| Author | Josianne Cutajar |
| Abstract | Primary health care in Malta is provided either by private general practitioners or by medical officers at the publicly owned health centers. The service provided at the centers is free of charge, reasonably equitable and adequate. However since the middle of the 1980s there was a perceived need that this service still required further modification. This perceived need for a change was given a high degree of political attention and was one of the mayor electoral campaign issues presented by the National Party [PN] in 1987. In 1998 a Service Quality Survey was carried out at Floriana\Qormi health clinics. These clinics work on the same structure used presently at Mosta health clinic. Although the study was limited to Floriana and Qormi and restricted to patients attending the clinic between 8.00 a.m. and 1.00 p.m. during the last week of July, some interesting conclusions were made. In general, 86% reported that the medical service provided is good. 54% stated that they would prefer an appointment system. In the section of the questioner that was dedicated for general comments, all patients who responded requested a follow-up system. The service provided at Mosta Health Center is impersonalized with patients unable to see the same practitioner for follow-ups or for any consecutive visit. Patients usually have to wait a long time in crowded waiting rooms to be seen by the doctor. There is a high level of duplication of services and beurocracy. Doctors have to fill in numerous repetitive forms and prescriptions rather than actually spending time in interviewing and examining the patients. Although the quality of medical care given is not an issue, the service lacks micro-efficiency and is presented in a fragmented set-up. The practitioners are demoralised as can be seen by the present dispute between the government and union of doctors, a dispute that has been going on for the past twelve months. The service is unsustainable with persistent drainage of personnel. It urgently requires some form of restructuring. By introducing modern concepts, primary care at the clinic will become more holistic and patient-centered; built on relationships in a health-promoting environment. Appointment Systems Between 8.00 a.m and 5.00 p.m.. Each doctor sees about 23 patients\day including routine consultations, acute illnesses and emergencies. By analyzing this data it is proposed that each doctor will have an appointment list of 18 patients, with 15 minutes allocated for every consultation. [MRCGP standards recommend 10 min. for each patient.]. The appointment list will take up 3 hours of his working time and the rest of the duty [2-5 hours more] can be dedicated for home visits, emergencies or acute cases. Voluntary Registration to a G.P. Once an appointment system is established it would be easier for a patient to be seen by the same practitioner. The new set-up provides a better environment where patients may be able to register to a particular doctor or at least are able to make an appointment with a doctor of their choice. |
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| Key words | appointments, patient registration, Primary care, general practice |