I refer to Stephen Calleja’s article “Sick leave abuse – Doctors are blamed... but others are involved – MP” (TMIS, 31 May), where I was quoted to have stated that the system should change to one in which sick leave certificates are “issued exclusively by the company doctor, as long as he is obliged to examine, investigate and treat the worker...” In fact in my e-mail to your correspondent, this statement was preceded by the words: “But if you did hear me out in Parliament on May 12th”, referring to the estimates of the Occupational Health & Safety Authority (OHSA) - http://www.gov.mt/frame.asp?l=1&url=http://www.parliament.gov.mt.

In Parliament, as reported in The Malta Independent of 13 May, I focused on the waste of medical resources in having company doctors used solely for verification purposes, and this while having overburdened public health centre and private family doctors.

I referred extensively to an article entitled “Medical clinics are springing up at businesses – and savings are substantial” by David Welch (17 August, 2008):

“The company doctor is back. It’s a tradition with roots in the 1800s, but the practice fell from grace in the 1930s and 1940s, when critics complained that the doctors were mainly serving the employers’ interests. A recent study by benefits-consulting firm Watson Wyatt Worldwide found that 32 per cent of all employers with more than 1,000 workers either have an on-site medical centre or plan to build one by 2009.”...

“We’re talking about a microcosm of health-care reform,” says Hal Rosenbluth, president of Walgreen’s health and wellness division.

Tracy Swanson, vice-president of workforce planning, benefits, and compensation for Disney’s parks, says the programme is partly a response to the state’s shortage of physicians: “We can’t afford to wait for the government to solve this.”

I insisted in Parliament that industrial estates and several government departments here in Malta should fit into our economies of scale. Shipyard workers have had this opportunity for some years. It is quite obvious that the worker must approve and that the clinics are regularly monitored to ensure they emphasise patient care over and above savings. Hence, this would not breach professional ethics. In my book, it is unethical to avoid looking after a sick employee who not only consents to but also demands your service. And to avoid the obvious is the only reason to refuse filling in the official “blue” sick leave certificate.

In the first quarter of this year, sickness benefits increased by 3.5 per cent over the same period last year. Moreover, while other states are restructuring to make up for the shortage of physicians, Japan is currently even recruiting those on pension. Here we are not only still demanding the highest grades for students to choose medicine, but five years ago, a mandatory three-year training course was set up for a graduate to be allowed to work as a GP, now honoured to be called a specialist in family medicine.

All this shortage is resulting in less quality time with patients and higher professional fees by most health workers whose livelihood is not threatened at all.

Dr Jean-Pierre Farrugia MD, MP

FLORIANA