A registration system for patients with a family doctor is at the core of the much-awaited reform in primary health care, which was launched this morning and opened for consultation.
The reform revolves around the registration system with family doctors who will be their first point of contact for all their patients' medical needs.
A reform report announced by Social Policy Minister John Dalli points out that one of the problems in the current healthcare system is fragmentation and lack of continuity in patient care and says it should be a priority to create seamless and coordinated quality care services to ensure synergy between different services.
Patients will be free to choose their chosen care provider. With the patient's consent, the doctor will be able to access the patient's records, public laboratory and radiology investigations, prescribe from a pre-determined schedule of formulary medicines and refer the patient to out-patient appointments and day-care procedures.
While the patients will not have to pay for a registration fee, they will continue to pay the private doctor's fee. However, there will be a means-tested mechanism to identify those who cannot pay, and for whom the government will pay a fee.
Moreover, people with chronic diseases will be able to see their family doctor for follow-up care and repeat prescriptions, which will be subsidised through a reimbursement system.
Although the emphasis will be on the relationship between the patient and the family doctor, health centres will remain and they will be developed into hubs for primary and secondary care interventions at regional levels.
There will be three or four health centres in Malta and another in Gozo which will serve as a one-stop shop for community care and for specialised care for certain prevalent diseases and conditions.
They will also be equipped to treat minor but urgent conditions which might not be easily treated by the family doctors.
These regional centres will continue to see urgent cases who have not been referred by their GP, but non-urgent patient who go to hospital's emergency department without being referred may be sent back to either the regional 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 (bereg) will provide specific services and support to hospitals, family doctors and the community as a whole. While government family doctors can still continue to do private practice, they will not be able to enrol into the registration system.
Mr Dalli said the reform would enable Mater Dei Hospital to perform its proper function as a tertiary acute care hospital. The reform would relief Mater Dei Hospital from a lot of work which did not need to be done there.
Mr Dalli said the government would help the doctors set up the IT systems necessary to access records and would also be promoting group practices.
The consultation process will include a rage of meetings with workers and other operators as well as doctors and patients.
Parliamentary secretary Joe Cassar said a call centre with the number 188 had been set up for people to ask question or offer suggestions.
The consultation document is to be made available on sahha.gov.mt