Doctors deny abuse of sick leave system

The Medical Association of Malta has categorically denied the claim that doctors are abusing the sick leave system.

The association reacted strongly to a report, carried in yesterday's The Times, about a government clampdown on sickness certificates and deplored what it said were unofficial leaks of incomplete data and unscientific conclusions.

It said these had not only put the medical profession in a bad light but also embarrassed the government unnecessarily.

MAM added that it had contributed, in very constructive talks with Social Policy Minister Lawrence Gonzi, to improvements of the sick leave certification system and in closing possible loop holes.

"The leaks of misleading data are therefore inappropriate and counter-productive. Such leaks go contrary to regulations and reflect badly on government officials responsible to maintain the confidentiality of such information," it said.

The Times on Wednesday revealed that the government had sent "warning letters" to 200 doctors for issuing an excessive number of sickness certificates to certain patients for the same condition.

Sources close to the Ministry for Social Policy said one particular doctor had issued more than 3,500 sickness certificates in eight months and warned of action if the pattern persisted.

The sources said the government had also analysed the income declarations submitted by medical doctors and found some to be declaring very little income.

MAM said the computerisation of the database of sick leave certificates had been an improvement. However, MAM officials, it said, had pointed out that many of the analyses performed were inappropriate and unscientific and one could only interpret the results with some caution.

The association said that patients discharged from hospital after suffering heart attacks, major operations or fractures were greatly inconvenienced having to get certificates every week. Doctors were trying to reduce the hardship caused by insensitive bureaucrats. It said doctors who issued a large number of certificates could mean they were very busy, not that they were abusing the system. Doctors with a high turnover were usually the most widely respected for their service and integrity.

Many chronically ill patients had to wait for months for their invalidity board hearing and it was for this reason that a patient might need 22 consecutive sick leave certificates.

It said, however, there were a few individuals who faked illness and placed doctors in a difficult position. The fact that the vast majority of certificates covered three days or less showed that doctors generally were very considerate and judicious.

It also said that health centre doctors and doctors employed by private firms were paid a fixed salary which clearly explained why a high number of certificates was not accompanied by a proportional increase in income from private practice.