A directive for health centre doctors not to make house visits has been put on hold for a week, giving the government time to explain to the public when such calls are justified.

The Medical Association of Malta complained on Thursday that its members were being subjected to verbal abuse and were expected to visit patients who could have easily sought treatment at a health centre. It warned that if the government failed to address the situation it would instruct members to stop doing house visits from Monday.

“As a sign of goodwill we have postponed the directive by a week to allow the government to explain the guidelines which regulate when health centre doctors are expected to make house visits,” MAM general secretary Martin Balzan told Times of Malta.

The decision was taken after the Health Ministry issued a statement yesterday saying it would adopt a “zero tolerance policy” with regard to any form of verbal or physical abuse towards its employees. Once such instances were investigated and confirmed, no measures would be spared to address unruly behaviour, it added.

It was also announced that an investigation was opened into alleged misconduct by a health centre doctor who reportedly refused to examine a patient during a house visit.

The ministry said clinicians were obliged to prioritise patient requests according to the seriousness of the condition, especially during this time of the year when there was a spike in cases of respiratory diseases.

Health centres’ house visit triage guidelines

Doctors at health centres should deal with home visit requests by consulting a set of guidelines, established in the collective agreement signed in February 2013. Nevertheless, it is ultimately in the doctor’s discretion to refuse or accept a home visit according to medical judgement.

Requests which should definitely be accepted include:

• Bed-bound patients

• Deceased person

• Combination of fever and rash of recent onset

• High-dependency individuals (severe handicap, severe mobility problems, terminally-ill patients)

• Individuals with a very weak immune system

Request that should also warrant an urgent transfer to hospital:

• Chest pain suspected to be of cardiac origin

• Severe shortness of breath

• Severe haemorrhage

• Major accidents

• Unconscious patients

• Suspected overdose

• Suspected cerebrovascular accident (stroke)

• Any other condition deemed as urgent by the GP

Requests where home visits may not be necessary:

• Minor symptoms of childhood (mild fevers, coughs and colds, earache, diarrhoea/vomiting and minor cases of abdominal pain)

• Ambulant patients with minor problems such as cough, sore throat, influenza, back pain, constipation, abdominal pain, headaches, joint pains and general malaise

Request which should be definitely turned down

• Bloodletting in ambulant individuals

• Sick leave certification of ambulant patients

If a patient gives incorrect information to induce the doctor to do a house visit, GPs are encouraged to report such cases to the management so action is taken to educate the public to make better use of the service.