The Parliamentary Secretary for Health has announced that the consultation process on primary health care is due to kick off "soon". Of course, addressing and, hopefully, solving the pending ills present in primary health care will go a long way in curing the malaise in the health sector in general.
While Health Parliamentary Secretary Joseph Cassar may be excused for coming up with this now, his predecessors cannot, including the present Minister of Social Policy who was on the Cabinet in the past, even as Finance Minister. The primary health care system has been allowed to deteriorate for years. This is very probably due to the glaring fact that it takes money to run this service, something that is clearly lacking and, therefore, cannot be used to support this and many other initiatives in the health sector.
With sufficient funds, health centres could be refurbished, students could be tempted to take up nursing with an appropriate salary package and doctors could be tempted to remain in the health sector - if conditions were right. The usual buzzwords and promises of equity, accessibility, efficiency, accountability and sustainability will not stand up to scrutiny when these very factors, or, at least, some of them, seem to be missing in the new hospital and elsewhere too. Witness the countless letters in the press lambasting the unacceptable waiting times in a "state-of-the-art hospital" that cost so much to build and remains very expensive to run, notwithstanding the shortcomings.
Group practices, as mentioned by Dr Cassar, will only work if individuals are adequately motivated - including financially - to provide a service and to seek like-minded individuals to work with. Such practices have been operational with great success for many years in the private sector but are, of course, expensive to run. However, they do have the huge advantage (to the patient) of operating 24/7, come rain or shine, weekdays and public holidays. Yet, family doctors will only be persuaded to rope themselves into such a system and serve as an interface between the patient and hospital care if the sufficient incentives, again, including those of the financial kind, are in place.
Doctors have left the NHS primary care either because they were unable to take the system any more and/or because the system leaves them underpaid. This, and other issues that emerge from time to time, mean that doctors are likely to be very wary of having anything to do with NHS services within the community, especially given the manner in which the Pharmacy Of Your Choice scheme has been handled. In the circumstances, it may be a tad too optimistic to think the scheme could take on the added load of doctors directly inputting prescriptions for their patients.
Having said that, yes, a system that works through group practices, where the patient always has a point of care available, a medic that has real-time access to electronic patient records and who would also be able to order tests and view their results, would be laudable. But this cannot be afforded at this point in time, both financially and because of the further strain to an already overburdened system that cries out for remedial action.
What is imperative is that action is taken and that the health authorities take the people in their confidence. Remaining mum and refusing to communicate with society via the media, as the Social Policy Ministry is evidently bent in doing, can only lead to gangrene and, possibly, even amputation.