The government offered family doctors an “insulting” €10 to follow up patients with mental health problems, the Times of Malta has learnt.
“Had they asked for unpaid volunteers, it would have been less insulting,” Anthony P. Azzopardi, president of the Association of Private Family Doctors, said.
In May, the government rolled out a scheme whereby patients with mental health problems who have been stable for a year would be able to visit their family doctor up to three times a year.
Health Minister Chris Fearne said such patients were only scheduled for an appointment with their psychiatrist once a year. However, in the interim, their condition would sometimes deteriorate, leading to hospitalisation.
Under the scheme, private GPs would be able to examine the patients up to three times a year at their clinic and detect those about to suffer a relapse.
The doctors could, therefore, prevent the patients from being admitted to Mount Carmel Hospital, Mr Fearne said.
What we are being offered reflects how we are valued
An expression of interest for private practitioners who wished to form part of the scheme was launched. Dr Azzopardi said that GPs had received a circular requesting their participation four times, suggesting the take-up had been poor.
“Consultants are paid between €60 and €70 per session. We expect acceptable remuneration. What we are being offered reflects how we are valued,” he said.
A spokeswoman for the Health Ministry said an informative seminar was held for interested GPs and 13 family doctors agreed to join the scheme. “Care protocols have been established. Patients will continue to be seen on a yearly basis by their psychiatrist but, in addition, will have up to another three visits at their participating GP every year,” she said.
“The scheme is aimed at psychiatric patients who would have been treated for acute episodes by the mental health services and followed up for at least a year. The patients eligible would have had episodes of psychiatric illness that require long-term follow-up mainly for preventive reasons.”
The scheme would target patients suffering from psychosis, bipolar disorder and recurrent unipolar depression. Patients with such conditions, Dr Azzopardi said, would not pop in for a quick, five-minute check-up. The first visit in particular would take a long time, until the doctor was acquainted with the patient’s history and needs.
The ministry defended the €10 fee, saying this was based on what private GPs charged on average for consultations. Such fees had been reported by the National Audit Office in its recent performance audit as being between €9.26 and €9.49 per consultation, it said.
Dr Azzopardi insisted the problem was not only with the fee. “It’s not just about the fee. We would also need to conduct certain back-up tests due to the medication, including monitoring blood levels, which we are not authorised to do.
“Also, if the government is offering to pay for three appointments a year, what would happen if the patients turn up five or six times? We can’t really turn them away. Perhaps a voucher system would be more appropriate,” he continued.
A scheme was also rolled out by the government involving GPs carrying out check-ups for breast cancer patients who have been clear for more than five years.
“Officially it has already started but we’re still waiting for guidelines. The government seems to have a habit of rolling out schemes without proper discussion. What should I check for and how should I communicate feedback to the patient’s consultant? We’re still in limbo,” Dr Azzopardi said.