The Times - Plans to audit medical care - 20/4/2006

Plans to audit medical care
Cynthia Busuttil

The authorities are planning to introduce medical audits within the health system, Health Minister Louis Deguara said.

A medical audit is the evaluation of medical care in retrospect through the analysis of medical records. Every doctor would be audited on his or her results, he told The Times.

The minister said that, for example, there could be a case of two surgeons carrying out the same type of intervention, with the patients of one suffering more complications than the other's. This would indicate a problem that needed to be looked into.

Without a medical audit, cases would be dealt with only in terms of numbers, which did not have the same significance as seeing individual cases.

When contacted, the general secretary of the Medical Association of Malta, Martin Balzan, said the association accepted the employer's right to audit a doctor's turnover.

On the other hand, auditing of results could be counterproductive and the association was more in favour of doctors auditing themselves. He pointed out that if medical audits on results were introduced within the health system, there was the danger that no doctor would want to see the more difficult cases.

"Doctors might become choosy so that they have good statistics," he said. This, he continued, would even have financial repercussions on the health system, because if no doctors would want to deal with the high-risk patients, the government would have to send more people abroad for treatment.

A Eurobarometer study, published earlier this year, shows that a staggering 82 per cent of Maltese respondents think medical errors are a sticking problem here, and 43 per cent said they were worried about suffering a serious medical error. Almost half of the Maltese respondents said hospital patients should be worried about serious medical errors.

However, only 22 per cent of the Maltese respondents said they or a family member have suffered from a serious medical error in a local hospital, ranking Malta eighth among EU countries. Twelve per cent of local respondents said they often heard or read about medical errors in Malta.

Spaniards ranked highest among the 25 EU countries, with 61 per cent of respondents saying they had often heard or read about medical errors in their country.

The Maltese are 85 per cent confident that dentists will not make a mistake that would harm them. Confidence in doctors stands at 83 per cent while that in medical staff was ranked at 80 per cent.

Asked for his reaction to the survey's results, Dr Deguara said one needed to look at these figures "with one's feet on the ground". He said the increasing number of people seeking hospital services "nullify these statistics".

When it was pointed out to Dr Deguara that, given Malta had only one state hospital, many people did not have a choice of where to go for treatment, he said independent surveys have clearly shown that people were confident with the quality of service.

On the other hand, people seemed to be unhappy with the hospital's "hotel" services, he said. The health authorities were realising that they should concentrate their resources on medical services while farming out ancillary services such as cleaning, laundry services and food to other firms.

He said work on the tendering process for the food supply at Mater Dei Hospital was in progress.

"We believe the health authorities should concentrate on providing a medical service," he said.

The minister said that although Malta was seeing an increase in the number of patients who took action against a doctor or the hospital if they suffered a medical error, their number was not high.

Stressing that all mistakes should be avoided, he pointed out that independent surveys have shown that the majority of people have full faith in the service.

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