New policy at Emergency Department
Patients with minor complaints sent to health centres
People with minor complaints who call at Mater Dei Hospital’s Emergency during the day without a doctor’s referral will be sent to a health centre in line with a new policy. The policy came into place last week through a Health Department circular signed by Mater Dei’s chief medical officer, Natasha Azzopardi Muscat.
With patients already experiencing long waiting times, the Accident and Emergency Department has witnessed increased “walk-ins” – patients who go there instead of to their GP or a health centre.
A “significant increase in daily attendances” was noted, the circular pointed out. Dr Azzopardi Muscat said some individuals referred themselves “inappropriately” to Emergency even when they had minor complaints that could be easily treated elsewhere.
A poster displayed at Emergency’s main waiting area informs patients that if they come without a medical referral and if, after medical triage, their condition is considered to be non-urgent, they will be re-directed to a health centre, according to Dr Azzopardi Muscat.
“This policy was implemented to give Emergency patients more timely care,” Dr Azzopardi Muscat said.
An estimated 9,160 patients went to emergency last month, a 13 per cent increase over February 2011. Of these, 61 per cent were high priority cases that almost all led to admission in hospital.
A total of 2,896 patients were referred by other health professionals or institutions and almost 6,250 were walk-ins.
Almost 1,850 of the self-referred patients were high priority, 1,074 were medium and 946 had conditions considered to be low priority. The remaining patients required treatment in other departments such as paediatrics, obstetrics, gynaecology, ophthalmic and dental, among others.
Of the patients who had a referral, 1,130 were high priority, 786 were medium and 372 were low priority while the rest required treatment in other departments.
While educating the public about the use of emergency would continue, Dr Azzopardi Muscat said other action had to be taken.
Between last Wednesday and Friday, 869 patients called at emergency, including 564 self-referrals.
“There were 41 redirections during those three days,” Dr Azzopardi Muscat said.
The redirected cases were patients who had the “same, non-urgent complaint” for months or years or who wanted an earlier outpatient appointment.
When asked to define “minor complaint”, Dr Azzopardi Muscat said that each one was “taken on a case by case basis” following a medical examination of the patient. “Generally speaking, complaints that would have been there for a period of time are not classified as emergencies,” she explained.
The policy is being implemented between Mondays and Fridays from 8 a.m. to 5 p.m. Only patients who can be treated at health centres are redirected and those with fractures and dislocations are treated at Emergency.
Although it was “possible” that people with minor complaints would start turning up after 5 p.m., Dr Azzopardi Muscat said the policy would have to be monitored for its effectiveness.
What happened if someone required an X-ray?
Dr Azzopardi Muscat said Mosta was the only health centre equipped with a digital X-ray machine linked to Mater Dei Hospital. The service at Mosta is offered between 7 a.m. and 7 p.m. “We are working to try and increase our digital X-ray facilities in health centres,” she said.
“The exercise will be monitored and results will be fed into an audit so appropriate guidelines may be drawn up. This policy will be evaluated and fine-tuned over time,” she added.
Patient safety remained a paramount consideration throughout, Dr Azzopardi Muscat insisted.
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Francis Grech
Mar 16th 2012, 00:56
I wholly agree with Mr galea's comment that if for instance a small token can be charged for service rendered at A&E departement you want get a lot of people going there unless it is an emergency situation, but than again that's what you get if you advertise and boost every time that we have a state of the art hospital every body will want to have visit if it's for free,further more if people like me 75 yrs go to the local clinic for a blood test as last week it was (Liver awarness )week and being told that you have to wait till May to get one,after being told that I have to be reefered by my GP I will ask what's the use if local clinics if they as well are turning patient's away.
Joseph Borg
Mar 15th 2012, 14:32
IDEA TAJBA...........taf fejn tinsab il problema???? li s servizz fic centri tas sahha huwa tal qamel!!! i.e x rays digital Mosta biss sas-7pm......l ohrajn hemm minnhom sal 5pm biss , is sibt sa 1pm u il hadd ma jifthux ghalkhemm minhix cert regax kien hemm xi caqlieq fil hinijiet ricentament.
So nistaqsi.....jekk inmur is SIBT jew il-HADD l emergenza ghal "cucata" x ser jigri??? ser jibghatuni il health centre ghalxejn jew ha jghiduli stenna sa nhar it tnejn? jew kulhadd imur il Mosta?
Jiena nahseb li kif jghid il Malti qed inraqqu il pannu bil qarha hamra!
Il problema principali ghaliex KULHADD jaqa l emergenza hija semplicissima u ma ghandekx bzonn tmur l universita!
In nies tilfu il kredibilta fil kura primarja....dan ghal hafna ragunijiet fosthom , nuqqas ta servizzi offruti 24hrs bhal Xrays, ECG, Gibs etc etc. Certi tobba "antiki" li qeghdin komdi jaghmlu il minimu possibli, nuqqas ta nurses trenjati f certi centri tas sahha u problemi ohra
So qabel ma ttiehdet din id decizjoni missu l ewwel verament sar il famuz Reform of Primary Health Care u mhux tpatpit fil vojt , hafna rakomandazzjonijiet u studji u fil verita ma jsir u ma sar xejn. Jekk minhix zbaljat ftit snin ilu hareg ukoll xi booklet fuq il famuza Primary Health Care Reform!!
Il kura primarja ila li qabdet in nizla....so jiena ma niblejmjax lill poplu li qed jirrikorri ghal emergenza ghax let's face the reality minghajr hafna tlaqlieq.....Jekk jinqalalek xi haga fil weekend ma ghandekx alternattivi...jekk tiflah thallas tmur fil privat u tinqeda fejn l istennija hija hafna anqas....jekk ma tiflax thallas tirrikori Mater Dei l emergenza....ghax mhuwiex fatt mistur li t tobba tal Familja fil weekend ma taqbadhomx anqas jekk taghmel weghda lill ta Pinu filwaqt li fic centri tas sahha jew huma limitati biex jahdmu jew ma hemmx interess ghax hemm min hu komdu hekk!
Qabel verament issir riforma dicenti tal Kura Primarja fejn ahna ha nibqaw u immarkaw x imkien dan li ha nghid.......in nies MHUX SER TONQOS mil emergenza ghax issa jew jibdew it tobba jirreferu lill kulhadd addocc bhal ma hafna diga jaghmlu (u HADD ma jiehu azzjoni ghax meta kien hemm min prova gie mwaqqaf mil famuza MAM li mohha biss biex tiggieled mal MUMN) jew inkella jibda jkun hemm is short cuts ta nies imorru ghand it tabib jiffitawh biex jibghathom mater dei.
Biex verament tahdem din is sistema il poplu jrid ikollu servizz dicenti fil komunita! Ma nahsibx huwa hobby tan nies imorru jaghmlu sieghat jistennew l emergenza....jaghmlu hekk ghax ma jinqdewx x imkien iehor!!
Scenario ta l ewwel buzullotta li ha tinqala.......tmur l emergenza, tweggha saqajk, tkun qed timxi fuqha, jarak in nurse u it tabib, jghidulek dan kaz ta health centre, tmur tiehu x ray, isibulek hairline fracture li ghanda bzonn gibs u jergaw jibghatuk lura Mater Dei!! Dan huwa STAT TA FATT li ha jigri ghax l ebda tabib ma huwa x ray machine u mill esperjenza tieghi ghal zmien twil nahdem l emergenza, gieli kien hemm kazi fejn tahlef li jkollu ksur persuna u ma jkollux u vice versa!
Barra min hekk diga t-tobba fic centru tal Mosta minkejja li in nurses inghataw tahrig kif japplikaw gibs baziku irrifjutaw li jiehdu responsabilta li jordnaw gibs fuq xi hadd!!
Biex din tirnexxi trid:
1) taghmmar KULL centru tas sahha (Mosta, Paola, Floriana at least) B digital X Ray machine
2) Taghmmar KULL centru tas sahha B ECG technician at least bejn 7am u 7pm jew jigu trenjati in nurses jaghmlu ECG baziku (bhal ma jsir fil privat) halli jkollok servizz 24hrs
3) Taghmmar ic centri tas sahha b point of care machines li jistaw jahdmu demm ta emergenza there and than halli tevita hafna riferti bl sens lejn Mater Dei....dan diga jsir fil privat u sahansitra f certi spizeriji.
4) Titrenja lill KULL infermier kif japplika gibs baziku
5) Tinqata il burokrazija grassa li tezisti
6) L MUMN u l MAM ma jibqawx qishom il vavi jiggieldu kontra xulxin!
Dan kollu li semmejt ma jirrikjedix miljuni ta liri imma biss ftit eluf li eventwalment inaqqsu bis serjeta u mhux taparsi n nies milli jmorru l emergenza.
Jekk ma jsirx hekk...hmir konna u mija ha nibqaw.....mind my words......specjalment jekk tikkunsidra li ghal xi raguni sopranaturali hemm hafna sahha min certi nies fic centri tas sahha u dejjem sabu lill mahbuba MAM (li tant taqbez ghal marid) tiddefendijhom!
Kif ghedt , this does not require rocket sience to notice.....anki censu tal pastizzi (with all due respect lill pastizzara) jinduna b dawn n nuqassijiet!
It tieni imbghad nibdew verament nindirizzaw il problemi ta Mater Dei, ghax 30 pazjent go kuritur mhuwiex rizultat ta nies li jmorru l emergenza ghalxejn imma biss mis management ghax la ghandhom bzonn joqghodu l isptar ma marrux l emergenza ghalxejn...jew le?
Imma dik problema differenti so ejja ma naqbzux fuq issue ohra rigward is state of the art Health service li ghandna go Malta.
Allahares ma hawnx il maggor parti tal istaff (Tobba, Nurses, Nursing Aids, Carers etc etc) li huma dedikati u verament jaghmlu xogholom sew ghax kieku ilna li missejna il qiegh!!
Kenneth Galea
Mar 14th 2012, 21:14
@Nazzareno Cortis
First of all you do not tell me to shut my mouth. I am a middle class individual who work hard to earn a living. It is not rocket science to distinguish between an emergency and non emergency. Patients are flocking to A&E even with flu symptoms. We pay taxes and NI whether or not the economy is booming, however from the point of use at A&E I rather pay a fee and not end up waiting for hours on end. What are the centres known as polyclinics doing? They are there for a purpose. If a fee is introduced to visit A&E the numbers will be halved. But in Malta everything is expected for free and this mentality needs to change once and for all. You sound like those ones who want everything for free and want to put your feet up all day long.
Joseph Grech Attard
Mar 14th 2012, 18:00
"NEW" Policy? LOL!! This is history repeating itself! This same "new" policy was implemented more than 30 years ago at St' Luke's Hospital. The studies and actions are exactly the same but the the "wound' had started slowly to heal by the introduction of the Polyclinics; when, suddenly, out of the blue, "expert" PN governments re-named the Polyclinics "Health Centres, " only to slowly kill them by time and bring them to the disastrous situation they are in now! Why was this done? Obviously to please private practice GP's and specialists, together with private hospitals and clinics!! This went well until the people, again due to mismanagement and bad-planning of extreme Capitalistic PN and GonziPN governments, squandered all their money because "Money is no problem" went the saying. Now, that finances are in a mess, and people cannot make their financial ends meet, citizens cannot go back to the government family physician scheme because it has become, however, practically non-existent. So, they go to the 'state of the art' hospital, which, if it continues in its present state of affairs, will soon resemble more a 'state of the art' stable than a multi-million euro hospital. Being Lent, may God make any false and irresponsible policy-makers, repent!
E. Azzopardi
Mar 14th 2012, 16:37
Good, about time we learn or rather get diciplined.
Mr mario aquilina
Mar 14th 2012, 16:33
State Of The Art - the building or the people running it?
Frank Galea
Mar 14th 2012, 15:22
With all due respect, I think the Government is putting the cart before the horse. Before such a measure can come into effect, the Health Authorities must guarantee that all Health Centres are fully operational 24/7 with doctors and other medically qualified personnel available to deal with the public. If no such guarantee is given by the Government, the public will continue to go to the Emergency Department because it is aware that at Mater Dei the treatment is far better than at the Health Centres, although the time they spend there depends on the decision taken by a nurse at Triage. Again here I appeal to the Health Authorities that a doctor should examine the patients at Triage and not a nurse! Reaction to my comments by Dr. Azzopardi Muscat would be most appreciated.
Lawrence Fenech
Mar 14th 2012, 14:09
This will probably cause discrimination between one emergency and another. What a stupid idea.
Wilfred Camilleri
Mar 14th 2012, 14:40
No it's not! People who go to emergency for the treatment of conditions that are not an emergency clog the system and get in the way of patients who really have a medical emergency. The emergency department can only handle a finite number of concurrent emergencies. People with minor complaints should go to a clinic or to their doctor.
Antoine Vella
Mar 14th 2012, 14:54
Aħjar ma ngħid xejn min hu stupid.
This will create a distinction between an emergency and a non-emergency.
Mr Henry A. Grima
Mar 14th 2012, 15:30
Is it an emergency or is it not an emergency?
So you are agreeing that there are emergencies and 'emergencies'.
The whole idea is to distinguish between the two.
Something simple as this and it gets some people all het up.
And there is no reason for any amount of euro to be charged at the door either.
But I do think that some sort of security is needed to convince some 'patients' that they are not fighting fit.
A spare mattress in a safe place could always be provided if the impatient 'patient' persists.
A Galea
Mar 14th 2012, 14:01
Yes many times you have to wait quite a long time at Mater Dei A&E, but guess what, you have an alternative. Go to a private hospital (perhaps you should get health insurance) and you will wait a lot less. So don't complain, be thankful it's free and a lot better than many hospitals abroad.
P Bonnici
Mar 14th 2012, 16:55
I live in London and the waiting time in emergency departments could be up to 5 hours for a non emergency case.
You go during a weekend evening, and it is like hell on earth with vomiting violent drunkards. The Maltese do not know how lucky they are!
Joseph Calleja
Mar 14th 2012, 13:58
The policy is set, but the question remains. Are the Mater Dei authorities going to enforce the rule, or will it disappear after a week or two?
mary pace
Mar 14th 2012, 13:13
I wish to say ''BIG THANK YOU ''to the emergency Dept,ITU & neuro medical ward, for the care they gave my son Martin Silvio, during his stay,They are truly dedicated stuff, I cannot say it enough,THANK YOU
julian caruana
Mar 14th 2012, 13:07
better a couple of police officers for the next few months... wait and see
S.M. Cuschieri
Mar 14th 2012, 12:59
I am sorry but whenever I needed the services of the Mater Dei emergency Department, I was always seen to in adequate time. But, having a good deal of medical training behind me, I have enough grey matter to realise that if there are priority cases, of course I have to wait!! But you find the occassional tunnel visioned lay by person, who with a sprained ankle expects not to wait and may even blame the PM on top of that!!! I totally agree with the above mentioned policy re redirecting people to health centres if their case is not serious but I would reopen the clinics and make them all 24 hourly again though.
Doris Farrugia
Mar 14th 2012, 16:14
A 24 hour clinic should have an x-ray machine and radiologist available or on call.Went to clinic and after nebulizer the doctor told me to go for a chest x-ray the next morning at the same clinic to be sure everything was ok.In fact after taking an x-ray the following morning it was decided that it was chest infection and was given treatment.
Kenneth Galea
Mar 14th 2012, 12:55
Definitely the way forward. Everybody goes to A&E for the slightest thing. The polyclinics are there to deal with minor health conditions and certainly agree with their referrals. Make the patients also pay a fee of at least EUR20 like they do at most EU hospitals at A&E. Alfred Sant was right when he introduced a fee at the Government pharmacies but he was ridiculed.
The mentality of the patients need to change once and for all, this is not a nanny's state where the Government is expected to look after us from cradle to grave. With a fee of EUR20 the numbers will be reduced drastically at A&E. It is also important that only those who are entitled to use the health services in Malta use them, we should take our ID cards to A&E should we need to use its services.
Nazzareno Cortis
Mar 14th 2012, 15:26
Dear kenneth------you must be one of the well offs!!!!Has it ever entered your mind that most lower class citizens,and workers,and pensioners--- cannot afford what you are suggesting????? And by the way----How can the common people know if what they have is an emergency or not???? I am sure that all those who go to the emergency at Mater Dei cannot distinguish if they have an emergency case or not. So,please shut your mouth and be reasonable!!!!!
Kevin Kevin
Mar 15th 2012, 09:31
or rather, issue a fee when a referal is issued. The fee should be minor however as something like 5 euro simply to discourage the practice . . that way people would think twice about going to emergency for non-emergencies.
Matthew Camilleri
Mar 14th 2012, 12:26
I think it is time to reopen the polyclinics on a 24 hour basis again!! Without them people will go to hospital for no apparent reason
S.M. Cuschieri
Mar 14th 2012, 12:53
Well said.
Anna Borg
Mar 14th 2012, 13:51
I agree that the Health Centres around Malta should be open 24hrs a day 7 days a week and offer all the necessary care for non-emergency interventions. A couple of years ago my 3 year old son broke his arm ( we didn't know that) at school and since we thought it was minor we took him to the Health Centre. The doctor was very understanding, but he could do nothing without having an x-ray available, so he referred us to the hospital as the health centre did not have an x-ray machine available in the afternoon. We would have saved our little boy a couple of hours of needless pain had the health centre been equipped. Needless to say, since then, whenever we have an emergency we go to the hospital straight away. Also keep in mind that whatever may be a minor ailment for the others, for the person in pain, it is major.
Antoine Vella
Mar 14th 2012, 14:57
We don't need a health centre in every village. If people are willing to travel to Mater Dei they should find no problem with going to a neighbouring town to see a doctor.
Antoine Vella
Mar 14th 2012, 12:23
Joseph Muscat and his Elves will, no doubt, object.
I'm wondering what excuse the MUMN will find to support the PL and protest against this long overdue measure.
Mr Angelo Abela
Mar 14th 2012, 13:06
This country would be so much better without partisan attitudes like yours. If you have nothing intelligent to say regarding the article (be it negative or positive) then don't post. Spewing political propaganda and calling people names does not do anyone any good.
Dominic Chircop
Mar 14th 2012, 13:39
This has nothing to do with Joseph Muscat (or Lawrence Gonzi for that matter.
As long as people are referred to adequately equipped health centres or polyclinics, no one will grumble.
But one canrest assured that should one of the sixtynine Onorevole needs to go to Mater Dei, he will not be treated like common mortals. We have never ever heard of any Onorevoli not being accommodated in a hospital bed.
Antoine Vella
Mar 14th 2012, 14:52
Whenever something goes wrong (or apparently wrong) the 'let's blame the minister and GonziPN' brigade pipes up but if a positive step is taken, then it's 'let's keep politics out of it'.
Joseph Vassallo, (Bugibba)
Mar 14th 2012, 12:15
This directive is seriously politically-brave because it can, in no way, be called voter-friendly. Imagine how a genuine patient feels when told to leave and to go to his local health centre.
It will cause government and Minister Cassar [a hard-working minister in my humble opinion] to face the wrath of many a disgruntled patient-voter. Be aware that the will to improve health services arises, not out of medical needs, but out of political ones which has the same good effect, if not even better.
I'm sure some patients go to A&E seeking attention rather than treatment. I also think there is a dire need for some lateral thinking about the preference of A&E over district health centres. I would specifically isolate the lack of easy access.
At MDH A&E, one drives up, gets out of a vehicle and goes straight into the waiting hall that is on the same level as the car park; there is always someone outside to assist if needed, which makes one feel welcome and attended.
At Mosta and Rabat health centres, one has to first find somewhere to park (but where???), then walk to the clinic and laboriously climb some steep flights of stairs.
Having attended [some time ago] the Mosta clinic, I can say that I found it depressingly dull and slow moving. I also formed the impression that it was over-manned administratively and under-manned medically.
I had to walk a considerable way with a serious leg injury that took months to mend. Meanwhile, the parking spaces adjacent to the clinic were taken up by unconnected vehicles and/or staff personal vehicles. I didn't even see an ambulance bay.
All this boils down to management, organisation and professional discipline. If the access problem (parking) is given some attention, much discord would be gone as would much of the preference for MDH A&E.
I imagine (I hope so anyway) that government has better-and-younger brains than mine at its service to find solutions based on management rather than speeded-up medical attention. At least they would have the benefit of statistics to work with.
For instance, instead of staff hanging around upstairs unoccupied, one person [with the right attitude] could be detailed to man the entrance and welcome or assist as necessary. A little brightening up (maybe this has now been done) would not go amiss either. Practical signs also need to be given preference over religious effigies. As I remember, there was no highlight of the elevator or its availability and I painfully hobbled upstairs when I could have used the lift.
Some patients, waiting or arriving during my visit, seemed to be regulars which suggests that chronic cases could be treated in a separate room set up for them only.
For several hours, there was only one doctor available for quite a number of serious and not-so-serious patients; he referred me for X-ray with instructions to return immediately for his diagnosis, but was again relegated to the back of the queue. After further hours of waiting for his diagnosis, I was told the doctor had one home while I was still being X-rayed but there would be another doctor coming shortly if I cared to wait. THAT is not good organisation nor is it good management.
None of this will improve the bed-in-corridor situation of course. If patients have been given a bed, it must be that they need it and are not there capriciously or frivolously.
Maybe it is time to reintroduce "time and Motion" studies.
Pippo DeMarco
Mar 14th 2012, 11:58
Anyone visiting Mater Dei emergency unit might reasonably conclude that Malta had consumed by Münchausen syndrome. - Hopefully this will stop those attention seekers and timewasters who could easily be dealt with at a local centre. Our medical professionals are already over-stretched, yet some people cannot resist the urge to burden them still further..
A health service that is free at the point of delivery is something to be cherished, however, it is frequently abused simply because it is (perceived as being) free.
Nothing in this life is free and one way or another we all pay for our health services, and the more they cost to operate, the less state money is left over to pay for other essential services and benefits.
This isn't rocket science or complex economics, it's just plain common sense. But unfortunately, common sense isn't as common as it used to be.
Joseph Borg
Mar 14th 2012, 11:43
"The service at Mosta is offered between 7 a.m. and 7 p.m."
This is not true. If a doctor is not present at Mosta health centre to give you the go ahead to have an X-ray, you would need to go to Materi Dei.
This happened to me. I had a minor accident and went to Mosta clinic at 5:30pm. A doctor was not present and the reception staff told me that X-Ray department closes down at 6:30pm. The doctor never showed up so I had to call my doctor to get a referral. Then, I ended up at Mater Dei at 8:00pm to get an X-Ray.
Antoine Vella
Mar 14th 2012, 12:16
You should have reported this.
Daniel Vella
Mar 14th 2012, 12:31
I had your same problem. Went to Mosta clinic at 17.45 waited in the shed provided until it was my turn to be visited by the doctor but by that time, the X-Ray department was closed so my only option was to go to MDH and i was issued a referral for it but I preferred baring the pain and did not do the X-Ray at all. Result - the X-Ray room at Mosta clinic was not being used at all while i was waiting and i got a bad service. Had there been a somebody to issue a piece of paper on time things would have worked out as they should. Bureaucracy always hinders everything.
Ivor Ramsden
Mar 14th 2012, 13:17
@ Daniel Vella - If you could bear the pain, why did you go to the health centre in the first place? Are you really saying that the pain became bearable because you couldn't be bothered to make some effort to go to MDH?
Angus Black
Mar 14th 2012, 11:33
About time, although not enough to cut down abuse. A nurse or a doctor is still required to determine whether the 'emergency' is genuine or not. This will still cause delays. The solution is simple. Charge 20 euro upon admittance and prior to being seen. If the nurse/doctor determine that the emergency is genuine, then refund the fee.
Obviously ambulance cases would be excepted since those cases would be serious enough to warrant emergency care.
Charging the 20 euro fee (refundable if case is genuine) will make people think before they misuse the system and will have nothing to do with providing the public with 'free health services'.
Unfortunately the abusers will not be deterred unless they are hit in their pockets
E Schembri
Mar 14th 2012, 11:55
I agree with the idea, but in practice it won't work when you consider all the paper work, receipts, cash handling and manpower required to manage it.
Also, if you have a genuine emergency and rush off to hospital with nothing else than your car keys, what are you supposed to do? Go back, and withdraw money from an ATM?
If you are diagnosed and don't have an emergency case, they must polity kick you out. I'm sure people will not return if this strict policy is kept.
Joseph Calleja
Mar 14th 2012, 11:55
Oh what a shame Dear Angus. All hell broke loose when Dr Michael Farrugia as Labour Minister for Health introduced a fifty cents charge when picking free medicines from hospital. I fully agree with what you said but politically it is anathema. Try something else, please.
Antoine Vella
Mar 14th 2012, 12:21
Joseph Calleja, Labour's idea at first was that 50 c (more than 1 €) would be paid for EVERY medicine collected; this was later changed to 50c for the entire prescription, after widespread outrage.
What Angus Black is suggesting is that the charge would be payable only in cases of abuse (consider it an unofficial penalty) while genuine cases remain free.
J.C. Borg
Mar 14th 2012, 11:27
Some contributors here seem to agree with those who are undermining our Health Service. Will they continue doing the same thing if there is a chenge in Government?? Naturally the population and patients will remain the same.
David Farrugia
Mar 14th 2012, 11:24
Solution to the Emergency Department is primary care. But the Government has no money. Who said that our health system is free. I had to buy a medical insurance in order to be treated as a human being.
E Schembri
Mar 14th 2012, 11:24
About time!
Minor cases should never be treated in an emergency department as this supports the mentality that the hospital replaces the GP doctor.
Unless it is a doctor referral or a genuine emergency, cases must be refused upon first diagnostics. That way people will learn how to use their GP and stop hogging free services!
W Cassar
Mar 14th 2012, 11:21
Only if health centers are better equipped will this have any effect . Its useless going to see the GP to be then told we can't check you here as we dont have the equipment.
Patrick Zammit
Mar 14th 2012, 11:06
This will not solve the problem of people being put up in corridors.
These kind of patients had a serious enough problem to begin with and would still have to be sent to Mater Dei from their GP or the health centers if they turned up there.
Why were the health centers downgraded/closed down when a minister once said that old persons who cannot sleep go to the polyclinics simply to find someone to talk to?
D Mifsud
Mar 14th 2012, 11:00
What's the problem with this policy? You can still go to Emergency Department for your twisted ankle or sneezing. Nobody is stopping you. Nobody is asking you to decide for yourself whether your ailment is an emergency or not. Once you are seen in Triage, someone medically qualified will decide. Then, if not an emergency, you'll be sent on your way to the health center with the peace of mind knowing your ailment is not serious and you're not about to drop dead or have your foot amputated.
@R ferriggi. The STREAMING system you talk about is already there. People with twisted ankles etc etc get their lowest priority (Priority 3). They end up waiting over 8 hours in the waiting room. They are the ones who complain about very long waiting times and this leads to the media coverage, as well as obviously hogging the whole emergency department since eventually they are seen to and this takes time out of a doctor who should be seeing Priority 1 and 2 patients.
So yes, go to Emergency. Whether you tried "abusing" the system for something which you knew was not an emergency, or whether you weren't sure and went as a precaution, NO PROBLEM, you're now safe and on your way to a health center, leaving the doctors to deal with the urgent stuff.
Mario Fava
Mar 14th 2012, 10:51
Li hafna nies izuru id - dipartiment tal - emergenza, huwa sinjal ta fiducja fis - sistema tas - sahha ta' Malta. Muhx facli wiehed jiddeciedi fejn ser jiehu il- pazjenti gheziez taghna f'sitwazzjoni ta' mard, ikun xi jkun. Il - Maltin poplu qalbieni u jara li meta xi hadd ikun marid jiehdu fl- aqwa post ta kura. Il - problema fl - opinjoni tieghi hi li dawn in - nies, jekk ikunu mghejjuna jiehdu decizzjoni jghamlu iktar spazju lil dawk li jridu juzaw is - servizzi tal - emergenza kif suppost.
A. Borg
Mar 14th 2012, 10:33
Il-poplu la jkun b'xejn jiffolla! Kieku bil-flus ikeccu l-haddiema!
Patrick Zammit
Mar 14th 2012, 10:55
Who told you it's free?
If I remember correctly, VAT was specifically increased from 15% to 18% to cover health expenditure.
R ferriggi
Mar 14th 2012, 10:25
WRONG PANIC DECISION!!!
IN THIS WAY, THE EMERGENCY DEPARTMENT IS NOT REALLY WHAT IT IS CALLED......
CANT WE SEE EVENTUALITIES WHERE WASTE OF TIME CAN LEAD TO SERIOUS CONSEQUENCES??
WHY DONT WE SIMPLY CREATE A ''STREAMING'' SYSTEM AT EMERGENCY??
OBVIOUS EMERGENCIES ARE DEALT WITH IMMEDIATELY.
EVIDENT NON-SERIOUS EMERGENCIES ARE DEALT WITH DIFFERENTLY.
AND ''EMERGENCIES'' WHICH PROVE OTHERWISE ARE DEALT WITH ACCORDINGLY.
M Ellul
Mar 14th 2012, 10:45
Caps lock. Press once to switch off.
R ferriggi
Mar 14th 2012, 14:59
absent mindedness. no offence.
Mr Henry A. Grima
Mar 14th 2012, 10:24
Does this mean that one could have gone to the EMERGENCY!! Dept with a minor ailment? and was accepted??
No wonder there were complaints about too loooong neverending queues.
It was bad enough at St Luke's when real emergencies were seen to after hours of waiting.
I should know; I was one of them. I used to have my heart racing at 210 beatsa minute.
But I still was seen to after waiting for an hour, and rushed over to the the CCU.
jonathan galea
Mar 14th 2012, 10:21
Well done, emergency department and staff should just be used for emergency cases. Keep up the good work.
Paul Caruana
Mar 14th 2012, 10:21
The key to solving the problems being caused by the huge influx of patients at Mater Dei is to invest more and more in the peripheral health centres. Once these gain the trust of the Maltese public, you will start to see more people going to their nearest heath centre rather than going directly to hospital.
M. Bezzina
Mar 14th 2012, 10:19
Ghadna poplu marid mela biex kwazi marru tlett elef ruh.....
B Borg
Mar 14th 2012, 10:38
3000 are less than 1%
J.C. Borg
Mar 14th 2012, 11:16
@ M. Bezzina - Mhux inthom marradtuh, dejjem twieghduh elezzjoni bikrija.
Bernard J Schranz
Mar 14th 2012, 10:07
There is one sure way of sorting this out and that is MAKE PEOPLE PAY FOR THE SERVICE !!!
If they are found to merit Emergency treatment, then refund them. If not, they lose the money.
You will be amazed how quickly the Maltese will learn. We are a whole lot of people who want everything for nothing and then still complain when action is taken. People are selfish by nature and where health is concerned will only look at their personal interests and head straight to the Emergency Department at Mater Dei when they could have easily referred themselves to their own GP (at a cost) or else to the Health Centre.
Remember the charge levied by Alfred Sant for issuing of Medical Certificates (if I recall well... there was a charge introduced for something medically related at least) and how fast the demand suddenly reduced. Unfortunately this is the only way people will learn in Malta !!!
A Cachia
Mar 14th 2012, 10:07
Now let's all hope that the Health Centres are well equipped and well staffed for this....
john vella
Mar 14th 2012, 10:02
Dr. Busuttil please note!
Considering my self as one coming close the twilight of my years I find this New Policy so ridiculous, to use an example if one with a chest pain, is it gass in the stomach or heart attack that need urgent care?
The last time I needed assistance I found Qormi Center closed so I had to go to Floriana Center waited for the duty doctor who sent to Mater Dei.
After all the tests and two days later it resulted it was gas in the stomach.
If those in the know did not know what I had, how on earth can a citizen generally not in the know diagnose a
problem? How silly is the logic because he can walk to the Emergency Department for the authority he is not an emergency case?
frances borg
Mar 14th 2012, 10:11
come on-the issue is not for cases such as yours but for cases such as a twisted ankle or for somebody who has had a problem for sometime and then decides he wants to see it treated today!!!! once again its all about education.
j brincat
Mar 14th 2012, 09:53
Who was it that said that Health Centres are there so that patients chatter with the nursing staff and so reduced the services offered?
Management by crisis is the order of the day!
(jb)
Michele Buttigieg
Mar 14th 2012, 14:00
your comments are always excessive jahasra!
frances borg
Mar 14th 2012, 09:49
@Charlotte Sant Portanier
Not everybody has the luxury of being a head pharmacist in australia or to be married to an ED and ICU Consultant at armadale hospital.
I suppose in Australia every simple joe has the medical knowledge to decide what is serious and what is not!!!!
http://au.linkedin.com/pub/charlotte-sant-portanier/34/495/150
https://www.facebook.com/search/results.php?q=Charlotte+Sant+Portanier&init=public
A DALLI
Mar 14th 2012, 09:46
I fully agree with this, i only visit the emergency department if i have a referal by my doctor or it is something serious, and it is not nice waiting in a room full of people waiting to be seen when they could have gone to a health centre
i witness with my own eyes once, when a patient was waiting to be seen for mosquito bites, unbelievable, he should have gone to a health centre first and then go to emergency if told to do so
another case a woman was telling me how her mother INSISTS that they take her to emergency every week and there is nothing wrong with her
so i think with this new plan i think that the emergency department may not be so full
Anthony A. Mifsud
Mar 14th 2012, 09:39
Who's fault is this Chaos? The system failed. One should assume responsibility and should carry his own weight ? Take Dr. Debone words !
Way forward is going back to the old system . Reopen all Polly clinics
Toni
Lucienne Dimech
Mar 14th 2012, 09:39
This is sensible. It should avoid people with a minor ailment to occupy precious space at the emergency department.
frances borg
Mar 14th 2012, 09:39
hope it works more than the highly publicised campaign of last year that involved a bandaged finger.
once again it all boils down to having efficient health centres-the same health centres some misguided minister wanted to destroy with the result my father had to wait for a ridiculious amount of time before being processed through the emergency department.
why heads have not rolled following the mater dei bed debacle is a mystery! I would not have minded having to wait so long for an severely over budget hospital but the least I expected was to have enough beds to cater for me, my loved ones and the rest of the maltese population.
Mark Brincat
Mar 14th 2012, 09:34
I don't agree with this stand ... I suggest a simple procedure ... each patient coming into the Emergency would be checked and according to the ailment he should be prioritised. Patients with lower priorities should always be taken care of after the higher priority patients. If your ailment is not so serious then first of all you could have gone to a Health Centre in the first place, and second, others with more serious ailments should be treated before.
Franco J. Piccinino
Mar 14th 2012, 09:53
What you are suggesting has been in action for years. It was even done in St Lukes Hospital. It does not work because people do not understand that "Emergency" Department is for emergencies only. This is a good idea. People have to learn.
Kenneth Scerri
Mar 14th 2012, 09:53
u inti x'tahseb li kien isir qabel!!?
J. Tanti
Mar 14th 2012, 10:04
I agree with you and from what I have seen when I needed to accompany someone there - thankfully only twice so far - that is what happens. However, on one of my visits, there was a commotion to the extent that hospital security had to intervene since patients with presumably minor complaints starting shouting about the long delays (some said they had been there for over 8 hours) while others who came in after them were seen to first. They even complained that those who were wheeled in from an ambulance were being given priority!
Their argument for being there was that they pay taxes and should not be made to wait so long or pay for private care when they had to see a doctor. They further argued that Mater Dei was more convenient for them and hence they did not want to visit a Health Centre.
If these types of incidents are frequent, then I am not surprised that this type of policy had to be enacted.
Mark Brincat
Mar 14th 2012, 10:08
X'kien isir qabel? Intom bis-serjetà? Tmur għal xi ksur u jdewwmuk 4 siegħat!! Dik prijoritizzazzjoni?! Mela tajjeb ... tmur il-Health Centre ... tagħmel is-SIEGĦAT tistenna fil-kju sempliċement biex tintbagħat l-Emerġenza f'Mater Dei, imbagħad tmur Mater Dei u tagħmel is-SIEGĦAT TERĠA' TISTENNA FIL-KJU BIEX TINQEDA!!! Bla sens!!!
Is-sistema li semmejt jien QATT ma kienet taħdem. La Mater Dei lanqas St. Luke's! Kull ma kienu jagħmlu joħdulek id-dettalji imma l-ebda tabib ma kien jiċċekkja l-entità tal-emerġenza!!
S. Camilleri
Mar 14th 2012, 10:23
If you read the statement it says "... after Triage assessment ..." This means people won't be turned back immediately.
I agree in principle on this move but it feels like putting the cart before the horse ... Has anyone tried to visit a healthcenter after 5 pm? Often there is no personnel to treat an open wound properly. What about a 'simple' diagnosis that requires an X-ray? Are health centers equipped to handle specialised patient categories such as paediatric cases?
E Schembri
Mar 14th 2012, 11:16
But remember that every patient must be first diagnosed before deciding the priority. If many minor non emergency cases are ending up at the emergency, this alone puts strain on the system and fills up the waiting room causing stress on other people waiting and the staff themselves.
Minor cases must never end up at the emergency and must NOT be treated. Otherwise you will never get rid of the minor cases if you keep treating them.
If you are sick call your GP and pay your €12. Everyone want everything for free!
Lawrence Fenech
Mar 14th 2012, 09:33
A fast "WAY OUT" back door.
Mr Hans Borg
Mar 14th 2012, 09:30
This 'new' policy reflects the panic state in which the GonziPN is in.
People are spending long hours and sometimes days on stretchers until they are allocated a bed.
This 'new' policy does not address this problem and is only intended to shift the responsability on the so called (by Minister Cassar) "frequent flyers"
Ms Maria Vella
Mar 14th 2012, 09:41
That is a problem yes, but this is a problem found in most hospitals abroad too! In some cases old people are just 'dumped' there because 'caring' relatives can't be bothered to take care of them increasing the work load and capacity.
Also, there is a problem due to the lack of common sense when using the A&E department. If you have twisted your ankle or sneezing go to your GP or health centre!
Andre Cilia
Mar 14th 2012, 09:42
Have you actually ever went to the hospital? if no just shut up and let the professionals do their work
Franco J. Piccinino
Mar 14th 2012, 09:55
Why does everything have to be politics????
Luke Duncan
Mar 14th 2012, 10:36
and yet (with all your negativeness) you still haven't suggested an opinion for a suitable solution Mr.Borg
Mr Hans Borg
Mar 14th 2012, 12:24
Telling people to shut up, labeling them negative and asking them for solutions is a very effective way of regaining the people's trust.
mario gellel
Mar 14th 2012, 09:28
AND HOW ON EARTH CAN ONE SPECIFY A HEALTH PROBLEM AS NOT MINOR SO AS NOT TO PAY FOR A "NEW TAX" FOR A HEALTH CERTIFICATE TO BE RECOMMENDED TO HOSPITAL???????
OR ARE WE ONLY RECOMMENDED TO TAKE OUR BELOVED ONES TO HOSPITAL WHEN THEY ARE DEAD?
Charlotte Sant Portanier
Mar 14th 2012, 09:33
Use your common sense Mr. Gellel
Mr R Rizzo
Mar 14th 2012, 10:06
don't be stupid!!! A common cold is considered minor... on the other hand a bronchitis (severe chest infection) is not considered minor even though a patient can stay at home while being cured. In most cases people avoid setting up an appointment with the outpatients and prefer to go to emergency just because they are examined within a few hours rather than having to wait weeks if not months had they have called for an appointment. There are others who would rather go to Mater Dei and get a free visit instead of paying 10 euro to their GP. Some elderly people visit Mater Dei just because it's a state of the art, free accomodation and better equipped than hotel rooms with dedicated nurses checking on them every so often.
Please choose the reason of your report below: