Michael Netto

At the cores of both the nursing profession and trade unionism are a central theme of caring and concern – for the sick and injured…or for the welfare of one’s fellow workers. So it is tempting to think that when, more than 20 years ago, Michael Netto decided on a change of career his trade unionist credentials drew him to train as a nurse. But high-minded though he is, in this instance the dedicated trade unionist disappoints…for the explanation of his career switch is more mundane – he was persuaded to look at a future in nursing by his radiographer sister Annie.

“But that doesn’t mean that there are not parallels in the two commitments, though this was an understanding that came to me later,” Netto tells VOX when we meet for coffee. “It didn’t influence me at the time…though now the two go hand in hand. What’s more, though there is no reason why either nursing or trade unionism should pull in different directions, I think that if it ever reached a moral parting of the ways that I would put the needs of the patients first.”

MOTIVATION

And it is his concern for the patients in the hospital - or among those served in a wider context by Gibraltar’s Health Authority - that motivates what the GHA management and Government have criticized as his – and the union’s – “interference in areas that are no business of the union’s,” as a GHA manager recently put it.

“They say that I should look after the affairs of the nurses, and that the way the hospital is run is the management’s business, has nothing to do with us. But if things are managed badly and this leads to stresses among the staff, it is the patients who suffer.”

And it is the welfare of the patients that remains uppermost, even when the union – or the nursing section for which Netto has been a senior shop steward for nearly two decades – decides to stage protests to draw attention to grievances that are too often ignored by management, he points out.

“If we stage some sort of demonstration or walk-out, it is usually done at lunchtime or when the nursing staff have some sort of break – and we always ensure that enough staff remain on the wards to see to the patients,” he stresses.

The son of Jaime Netto – who, as the first District Officer of the Transport & General Workers Union (TGWU) is arguably the father of the trades union movement on the Rock – Michael Netto grew up with the movement’s ethos in his blood. From early in his working life, training and qualifying as a government-employed construction technician, he was involved in union affairs and ancillary bodies such as Action for Housing (the nursery for several of the Rock’s activists); and there were many who expected Netto to stand as a candidate against Charles Sisarello in the recent election to find a successor to Louis Montiel as TGWU district officer.

FREE TO CRITICISE

Though the two activists are close friends, and Sisarello sees Jaime Netto as his own mentor, this did not affect the charge nurse shop steward’s decision not to stand. “I am devoted to the union, but I am committed to working voluntarily. I would not want to be its paid employee for that would prevent me from being critical when criticism is needed. The union is not always right – nor are the nurses - and I want to be free to say so, loudly and clearly, when I feel this is the case.

“I need to be able to be critical of the system and, at times, of colleagues. And, as a representative of the working class, I need the freedom to be able to say ‘This is wrong.’ Anyway, to a certain extent, nursing is independent of the main thrust of industrial unionism.”

Greying hair trimmed en brose and a salt-and-pepper beard add a touch of gravitas to Netto’s remarks and rightly so, for he is a thinking man who has seen massive changes in his chosen profession during the past quarter century – many for the good but some for the worse. And though he was not initially as shop steward - “I was on the nursing section of the ACTSS district committee [the non-industrial section of the TGWU] – from the outset he was concerned with the rights of both nurses and patients. And it is a concern that has shone through all his activities since those early days.

SEEING THE WORLD

When he returned from working in the UK 24 years ago – “I wanted to see something of the wider world” he explains with a twinkle in his tawny eyes – he felt that he needed to change direction. His sister, now superintendent in the new St Bernard’s X-ray department, “talked to me about nursing as a ‘caring’ profession and she thought I might like it…and I did.”

(Netto, who trained for three years in Gibraltar and then spent a further six months at a hospital in Sheffield to complete his training, believes that today’s training levels are not what they should be.)

“Today there isn’t time to enjoy work…for the system doesn’t provide enough support for nurses to be able to spend more time with their patient – yet that, and treatment of course, is what nursing should be about. Now few of us have the time to provide that essential ingredient in patient care. There are still moments, of course, when you feel that you are providing this, moments which you enjoy and can really feel good about, but as the nurses’ workload grows these are becoming less and less frequent…not just for me but for my colleagues.”

His willingness to criticize the system as a whole – regardless of political implications – has brought him into conflict both with the Bossano government and with the Caruana regime – in which Netto’s brother (himself a former union activist) is a minister. And in the past his criticisms have led to change – though, as he sees it, this has still not been extensive enough.

NO ADVANCE

“Many good things have been done by the present Government – but there are areas where we as a health service have made no progress at all,” he says tapping his coffee cup for emphasis. “A case in point is King George V – where there has been no advance at all and the psychiatric patients have missed out and KGV has become the Cinderella of the Gibraltar Health Authority.

“In the sphere of health care – as opposed to emergency treatment and the nursing of the injured or the seriously ill – it is the elderly, the children and the psychiatric patients who need most yet seem to be getting the least. Certainly our attention to the psychiatric patients is falling short and there is a deficit of beds for care of the elderly…and unless something is done – and done soon – we will face the same beds crisis that the hospital faced last winter.

“We should be doing more in the spheres of home care and providing meals on wheels…and we need more district nurses. Somewhere along the line, the Government has got its health care priorities wrong. It is all very well to make a huge investment in a new hospital and to employ more specialists and surgeons and expensive managers brought in from overseas – but these people need support; and that comes from the nursing staff…”

Here not only is the degree of training falling short of what it should be, but the nurses on duty in the wards are being expected to carry more and more responsibilities and to work longer and longer hours.

STRESS LEVELS

“Stress levels among nurses have reached a peak,” Netto warns. “Yet they are given more work. You cannot expect the staff to cope with both and I have had nurses, experienced staff nurses, in tears because of the pressures they face on a daily basis. And the paperwork has increased enormously – nurses now spend almost more hours writing and filling in the necessary documentation than they do actually caring for patients on a one-to-one basis. And that is wrong. It’s bad for the nurses and bad for the patients.”

But though Netto argues for change, he is equally convinced that it should not be “a case of changing for the sake of change.” And, he adds, the GHA and Government need to look at other health service models than that of the UK.

“I recognize that we in Gibraltar can be very insular, but we need to be more selective in the lessons we learn.”

It’s an on-going process that requires commitment – something Netto knows all about.