On 4 July 2013, the Clinical Chairman of the Primary Health Care Department issued a circular addressed to all general practitioners who work in the health centres. The chairman gave clear guidelines on how doctors must decide if they should visit patients at home.
In the “Home Visit Triage Guidelines” there is reference to the collective agreement between the Ministry for Health and the Medical Association of Malta signed in February 2013. It is stated that “this agreement supersedes all other agreements presently in force.”
It makes it unequivocally clear that GPs must follow the rules in this memo (27/2013) and no other instructions.
The memo in fact states that the GP or trainee will “decide whether the request merits a house visit”. The information in this memo helps GPs make a clear and informed decision to this effect. It gives real examples as to when a request for home visit should definitely be accepted and when such a request may be regarded as unnecessary.
The same document also gives examples as to when a “request for home visits should definitely be refused.”
Not only that, it also instructs all GPs to report to the Department of Primary Health Care when a patient misleads a doctor to do a home visit “by giving him the wrong information.”
The latest stories we read in the media, including this newspaper, related to political interference - cases where a doctor was instructed by one ministry or another to perform a home visit (or else) - are in direct breach and total disregard of this circular.
The cases flagged by the Medical Association of Malta reveal a political arrogance stemming from none other than the Office of the Prime Minister itself. This political interference is not just creating chaos for the doctors and medical practitioners who have to face the daily music in the health centres. It is also causing political discrimination in the health sector in general.
Ever since the MAM came out with their statement to the media, just over a week ago, people have been passing me information about similar cases.
The cases are various, from all over the country, and affect numerous patients. People are allegedly facing discrimination for medical appointments in out-patients, for non-life threatening surgery and, of course, in primary health care.
In his article “When patients seek help in high places”, published in this paper on Wednesday, MAM President Gordon Caruana Dingli, writes of how doctors are demoralised and lacking motivation simply because patients do not like making appointments with a GP in the health centres when they require a prescription or to do routine check-ups and investigations:
“Protocols should always be followed and patients should be informed about them with the aim of providing better care.”
Mr Caruana Dingli also insists that people in authority who ignore such protocols are undermining the system which “if it is allowed to work, will improve the standards of care in health centres for all and not for just one individual.”
I fully agree with this statement. I urge all those in power to help the system by educating people that we must trust our health care professionals and allow them to work freely and serenely in the best interest of the patients towards a more efficient and caring health care system.