Doctors associations want consultations on emergency services outsourcing plan

The Malta College of Family Doctors (MCFD) and the Association of Private Family Doctors (APFD) have expressed serious concerns over a recent proposal to outsource emergency services, which was issued without prior consultation with medical organisations.

This initiative mirrors a similar failed scheme from 15 years ago, the groups said, aimed at reducing waiting times at Mater Dei Hospital’s Emergency Department. The current situation is aggravated by a rapidly growing population, projected to reach 600,000 by 2027, and an ageing demographic.

The previous scheme, well-remembered by medical professionals, diverted semi-emergencies from health centres to a publicly funded private service, while those with minor ailments continued to burden the Emergency Department.

Both MCFD and APFD emphasise that for a new initiative to be effective, it must include proper triaging by medical professionals to direct patients appropriately. This could mean referring them to their family doctor, semi-emergency services in health centres, emergency services in private hospitals, or the Casualty Department at Mater Dei Hospital.

The two organisations said patient safety must be the top priority in healthcare provision, while family doctors act as crucial gatekeepers of the health system, preventing it from becoming overwhelmed.

Meanwhile, they insisted that emergency services should be handled by specialists trained in emergency medicine, working in environments fully equipped for such cases. Continuity of care post-discharge is also vital for ensuring longer, healthier lives, they said.

MCFD and APFD are calling on the Department of Health to engage in thorough consultations with the relevant medical organisations to ensure the success of this initiative. They advocate for better collaboration between primary, secondary, and emergency care to create efficient and sustainable management pathways. This includes empowering family doctors with more ownership, resources, and involvement, alongside leveraging digital health to integrate all medical systems.

The MCFD, a voluntary organization (VO/0973), works to enhance the academic and clinical standards of family doctors in Malta. Similarly, the APFD, also a voluntary organization (VO/1803), is dedicated to advancing family medicine and primary healthcare on behalf of private family doctors and their patients.

Meanwhile, the Malta Union of Midwives and Nurses (MUMN) has welcomed the Health Ministry’s decision, seeing it as a crucial step towards reducing waiting times at Mater Dei Hospital's Emergency Department and alleviating patient suffering.

According to the MUMN, the proposed system's benefit extends beyond shorter wait times; it ensures that from the initial stages, a consultant will triage patients, directing them to the appropriate facility, whether MDH or a private hospital, making the system nearly risk-free.

The MUMN emphasises that this consultant-led triage system will save patients valuable time, preventing unnecessary hours spent in the emergency department only to discover that admission is not required. 

Moreover, the MUMN has expressed its readiness to collaborate with the Health Minister to ensure the success of these proposals for the welfare of all patients attending the Emergency Department of MDH.