Cynthia Busuttil
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.
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Charles Grixti
May 28th 2009, 20:03
By 'free' we mean tax funded.
The dangers of removing this piece is that it looks to be the start of the gradual erosion of the Health System as we know it, and to the principle that every human being should have access to good healthcare regardless of their economic means. This is the foundation-stone of our Social Democracy!
Tthe relentless lobbying by the private health sector to degrade social medicine and so that in time, the people themselves will ask for a private system, should not be underestimated.
But once the private healthcare providers are calling the shots, the patient will cease to be the focus and be replaced by corporate profits. Many middle class people have been reduced to bankrucy and penury in the US where this system - medicine by accountants - has been in force for years. When your insurance covers only a limited amount (depending on the insurance policy you can afford) the patient is out of luck unless he can fork out the money himself. Consequently, only the very rich can afford the best medicine that money can buy, the rest will have to do without.
Is this the kind of Malta we want?
michael gonzi
May 28th 2009, 18:32
i must say that the beauty of our present system is that everyone can choose his own family doctor . If any patient thinks that his own Gp is overchraging or not delivering ,he can always change to another family doctor . Thereby he would know that probably others are charging much more than i do . i must be superman to be able to work at Emergency department in Mater dei as well as have my own private practice and be a parliamantarian , as well as a father of two sons and a grandaughter and see 60 patients a day plus house visits .Private general practioners are not included in the VAT system and therfore we do not issue a VATreceipt . WE still however pay our taxes and declare our assets which does not include a BMW and villas .
Galea. L
May 28th 2009, 17:49
M. Debono
I hope that you were not one of those who raised hell when Dr Sant introduced the 50c payment for prescriptions.
r ferriggi The system is SUSTAINABLE if the Gonzi takes the bull by the horns and stop SQUANDERING our taxes. As for paying for your own health services, pray God that you will never need certain treatments for the costs have led many a rich person to bankruptcy.
We should thank Dr Muscat for exposing this DIABOLICAL Gonzi plan.
Paul Borg
May 28th 2009, 14:16
If you are in doubt about this issue just log into www.direzzjonisuccess.eu. and you will find the "confidential report" as debated by the Cabinet and released by Joseph Muscat.
M. Debono
May 28th 2009, 13:55
@ D Schembri
It is always the same argument, everyone claiming that not even one service is free as we are paying taxes.
Currently all health services from Blood pressure monitoring up to brain surgery is FREE.
No government will give a tax break, or decrease taxes once Health is removed from the FREE services.
Therefore to pretend everything for FREE because you are paying taxes is not a valid argument.
Regarding Health Centres - they are currently being used by more than 80% of the population as a locum service (i.e. used only when their GP is unavailable).
If they are eliminated as this document is proposing, the other option is a very expensive private hospital, if your GP is unavailable.
carmelo briffa
May 28th 2009, 11:50
I am a pensioner and live in St.Pauls Bay. I do have a family doctor and regardless for what I go to see him , he stepped up his fees even though he also have a second good job in parlament. They never give you receipt. 9 out of 10 he reffer you to go to hospital. Sometimes I wonder how much he makes only in just one month. He see avarage of 60 clients per day ot including his visit to homes......What a robbery this is from out tax department.. No wonder they BMW's and beautifull villas......how about the goverment start cracking about the vateceipt from them , although again they will step up fees to make for their losses. Lots of shame to somne doctors
P.CASSAR
May 28th 2009, 11:40
What's this about taxing health care???
First of all we are already paying national insurance and secondly we pay regular taxes and vat on a myriad of things and services ( the most taxes in the EU). It is GonziPN who is mismanaging all our money.... like ministers buying Jaguars, over expenditures on all projects etc etc
Again please stop treating us as fools.
r ferriggi
May 28th 2009, 11:38
to Mr Calleja
forget partisan politics.
the system IS NOT SUSTAINABLE. do you ( can you) understand this please??
firstly,,,,, its being paid for by ( the hard-working section) of the people.
secondly,,,,, this ''free'' here and there was a myth created by Labour in the 70s and perpetuated by the PN until now.
maltese people - THIS SYSTEM IS NOT SUSTAINABLE ((credit to him,,,,even Dalli said it.))
Anthony Magri
May 28th 2009, 11:17
Free medical service at night should never be done with. Private doctors who spend the day seeing and visiting their patients are or would be reluctant to render the service during night hours. Doctors in attendance at the Govt health centres should remain available.at night.
A lot of emergencies occur at night, this has been noticed. There is even the impression that natural deaths occur most often at night.
N.Calleja
May 28th 2009, 10:39
The scope of creating such a hullabaloo by Joseph Muscat has reached its goal. On the eve of the European election Muscat could not resist creating confusion by rekindling an issue that was denied by the government. Even this time the Prime Minister's assurance that healthcare would remain free is not enough to keep big mouths from creating doubt amongst the population. We will hear more of the same during the remaining days before the election !!
D Schembri
May 28th 2009, 10:21
This is a mistaken perception. Health service are not free but paid through National Insurance conributions.
r ferriggi
May 28th 2009, 09:52
Scrap the current system where those who pay never use these services.
WHEN,,, you need the service,,,,, and it is an emergency, you go to private anyway and pay again.
or you are too busy to stay in the long queues.
or you are 'not eligible',,,,,, the famous phrase.
so,,,,,, i prefer to be given a tax break and let me manage my own health care.
this ''free'' education and free health care is an unfair gimmic.
PL and PN stop playing around with voters about it.