There is a serious lack of dialogue with the government, despite the great problems in the medicine and pharmacy sector, according to the Chamber of Commerce, Enterprise and Industry.

Even though the chamber had presented a set of proposals to revise the Pharmacy of Your Choice scheme, it did not receive any reply from the government, Reginald Fava, who chairs the chamber's healthcare business section said yesterday.

He criticised Social Policy Minister John Dalli for not replying to their request for a meeting made over two months ago.

Yesterday Mr Fava gave details of his section's proposals to make the scheme more sustainable. The main plank of the proposals is that patients would pay for free medicines at the pharmacy and are then reimbursed by the government.

The system, Mr Fava insisted, would reduce abuse, making it more sustainable than the present scheme.

People will think twice before claiming medicines for no reason if they have to pay, Mr Fava said.

The proposals include setting a tariff on how much should be reimbursed for each particular medicine. The tariffs would be agreed upon by the stakeholders and revised at least once a year.

Patients would also have the choice to opt for more advanced and expensive drugs, forking out the price difference.

On the other hand, a voucher system could be put in place for people who cannot afford to pay upfront.

The present scheme, which allows patients to pick up medicines they are entitled to from their chosen private pharmacy instead of a government pharmacy, was introduced last year in some localities. However, it was never rolled out to the whole country as promised and in July 2008 the government said it was evaluating it.

Mr Fava pinned this indecision on the haste with which the scheme was introduced. "Although it is a good scheme, it was quickly introduced before the general election and not everyone was consulted."

However, only this week Mr Dalli announced that the scheme would be extended to other villages - a move that was welcomed by the Chamber of Pharmacists and the Pharmaceutical Division of the Chamber of Small and Medium Enterprises.

In a joint statement, the two chambers said the scheme's extension was "a seal of success" for the community's healthcare services. They added that they actively participated in the fine-tuning process.

Earlier this month, Finance Minister Tonio Fenech admitted the government still owed medicine importers around €20 million - some of which had not been paid within the 150-day time window.