Helen Batty, a family doctor and professor at the University of Toronto, strongly believes that retaining the present system, whereby patients pay out of their pocket for GP visits, will weaken the revolutionary reform of primary healthcare being pushed by the government. In Canada, GP fees are footed by the government but patients pay for medications, mostly through insurance.

I was satisfied to note that we share the same philosophy. If I may reproduce what I wrote as soon as I read the final copy of the primary health reform consultation document (December 7), through the state's shelving of responsibility to enforce, by and large, solo middle-aged/elderly practitioners to "make arrangements to provide 24-hour coverage for registered persons" (6.1.1), private GPs will inevitably raise their fees substantially because (a) their service is exclusive and mandatory and (b) they have no other way to discourage demand.

Furthermore, I stated that, along with the pharmacy of your choice (POYC), this system subsidising patients receiving medication for chronic illness will further increase the 80,000 Schedule V (yellow card) users, with the government continuing to finance more medicines for those who could afford them. In fact, I recently asked how many patients are on this schedule and, the number escalated to 109,956 (PQ13,698) - and this without having widened the range of entitled chronic illnesses.

It was thus surprising to read Ivan Camilleri's report Brussels Warns Malta On Health, Education Costs (January 28), roping sustainability specifically to "collective agreements covering public health care and tertiary education employees" and not the exponential rise in the cost of medicines. But, in any case, primary health government medical doctors' working conditions were not improved, their number contracting by half in the last two years!

I am so sorry to note such short-sightedness.