Juan Ameen
Almost a third of outpatients miss appointment
Various reasons for missed appointments
Almost a third of those who had an outpatients appointment at Mater Dei Hospital last year failed to turn up, official figures reveal.
Out of the 378,800 patients given an appointment at various outpatient departments last year, over 106,500 did not attend and failed to inform the hospital, according to figures tabled in Parliament.
The pathology outpatients' department had the highest number of no-shows with about 35 per cent not turning up, and ophthalmology, the eye department, had the lowest - 17.34 per cent. The rest of the departments, such as surgery and medicine, had an average missed appointment rate of about 30 per cent.
Nationalist MP and family doctor Jean-Pierre Farrugia believes the high number of missed appointments might be closely linked to the long waiting lists. The urology outpatient department, for example, had a waiting list of about 11 months, he said.
"Sometimes such a long time passes between the time a patient is notified and the appointment itself that the patient would have solved the problem by going to a private doctor," he said.
Some patients tried to bypass the system by turning up at the hospital's accident and emergency department, preferring to wait for hours instead of months, Dr Farrugia said.
Labour MP Michael Farrugia believes that allowing family doctors to directly order tests at Mater Dei instead of referring their patients for an appointment can be a possible solution. Dr Farrugia, a family doctor, believes this system will cut down the red tape at the hospital.
"Why does a patient need a referral to outpatients to have a thyroid function test when it can be done by a GP? Why does a doctor have to send his patient to the outpatients simply to change the dosage of his pressure pills?"
Directly ordering the tests would ease the load on the outpatients department and shorten the waiting time for the appointment, he said. However, it was important to include an audit system to make sure there was no abuse.
Missed appointments cost money. A recent UK study revealed that more than 6.5 million missed appointments between 2007 and 2008 cost the health service about £600 million. The study linked the patients' failure to turn up to the long waiting time and pointed out that a reminder system might improve the situation.
One doctor working at Mater Dei's surgery department said calling up the patients beforehand might cut the numbers slightly but pointed out this was not a crucial factor.
There were many cases who did not turn up because they felt unwell such as the elderly, for example. Others simply went for the first appointment to be seen by the consultant and then missed the follow-ups that would be done with the clinical team. "They would prefer to be seen by the consultant and will go to his private practice."
Another doctor working at an outpatients clinic said some patients failed their appointment simply because they did not care less.
"Some people shop around for doctors; they go to different general practitioners who, in turn, make their own referrals and this ends up in multiple appointments."
One doctor was surprised by the figures and described them as "excessively high". He admitted that people did miss their appointment but pointed out he found it strange that the clinics in the outpatient departments were always full of people.
A Health Ministry spokesman said such figures worried the authorities because all clinic appointments should be fully utilised.
"This can be achieved if and when all patients with booked appointments understand it is their duty to inform the hospital that a scheduled appointment is no longer required so slots can be freed for the benefit of others," the spokesman said.
Education was the key to missed appointments, many of which happened because the time was not convenient to the patient or because they forgot or visited a consultant privately, the spokesman added.
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H Galea
Jul 7th 2010, 10:42
Why patients don't turn up for the sole reason, we have to present ourselves at 07:30 neaning we have to wake up early to travel, and then the Dr turnes up at 09:00. We end returning home at about 13:45 hungry as we are unable to leave the waiting room. We expect that tests results will be first sent to patients in writing home, where we can study the result and be able to ask questions later to our Dr or the Specialist. This systen will cut the waiting list at the outpatients by 25% or more and also the congestion at the hospital. We have become a race of lazy people, We want to learn IT but not to communicate, Dr's can send results over the internet.
Joe M. Anastasi
Jul 7th 2010, 09:41
I'm not surprised people don't bother.
I had an outpatients appointment a few weeks ago. I arrived on time at 9am to find a hall chock a block with people of all ages, shapes, sizes and colours, a foul stink of B O, and total chaos and confusion.
I was on crutches, and could find nowhere to sit, so I simply left and returned home. I didn't really have much choice, did I.
I have unfortunately had my fair share of hospitals in recent years and I have to say that every department I have been involved with has been excellent in every respect, but I certainly cannot say this of outpatients.
I don't know if the backward step of removing many of the polyclinics has anything to do with this.
Claire Busuttil
Jul 7th 2010, 00:21
I am sorry but cannot belive such a thing!! I hear a lot of people, including ppl very close to me, complaining the fact that are given appointments for the following year.....so.....I find it extremly hard to belive such a statement
Denis A. Darmanin
Jul 6th 2010, 22:11
A little late in the day, but still in time: Having had to wait ten months for an out-patient appointment, I kept it and attended. The foreign doctor went through the same procedure that my GP had done times before and would not listen to me or view my own personal file. I was given papers to get blood and other tests and an appointment for late December. Come December, I'll probably go through the same ordeal again and given another far off appointment.
Apart from the good argument that I should have done it all privately, my reply is "Why should I?" We have a state-of-the-art hospital, capable staff and I pay my taxes. If I'm due this free service, then I expect a better treatment. If it wasn't for free, then I would still pay a reasonable fee and still expect better treatment!
What’s wrong with our hospital? Is it the staff, the system, the amount of patients, not enough doctors and consultants? Whatever the reason, I’m surprised how a solution has never been found and ashamed to say that it doesn’t look like it will ever change or if anyone cares.
Ben Valletta
Jul 6th 2010, 18:14
last may i went to my gynea and she referred me to hospital to see a consultant regarding stomach problem......when i went to mater dei to book an appointment with the gynea s referral....i was informed that my appointment was for may 2011........well of course i had to seek private help as i wasnt going to wait till next year to know if i had something serious or not. In my opinion the first appointment should be within the month..and then if the case isnt serious one can be given a later appointment...but what if my case was something serious and i couldnt afford to seek private help??? Maybe thats why all those patients didnt turn up for their respective appointments!!!
Frank Galea
Jul 6th 2010, 17:26
Before putting the blame for missed appointments at Outpatients on the patients, the competent authorities should first examine carefully whether the present appointment by time system is working well. I speak from personal experience when some months ago I was given an appointment at 10am at the Orthopaedics Outpatients to be given the result of a test which I had done some months before. I parked my car 10 minutes before the appointment and went directly to the relative department. On my way in, I was stopped by Security personnel and when I showed them my card I was still denied entrance and told to wait outside. To cut a long story short, I managed to see the doctor at 1.15pm and when I complalned to Customer Care they told me that the situation was beyond their control! Needless to say I also had to pay a far larger parking fee! All this hassle for a 5 minute talk with the doctor (never the consultant!) I protested in writing with the Health Authorities but to date received no reply. How's that for efficiency!
Jenny Griggles
Jul 6th 2010, 17:05
Would also be interesting to know how many doctors, specialists, dentists etc etc have cancelled their appointment with clients and how often!
Paul Muscat
Jul 6th 2010, 13:26
Could it be they died of old age whilst waiting????
Claire Busuttil
Jul 7th 2010, 00:22
this is a more realistic statement...!
martin saliba
Jul 6th 2010, 12:52
Dose anybody expect anything different. The only reason why people miss their out patients appointment is because the appointment they are give is so far ahed in the future that they prefer to go to a private clinic not because they can all afford it but because the are eager to put their minds at rest or so that whatever medical problem they have dose not agrevate itself by the time their appointment is up.
P. Montebello
Jul 6th 2010, 14:34
If that is the only reason, then, they should have the courtesy to call the relative department and cancel their original appointment.
maria delicata
Jul 6th 2010, 11:22
one way of avoiding this is to designate a clerk to phone up the patient a few days prior to the appointment :1) to remind them 2) to help with transport arrangements if there is a problem for the patient to make their own way. if missed appointments cause the government a substantial amount of money then this would be a good investment.
CZARB
Jul 7th 2010, 07:46
Do you think that we should also send a limo while we're at it? A person should be responsible and remember his appointment
L. Muscat
Jul 6th 2010, 11:10
A number of patients such as the elderly or infirm often find themselves unable to attend appointments because they depend on others to take them. For them a simple appointment can be quite an ordeal especially if they have limited mobility, if they live alone or if they have no family or friends to help them out.
J.Tonna
Jul 6th 2010, 11:02
I wonder!!!!!!!!! Whenever i am given an appointment for 8.30 a.m. I am generally seen at 11.00 a.m. if not later. What then if all those appointments turn up???????
When once I had an appointment and developed a cold I phoned Mater Dei to tell them and ask for another appointment. I was, rightly, told to call myself with my card for the appointment, when I feel better. That is what everyone should do and not grumble and grumble.
Michael Parks
Jul 6th 2010, 11:00
Perhaps there should be a refundable deposit / fee.... attend, and you get your deposit back.
It's hard enough to get appointments here in the UK at the GP surgery because the list is populated with folks who don't turn up but take a consultation slot.
A.J.Borg
Jul 6th 2010, 10:52
Some patients pass away by the time their appointment is due. Others are constrained to go private as treatment is urgent. In fact, Cardiac services tops the list, no wonder why!
P. Montebello
Jul 6th 2010, 10:51
This is rather alarming. Slots can be made use of by other people who are denied a quicker appointment.
Can the health department make a nominal charge of say E 5 to a person who just ignores his appointment and then calls for another appointment? The charge will not be levied to those who inform beforehand of the cancellation or for justified urgent reasons. Furthermore it should not be so difficult since we all have our ID numbr.
We all know that if people will be more aware if they are charged in their pocket.
Ramon Casha
Jul 6th 2010, 10:38
Perhaps it wouldn't be a bad idea to request a deposit when the appointment is made. Even a small amount - say €10 - which would be refundable when the person turns up, or if the patient informs the hospital in advance.
On the other hand, it would be nice if certain hospital departments did not book all the day's patients at 8am.
G. Grech
Jul 6th 2010, 13:34
Some appointments are as far as 6months. The patient might have sought private health care, or at worse, might have died waiting for the appointment !!
Ramon Casha
Jul 6th 2010, 15:07
So if the patient seeks private health care they'd phone the hospital and cancel their appointment, and would be able to retrieve their deposit.