While Malta is still debating whether to allow nurses to administer drugs in emergency cases, specialised physiotherapists in the UK this summer were given the green light to independently prescribe drugs.
We waste hours – even days – until a person is finally referred to a physiotherapist
Their counterparts in Malta cannot even dream of this practitioner role.
“We don’t expect to be granted new responsibilities to prescribe medicines, without a doctor overseeing this decision, before setting up a specialist accreditation committee (SAC) to oversee continuous development in physiotherapy,” John Xerri de Caro, a physiotherapist for 14 years, said.
According to the 2003 Health Care Professions Act, a committee should be set up to issue specialist training certificates, act as an advisory body for training in special areas and accredit post-graduate training programmes, among other things.
A Health Ministry spokeswoman said the Council for Professions Complementary to Medicine had already asked the Superintendent of Public Health to set up an SAC.
“The proposals are agreed to in principle but further discussions are needed before the committee is formally set up,” the spokeswoman said.
The delay has put the Maltese physiotherapy field about 10 years behind the UK system, according to Mr Xerri de Caro, who has been president of the Malta Association of Physiotherapists since 2007.
Set up in 1974, MAP is a volunt-ary organisation representing the physiotherapy profession on the Maltese islands.
“Had this committee been set up nine years ago, we would now be able to speak about ways to develop a better health service.
“And one such way could be granting physiotherapists the responsibility to prescribe medi-cines independently.”
In a similar attempt, Health Minister Joseph Cassar last month announced that specialised nurses would be able to administer some medicines without a doctor’s prescription when patients were being rushed to hospital for treatment.
But the Medical Association of Malta soon threatened industrial action, saying it had not been consulted over the matter, the agreement did not conform to the Health Care Professions Act and the Medicines Act and there was no entity regularising the specialisation of nurses.
In the UK nurses have had a range of prescribing rights since 1992 and, in July, the Health Department announced that physiotherapists would also be given responsibilities to independently prescribe medicines.
The breakthrough follows a 10-year campaign by the Chartered Society of Physiotherapy, which is the UK’s professional, educational and trade union body for physiotherapists.
Pip White, from CSP, said that autonomous prescribing would be limited to the physiotherapists’ scope of practice and they would not be acting as doctors.
Furthermore, to register and practise as a prescriber, the physiotherapist would have to undergo an additional period of education in the sphere of non-medical prescribing.
At the end of the day, patients would get more timely access to the medicines they required without unnecessary delays in seeing a doctor, Ms White, who has been a physiotherapist for more than 20 years, said.
In Malta, MAP is raising awareness about this UK breakthrough, deeming it “a clear example of how physiotherapists as a professional body can help improve the national health system”.
But Mr Xerri de Caro believes there is “a long way to go”.
“As Maltese we’re small, so medical practitioners tend to protect their turf at all costs. But by protecting yourself, you’re providing a disservice to the patients and we need to change our silo mentality in the medicine field.
“We waste hours – even days – until a person is finally referred to a physiotherapist. Although the law actually permits self-referral, the system doesn’t allow direct access to hospital.”
In the UK, patients could choose whether to be vetted by an orthopaedic consultant, a doctor or a physiotherapist.
In Malta there were a number of barriers between people until one got to the person one needed to see.
“When we look at getting rid of these barriers, we are not looking at what we are going to gain on a personal level but how we could be positioned to improve the health service,”Mr Xerri de Caro said.
“But, to date, physiotherapists in Malta are still referred to as paramedics, as an extension of – or an assistant to – a profession.
“According to the 2003 Health Care Professions Act, physiotherapy is considered as a profession complementary to medicine.
“However, the physiotherapy profession does not complement other professions and it is not a vocational profession either. There is a vocational element but the role is not vocational.
“Physiotherapists are accountable, forthcoming and address patients professionally.
“Physiotherapy is an independent profession, full stop.”