdens, including transport and childcare costs, and that it was evaluating how it could help relieve some of those burdens. It said its priority was to listen to affected staff and explore practical support.

That leaves the key decision with government, which is both rule-maker and major employer. Times of Malta reported that it sent questions to the health ministry on whether it intended to cover childcare, transport costs and the infrastructure fee. The excerpt published does not include a ministry reply.

Pace said the union is not planning industrial action at this stage and wants an agreement first. For now, the dispute is still at the point where everyone says they are open to talks. The harder question is simpler: whether ministers are prepared to admit that a fee designed to extract more from third-country workers may end up being paid, one way or another, by the health service that cannot function without them.