FRANCESCA VELLA

The government does not seem to want to acknowledge the fact that “dealing with disease in a primary care setting is cheaper when compared to secondary care”, said Jürgen Abela, a medical doctor who has specialised in general practice and is a member of the Royal College of General Practitioners (UK).

Speaking to The Malta Independent on Sunday, the young doctor said that primary care, which largely refers to family medicine and health centres, is not given its due importance in Malta. He said health centres in particular are disorganised and lack long-term planning.

In an editorial he wrote for the latest issue of the Malta Medical Journal, Dr Abela said, “During the last few years, the development of Mater Dei Hospital has completely overshadowed primary care. Indeed one can claim that there has been no significant project undertaken in primary care over the last few years.”

A study by Dr Mario Sammut published in the same journal highlighted the dissatisfaction of GPs working in local health centres.

He reported that 41 per cent of GPs felt unappreciated, neglected and disrespected and 39 per cent experienced job dissatisfaction and distress.

Dr Abela said that while it was positive to see that the government has invested heavily in state-of-the-art equipment at Mater Dei, the new hospital cannot function properly without what he referred to as “an effective ‘gate-keeping’ service”.

In simple terms, certain cases that do not “deserve” to be treated in hospital should be dealt with at community level, thus allowing proper utilisation of the emergency service and reducing hospital admissions.

The government can save money by investing in decent systems that are patient-centred and which ensure a certain level of continuity.

“The impact of family medicine is quite strong when dealing with disease patterns; every additional primary care physician reduces total mortality by 34 per 100,000,” Dr Abela said in his editorial.

Explaining further, he spoke about guidelines that are being issued specifically for managing disease in primary care.

While saying that family medicine is gaining importance and recognition worldwide – particularly in the UK, where 75 per cent of the National Health System budget is directed towards primary care – Dr Abela said that, unfortunately, Malta is proving to be an exception in this regard. He pointed out that in more cases than one resources were not being utilised to their full potential.

“The current system does not encourage primary care physicians to carry out certain minor operations like the removal of sebaceous cysts, for example.

“Such operations are always carried out at Boffa Hospital or St Luke’s. It would be much more cost-effective to empower GPs at health centres, or those working in the community,” he said.

While he insisted on the need for the general practice specialist training programme, which was meant to be up and running following EU membership three years ago, Dr Abela expressed satisfaction that the training programme will soon start.

About 10 graduate trainee doctors have been awaiting the start of the specialist programme. Some of them have been waiting for more than a year.

“The fact that family medicine is locally recognised as a speciality is hailed by many as a big step forward. However, it can only achieve its full potential and credibility once the general practice training programme starts.”The government does not seem to want to acknowledge the fact that “dealing with disease in a primary care setting is cheaper when compared to secondary care”, said Jürgen Abela, a medical doctor who has specialised in general practice and is a member of the Royal College of General Practitioners (UK).

Speaking to The Malta Independent on Sunday, the young doctor said that primary care, which largely refers to family medicine and health centres, is not given its due importance in Malta. He said health centres in particular are disorganised and lack long-term planning.

In an editorial he wrote for the latest issue of the Malta Medical Journal, Dr Abela said, “During the last few years, the development of Mater Dei Hospital has completely overshadowed primary care. Indeed one can claim that there has been no significant project undertaken in primary care over the last few years.”

A study by Dr Mario Sammut published in the same journal highlighted the dissatisfaction of GPs working in local health centres.

He reported that 41 per cent of GPs felt unappreciated, neglected and disrespected and 39 per cent experienced job dissatisfaction and distress.

Dr Abela said that while it was positive to see that the government has invested heavily in state-of-the-art equipment at Mater Dei, the new hospital cannot function properly without what he referred to as “an effective ‘gate-keeping’ service”.

In simple terms, certain cases that do not “deserve” to be treated in hospital should be dealt with at community level, thus allowing proper utilisation of the emergency service and reducing hospital admissions.

The government can save money by investing in decent systems that are patient-centred and which ensure a certain level of continuity.

“The impact of family medicine is quite strong when dealing with disease patterns; every additional primary care physician reduces total mortality by 34 per 100,000,” Dr Abela said in his editorial.

Explaining further, he spoke about guidelines that are being issued specifically for managing disease in primary care.

While saying that family medicine is gaining importance and recognition worldwide – particularly in the UK, where 75 per cent of the National Health System budget is directed towards primary care – Dr Abela said that, unfortunately, Malta is proving to be an exception in this regard. He pointed out that in more cases than one resources were not being utilised to their full potential.

“The current system does not encourage primary care physicians to carry out certain minor operations like the removal of sebaceous cysts, for example.

“Such operations are always carried out at Boffa Hospital or St Luke’s. It would be much more cost-effective to empower GPs at health centres, or those working in the community,” he said.

While he insisted on the need for the general practice specialist training programme, which was meant to be up and running following EU membership three years ago, Dr Abela expressed satisfaction that the training programme will soon start.

About 10 graduate trainee doctors have been awaiting the start of the specialist programme. Some of them have been waiting for more than a year.

“The fact that family medicine is locally recognised as a speciality is hailed by many as a big step forward. However, it can only achieve its full potential and credibility once the general practice training programme starts.”