Polyclinic has become inadequate

The Victoria health centre (known as the polyclinic), has been functioning since October 1991. It provides a general practitioner service and an emergency clinic for minor injuries and illnesses and is also an immunisation clinic. These services together with the community nursing service form the main primary health care services, provided in Gozo by the government.

The polyclinic opens daily from 7 a.m. to 8 p.m., after which the service is provided by the Emergency Department of the Gozo General Hospital. There are also 12 district clinics with a doctor to attend to patients for a specified time during the week. These clinics serve mainly for prescriptions and the collection of free medicines.

Local councils are co-operating to maintain these clinics and upgrading them since most of them are simply a room in a school or part of the local police station.

More people have been making use of the polyclinic. Statistics show that from 1991 to 2004 the number of patients increased from 19,551 to 66,309. The clinic is particularly busy during the summer months, when patients include Maltese visitors holidaying in Gozo and tourists many of whom are from EU countries and thus entitled to free treatment.

Clearly, the polyclinic has become inadequate to meet demand. The premises consist of a waiting room, two small rooms where patients are examined, a treatment room which also serves as a store, an immunisation clinic, and two toilets. All these are crammed in a few square metres. Babies attending the immunisation clinic are in danger of being exposed to infectious diseases other patients may be carrying, especially in winter, when influenza is at its worst.

Besides, there is also lack of privacy as most of what is going on inside a consulting room can be heard by one and all in the waiting room!

Another problem is that of accessibility. The street where the clinic is situated is very busy and near a private school. Patients have problems parking near the clinic and during school days the street is closed for a few minutes when school is out so ambulances cannot has to get through while doctors cannot leave urgently visit a patient using their own cars. These are logistic problems, which have to be considered when choosing a new site for a health centre.

Lack of space is also hindering the staff, who one must say are doing their utmost to offer a good, efficient and professional service. They often take the initiative to improve the environment of the clinic and make it more comfortable and user-friendly. People who frequent this clinic, including foreigners are very satisfied with the service.

Visiting this small place one can notice that it is kept as clean as possible with a TV set and comfortable chairs in the waiting area and a digital blood pressure machine. These were bought with donations made by patients, mainly foreigners, in recognition for the excellent service they received.

Since January, a computerised patients' drug prescription system has been introduced to facilitate and standardise the prescription of repeat medicines. With this new system, the patients need not wait long for a simple repeat prescription, and wrong use of excessive medications is minimised.

However, it is becoming more difficult to improve the service if the space constraints are not overcome. Before deciding on new premises parking, accessibility and space must be taken into consideration.

One should also decide whether the service should be given on a 24-hour basis and not just during the day. It does not make sense for a patient going to the hospital emergency department at night to be first seen by a polyclinic doctor and then by the hospital doctor.

This duplication can be avoided and the hospital emergency department should be left for serious cases and not for people with minor problems which can easily be dealt with in a well equipped polyclinic. So, a new polyclinic should have a minor operating room, an X-ray machine and at least an ECG machine. This is the basic medical equipment which the present polyclinic lacks.

One should consider any changes in the primary care services in Gozo in the light of the general health reform the government intends to introduce. So the question is whether the government intends to extend and improve this service. One hopes that it will be considered by the people as an improvement, not a weakening, of the present primary health care system.