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NATIONAL AUDIT OFFICE REPORT: PRIMARY HEALTH CARE ? THE GENERAL PRACTITIONER FUNCTION WITHIN HEALTH CENTRES
10/01/2001
| The Report "Primary Health Care ? The | General Practitioner Function within Health Centres" was submitted to the Honourable Speaker for presentation in the House of Representatives in accordance with sub-paragraph 8(b) of the First Schedule of the Auditor General and National Audit Office Act, 1997. |
| The Report was laid on the Table of the House of | Representatives today, Wednesday, 10th January, 2001. |
| This performance audit sought to evaluate whether | GP services offered by health centres were provided in an effective and cost-efficient manner and yielding an adequate level of customer satisfaction. |
| The Department of Primary Health Care is | responsible for the provision of primary health care through seven health centres in Malta and one in Gozo. During 1999, 84 GPs (excluding part-timers) provided services to 474,187 users through health centre clinics, 41,750 home visits and 263,191 users at local dispensaries (bereg). These services represent 48 per cent of total health centre users. |
Audit Issues
| The effectiveness of the clinic service provided by | GPs and users' perception of the service were assessed through a survey held in all health centres. The survey indicated that users expressed a high level of satisfaction on the quality of service received. Most users indicated that they would continue to use the service in future. The service provided, however, is not considered as a personalised one. |
| This audit highlighted a number of issues that are | impacting on the cost-efficiency of GP services provided. These include the uneven distribution of GPs within the various clinics and the non-utilisation of an appointment system for regular users that is conducive to create peak and lean periods. Both issues are contributing to the non-utilisation of primary health care resources in an optimal manner and are reflected in the cost of providing these services. In 1999, average costs of the GP services amounted to Lm2.12 and Lm3.13 for a visit by the patient to the health centre clinic and for a doctor to visit the patient at home respectively. Services provided through local dispensaries cost, on average, Lm1.43 per user. The services are not considered cost-efficient. |
Recommendations
The National Audit Office recommends that:
a financial management structure be established at the Department of Primary Health Care to manage and address cost-efficiency indices for its centres;
health centre staff allocation be rationalised by taking into consideration user/staff ratios;
feasibility studies are undertaken prior to extending further the services provided by health centres;
Quality Service Charters be introduced in all centres;
an appointment system for frequent users of the GP service be considered;
information technology in health centres be increasingly utilised to collate and retrieve data more efficiently.
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