Sunday Times claims that doctors' charges are too expensive - 8/9/2003

Survey findings on high cost of private medicine confirmed
Pamela Hansen

The Medical Association of Malta has welcomed the results of the survey conducted by Professor Mario Vassallo for The Sunday Times and published last week.

The association said that the quality of the service given by the medical profession was reflected very well by the findings that 84 per cent of patients using St Luke's Hospital and 77 per cent of those using the health centres declared themselves satisfied with the service.

It comes as no surprise that 78 per cent and 73 per cent of the population use the hospital and health centres respectively; the service is utilised and appreciated across all social classes, MAM said.

One also has to consider that there is a shortage of doctors (up to 50 per cent) in the hospitals and in health centres. Yet, despite this, the medical profession is giving Maltese society both quantity and quality, MAM observed, adding that Professor Vassallo's study confirms the high turnover data from Casualty (110,000 per year), Outpatients services (400,000), operations (30,000) and health centre visits (over 1.1 million).

In this context it is clear that whoever tried to smear the medical profession by giving the impression that doctors were unproductive, and were not contributing sufficiently to the public health service, was "completely wrong", MAM said.

Doctors who give this service, despite being understaffed and underpaid, have been vindicated by the results of the study, it added.

As regards to the price of private medicine, surely general practitioner visits at Lm2-3 and specialist visits at Lm12-15 per visit cannot be labelled as expensive, MAM remarked.

Private hospitals have to put up with the same financial problems the government is facing. Indeed, it is difficult to perceive how the private medical service can be any cheaper, it went on.

Perhaps it is high time the government makes its citizens aware on the high costs of health care. The Lm100 million spent so far on the new hospital and Lm66 million per year spent on health care should be an eye-opener for all, MAM said.

The government might also consider giving financial incentives to people who opt for private medicine. This will help decrease the cost of private medicine, reduce waiting lists and overcrowding in the public health sector and reduce government expenditure, MAM concluded.

However, according to informed sources, the survey findings that private medicine is considered expensive by patients does not appear to be unjustified.

They estimate that five days a week nets medical practitioners Lm180 a day or Lm900 a week. Over a 40-week period net income from such a part-time job gives a return of Lm36,000!

This does not include any surgery services conducted before or after a private clinic, and for which patients are known to be charged in excess of Lm100 for a ten-minute consultation, as professional fees alone.

Diagnostic tests carried out privately are also quite expensive. An ultrasound at Lm31, taking up 15 minutes of work including report writing, cannot be labelled cheap, the sources said.

This charge more than covers the radiologist's time and the capital and recurrent expenditure involved in purchasing and maintaining equipment!

The same sources added that what irritates people most is that very often it is the same highly qualified doctors and their assistants who work in state hospitals who provide private medicine services.

It is perhaps high time for doctors to be asked to opt for either an adequately paid full-time public service job, or for private medicine and not use the former as the fishing pond for a lucrative private practice.

In turn, private medicine needs to be more regulated in the interest of the consumer, both by central authorities, such as the Departments of Health and Consumer Affairs, as well as by insurance companies, the latter acting primarily in the interest of their clients and not mainly in the interest of the medical profession, as often appears to be the case at present.

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