MP demands revision of doctors' minimum tariffs - 17/2/2006

Nationalist MP Michael Asciak yesterday criticised all governments since Independence for not having had "the guts" to establish minimum doctors' fees.

He told Parliament that the government should not be surprised at alleged abuses by doctors when it itself had not shouldered its responsibilities.

Dr Asciak said the existing minimum tariffs were last established in the 1930s and a revision was long overdue.

He was not advocating the same situation as in Cyprus, where doctors charged Lm10 per patient they saw, but he could not tolerate undercutting by some doctors who charged just Lm1 or Lm2 for house calls.

The Malta Medical Council had been calling on the government to revise the general practitioner tariffs for decades, to no avail.

The government needed to acknowledge that the current situation gave grounds for abuse. The honest general practitioner needed to be protected through modern regulation. The current situation was one reason why many doctors preferred not to be general practitioners, Dr Asciak said.

The MP made his comments in the context of amendments to the Social Security Act. He said that although 900,000 sick leave certificates were issued each year, this was one of the lowest ratios, if not the lowest in the EU. This did not mean that there were no abuses but this could be easily checked. How could doctors issue certificates without seeing patients, for example?

By and large, except for certain instances where the patient was well known to the doctor, the doctor needed to examine his patients.

There were a number of general practitioners who were, unfortunately, abusing the system. Unfortunately, there were doctors who would have another main job and also work in the private sector and charge a considerably small fee, undercutting their colleagues and endangering the medical profession.

Undercutting was the government's fault because it never had the guts to publish new minimum doctors' fees. The current schedule was issued in 1939 and established a minimum tariff of 45c for home visits and 25c for clinic checks.

It would be more difficult for patients to seek a doctor's certificate if they were charged Lm3 and not 50c for it, Dr Asciak said.

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