Cynthia Busuttil
'Wrong for doctors to dictate matters'
The Qormi health centre will be hit by doctor's industrial action. Photo: Jason Borg
Decisions within health centres cannot be taken by unions but by the management, Social Policy Minister John Dalli said in remarks critical of the directives issued by the doctors' union.
He said it was wrong for the Medical Association of Malta (MAM) to take matters into its own hands.
"MAM made some requests which we are studying but we will not accept to be dictated to by the association," he said in comments to the media a day after MAM issued hard-line directives which will see half of Malta's health centres remain closed from Monday.
When asked whether the authorities would be taking any legal action to ensure that the clinics are not closed, Mr Dalli said this was not an issue of legal action but dialogue.
"We have to find solutions which ensure that we get the full value from those working in clinics and hospitals," he said.
"The health service cannot revolve around the convenience of doctors who want to juggle their work in the clinic and their private practice," he said, adding that everything has to be centred around the patient.
He also insisted that health centre doctors needed to take on more responsibilities and stop sending patients to hospital for small ailments.
"You don't need to send someone to Mater Dei for a blood test," he lashed out.
MAM president Martin Balzan said that productivity was already very high, with health centre doctors seeing some 240,000 patients every year, and only few referred to hospital.
However, he continued, when there was a doubt about patients whom the doctors were not familiar with, they were sent for further investigations. "We will not take risks with patients' health," he said.
The doctors' union is also considering directing doctors at the hospital's emergency department not to see patients who are not referred unless it is a clear emergency should the department be inundated with people as a result of the clinics' closure.
"There are people who go to emergency because of a cold or a sore throat," Dr Balzan said.
Although he recognised that there was a shortage of health centre doctors, Mr Dalli said it was imperative to concentrate on the introduction of work practices which increased doctors' productivity and their contact with patients.
The MAM council issued the directives on Monday evening, under which doctors at the Qormi, Rabat and Cottonera health centres will report for work at other clinics from next Monday while the Gżira health centre will only be open half day.
The union complains that it has been calling on the authorities to concentrate human resources in fewer clinics as a short-term measure to alleviate the shortage of doctors but that no such action has been taken.
In Parliament on Monday, Mr Dalli forcefully attacked wasteful work practices in the health sector, saying that these had to be addressed so that available resources could be made better use of.
Referring to the shortage of doctors, he said this was not an issue of the government not wanting to recruit more people.
Mr Dalli said talks with MAM were still ongoing with a view to possibly averting the strike. Although MAM was one of the trade unions that least had a habit of making strike threats, such threats by all trade unions must stop because they caused intolerable harm to the well-being of those on the receiving end.
Contacted by The Times, Dr Balzan said there was still room for discussion before the directives kicked into force.
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S. Abela
May 13th 2009, 20:14
I work in a major health centre and do not, dear minister, 'juggle my work in the clinic and my private practice..'. I have chosen NOT to have a private practice, and yes, there are many of my colleagues whose GP work is only related to health centre work. I am often verbally abused because I have only two hands and cannot be writing prescriptions, carrying out consultations in the GP room, suturing a complex wound, and triaging 'urgent home visits' at the same time. I do not 'send patients to hospital for small ailments', but yes, if I think that a patient warrants an Xray and on that particular day, X-rays are NOT TAKEN in my heatlh centre, I have little choice but to refer. (Where I work Xrays are only taken 3 days a week, so the standard of care one receives as a patient is cruelly determined by the day and time one is injured..) Yes, if I think that patient needs an URGENT ESR blood investigation to confirm or exclude temporal arteritis, I will have to send him to Mater Dei 'for a simple blood test.' Please get your facts right, dear minister, before lashing out.
Patrick Sciberras
May 13th 2009, 17:40
The problem of people going to Emergency with minor ailments can easily be remedied if only there is a bit of political will to change bad practices, same goes for people going to out -patients for approval of the more expensive drugs (DTC approvals). Most family doctors are able to cope with these situations but are NOT empowered (political/Health Dept.decision)to do so, same goes for blood tests,mentioned previously.
If family doctors can order tests/prescribe what is best there is no need for referring a large percentage of patients.
J.Brincat
May 13th 2009, 15:53
Why is it that a family doctor cannot fill up a blood test form for a TFT or a PSA but has to refer the patient to a health Centre or Mater Dei for above tests? The minister should concider ending buraucracy and stop blaming the doctors for the problems at the health centres. You only reap what you sow dear minister!!
Galea. L
May 13th 2009, 13:45
That's the result of sweeping the problems under the carpet for far too long.
Albert Spiteri
May 13th 2009, 13:18
In a civilized society, a democratic government looks for long-term solutions, which means decisions are taken together with and only after proper exercise of continuous consultation, with unions. This fixation, or idea, call it whatever, that a minister listens, then decides 'in camera', or 'in cabinet', is 100% counter-productive. No union on earth would accept that. Dalli and his fellow men in this GonziPN immoral, illegitmate and illegal government should learn this, once and for all!
Mario Tabone-Vassallo
May 13th 2009, 13:02
Tabib jilhaq tabib biex jaqdi l-pazjent u mhux bil-kontra. Tabib ghandu d-dritt jara li l-kundizzjonijiet li jahdem fihom ikunu xierqa ghalih. Tabib ghandu d-dmir jara li l-kundizzjonijiet li jahdem fihom ikunu tali li ma jqeghedux lill-pazjent f’sogru mhux mehtieg ghax, nghidu ahna, t-tabib ikun ghajjien jew mhux imharreg bizzejjed. Kien ghalhekk li shaqna li fid-Dipartiment ta’ l-Emergenza ma hemmx bizzejjed tobba u hemm hafna tobba minghajr l-esperjenza mehtiega. Tabib ma jistax ma jarax pazjent minghajr riferta jekk ma jkunx cert li l-kaz mhux urgenti. Jaghraf dan biss wara li jezamina l-pazjent. It-tobba fl-isptar soltu jistghu jirrifjutaw li jaraw pazjent bla riferta ghax jafu li l-pazjent imur l-Emergenza. Hemm lok li pazjenti mhux urgenti ma jkunux ikkurati fl-Emergenza, izda xi hadd l-ewwel irid jaccerta ruhu/a li m’humiex urgenti. It-tobba ta’ l-Emergenza ilhom fit-tul wisq injorati meta huma x-xibka li thares lill-pazjent minn kull nuqqas li jista’ jkun hemm. Il-gid u l-htiega tal-pazjent jinhtiegu jibqghu l-ghan ewlieni ta’ kull ghemil u mhux jintuzaw bhala ghodda. It-tabib ma ghandux isib ruhu f’qaghada li jkun tant mghobbi li jaqdi inqas tajjeb mill-mehtieg.