Mixed feelings about plans to stop free service by doctors

News that the free doctor's service at health centres could possibly stop has been received with mixed feelings: some believe free healthcare is no longer affordable and others insist services should remain free.

"How can I afford to pay for healthcare on one salary?" Maria Gladwish, of Sta Venera, asked.

The Times took to the streets to gauge people's opinion after Labour leader Joseph Muscat published a report on patient registration, which was commissioned by the government but officially kept under wraps.

The report speaks about "a departure from the concept of totally 'free' medical primary health care to one which is means tested".

It proposes doing away with the free service doctors provide at health centres and turning private family doctors into the "primary gatekeepers" for access to healthcare services, except in emergencies.

Prime Minister Lawrence Gonzi denied any intention to introduce payment for healthcare services and sources said Cabinet did not agree with the removal of free services.

Therese Attard of Fgura, said there was no way she could stretch her pension enough to pay for health services.

Manwel Micallef, of Mosta, has his own views: "I never use the health centres but always go to my family doctor, so this would make no difference to me".

Frans Scarpello, 81, of Gżira, said healthcare should not be free to everyone: "Those who have money should pay for health services. I see people driving a Mercedes or wearing several gold chains picking up free medicines. That's abuse," he said.

Thomas and Rosaline Weaver of Mellieħa, preferred to pay if it meant getting better treatment. "I would not mind paying for a more personalised service but we cannot continue paying high taxes and then not get the service for free," the couple, which has lived for some years in the UK, said.

When Dr Muscat brought the report to light, Dr Gonzi said he was having talks with family doctors on the matter. The Association of Private Family Doctors however said yesterday it was not aware of any talks even though Health Parliamentary Secretary Joe Cassar had promised consultations.

Association president Anthony Azzopardi complained that on the eve of a general meeting in March to discuss an after-hours service, a member received a call from Kenneth Grech, president of the task force that drew up this report, saying it was inopportune to discuss the matter for the time being.

Questioned about this, the Social Policy Ministry said the government had no objection to an after-hours service by GPs and was in favour of the formation of group practices that could offer a holistic medical service to patients around the clock.

A ministry spokesman said Dr Grech's comments were in relation to the timing of the start of the public consultation process with relevant stakeholders.

Reacting to the news, the president of the Malta Union of Midwives and Nurses, Paul Pace would not comment on the report saying the union had not been involved in any discussions. "Nobody bothered to forward it to us. Should I have heard about it on television," he asked.

Mr Pace said he expected the union to be consulted before the document reached Cabinet level in order to avoid any problems before it got the stamp of approval.

The president of the Medical Association of Malta, Martin Balzan said the set-up of patient registration and continuity of care had advantages for both doctors and patients but getting rid of the free doctor service was unacceptable.

He also said the probability that private GPs offered round-the-clock coverage for patients registered with them was very remote and it was unlikely that group practices would be set up around Malta.

"We believe health centre services can be better organised but an emergency doctor service has to be retained," he said, adding the MAM would be proposing that blood tests and results were done by appointment.

Family doctor Pierre Mallia, who heads the University's Bioethics Research Programme, described the report as "all in all a good effort to improve" the system and said it would be opportune for Dr Muscat to declare whether he agreed with it in substance.

Dr Mallia said the fact that the report tried to do away with the existing dual system and competing interests of public health care and private family doctors would discourage the mutual burden the two have on each other.