The relationship between state and private primary care

Abstract

In Malta there is no uniform Healthcare system. There are government services divided primarily in State hospitals and health centres in the community; and there are private doctors - from primary to tertiary level. Although the system works somehow, it is by no means perfect and is confusing to the person trying to make use of both. Government doctors have on their contracts that they may work privately - this is one reason why many believe salaries have been kept quite low. Those who opt to work only in the private sector have a choice of making use of government services or using only private institutions for investigations etc. In primary care, it is impossible to always refer people privately for tests and speCialist consultations. The private General Practitioner thus usually discusses with the patient whether she wishes to be investigated at hospital or privately and explains the pros and t:;ons of each. Invariably, many opt to be referred to hospital for further investigations. Since medical insurance is still in its infancy in Malta, and since they by no means gives comprehensive unlimited coverage to the insured, many who have tests done privately pay for them personally. In this respect the health centres have offered a number of tests which the GP may avail herself of and which will thus save the patient some money.