Patients to register with private GP under proposed reform
Charlot Zahra A mandatory registration system for patients with a private general practitioner will be one of the hallmarks of the reform in primary health care, which was introduced by Social Policy Minister John Dalli and parliamentary secretary Joe Cassar yesterday morning.
Under the proposed reform, the GP will be the first point of contact for patients, who will be able to channel their medical requirements through the GP, rather than referring to Mater Dei Hospital.
The registration of patients would not be at a cost; however patients will be expected to pay the cost of their visit to the private general practitioner as usual.
Moreover, an unspecified means-testing system will be introduced at two levels – for those patients who cannot afford to go to the doctor for a certificate, and for the renewal of prescriptions under Schedule V cards (chronic diseases) and Pink Cards (low-earners). For those patients who cannot afford even a private practitioner’s visit, they will be able to visit their family doctors free of charge. A reimbursement system will then be worked out for each doctor, based on the number of patients registered under his practice. However, health centres would remain under the proposed reform and they would be developed into hubs for primary and secondary care interventions at regional levels. Asked about the time-frames for the building of these centres, Dalli said it would take some time before these centres are upgraded. “Things are not made overnight,” he insisted. Under the proposed reform, there will be three or four regional health centres in Malta and another in Gozo, which would serve as a one-stop shop for community care and for specialised care for certain prevalent diseases and conditions. They would also be equipped to treat minor but urgent conditions which could not be easily treated by the family doctors.
These regional centres would continue to see urgent cases who would not been referred by their family doctor. However, patients who do not have urgent ailments and who go to Mater Dei’s emergency department without being referred would be sent back to either the regional health centre or their doctor.
This is expected to relieve the pressure on the hospital Casualty Department, slashing the currently long waiting time and allowing patients to be better served within the community.
Moreover, clusters of district health clinics would be able to provide specific services and support to hospitals, family doctors and the community as a whole.
With the patient’s consent, the family practitioner would be able to access the patient’s medical records electronically. Moreover, the GP would be able to prescribe medicines from a pre-determined schedule and refer the patient to out-patient appointments and day-care procedures. One of the problems identified in the current healthcare system was fragmentation and lack of continuity in patient care. Therefore there was an urgent need to create a seamless and coordinated quality care services to ensure synergy between different services. The reform would enable Mater Dei Hospital to perform its proper function as a tertiary acute care hospital, relieving the hospital from needless primary and secondary health work which could be done elsewhere. The consultation process will be taking place till the end of January 2010, however Dalli said that it will extended if the need arose.
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