A booklet displayed prominently at the health centre in Victoria promises that “you can expect to be seen by a doctor in 30 minutes”. But on most mornings you would be lucky if you’re seen within two hours.

By mid-morning a build-up of patients fill the flimsy plastic chairs and straggles of people are forced to stand and sometimes spill outside the door of Gozo’s only health centre.

Opened in 1991, the centre has become too small for the volume of patients which, according to patients and staff, has been rising in recent years.

On busy mornings, clinical staff can barely cope in the small, cramped interior. Parents with children visiting for routine vaccinations – the immunisation clinic doubles as the office of the head nurse due to shortage of room space – sit next to patients waiting to see the GP.

“Some of those patients might have infectious diseases, such as the flu in winter,” a member of the staff said on condition of anonymity, “which they could potentially pass to infants.”

Space is so limited that two or three members of the staff sit in the small, boxy reception when not busy attending to patients. The reception, an aluminum construction, lends the interior a shoddy feel. The small and dreary GP clinic forces doctors to keep the door open. 

Staff amenities are scanty. Food-related facilities are limited to a fridge and kettle – a toaster that used to trip the electricity was thrown out. Brooms and cleaning accessories are tucked into the small staff toilet. 

Plans come unstuck

All of this was supposed to change with the opening of a new health centre promised to be completed in the first half of this year. Health Minister Chris Fearne made the announcement last June to the press at a shell building that was rumoured to have been intended as a museum but would be repurposed for the new health centre. Yet the shell building – situated across the street from the Victoria bus station – remains as it was during the press conference 10 months ago.

Asked what was holding up the works and when the new health centre would be opened, a spokesperson for Mr Fearne replied that “works are in progress, and the new premises is expected to open by the end of 2019”.

The door was padlocked on multiple visits to the place during working hours in the past two weeks. It looked like a derelict building site, surrounded by a perimeter wall and fence on which posters of upcoming events are affixed. Grass has grown between the outer fence and the shell building itself, and the tufty, erect grass on the aggregate ground outside of the door indicates that no workers have been walking in and out of the building. 

Patient pressures

Just over a hundred metres away at the present health centre, the number of patients keeps rising. Sources have told The Sunday Times of Malta that this is due to an increase of foreigners – residents as well as tourists – and the growing population of Maltese residents moving to Gozo for its cheaper flat rents.

Official figures show a sevenfold rise in the number of foreigners who used the health centre annually in the past five years, rising to nearly 5,000 last year and contributing to an average of 184 patients seen daily in 2018.

This figure was characterised as low by sources. Regular users of the health centre spoke of a growing problem of crowding, particularly in the mornings. In a visit by this newspaper recently, a member of the staff maintained that 150 patients had already visited that day and it was only 11.30am – the clinic is open from 8am to 8pm.

“We’re relatively quiet at the moment,” the staff member said on condition of anonymity. “The flu season has passed but work will start to pick up soon as the hay fever season gets underway, and then it becomes tough in the summer during the tourist season. Several hundred people typically make use of the clinic every day at the height of the summer.”

Eight GPs, seven full-time and one part-time, are employed by the State’s Primary HealthCare in Gozo to serve at the health centre, at the 12 town clinics, as well as doing ‘home visits’. Overnight they work at the Gozo hospital’s Accident and Emergency department because the health centre is unsuitable to remain open at night given its dearth of facilities.

A 30-minute promise... with a two-hour window

The new health centre will be designed to open round the clock and its services marginally expanded to cover mental health and podiatry. 

At present, the only time patients tend to be served by a GP within 30 minutes – as promised in the booklet – is between 2pm and 4pm, when two doctors would be serving on most days. At other times, the single doctor on duty has to serve at the GP clinic and the ‘treatment room’, where he is intermittently called to examine walk-in patients.

The workload has also increased following administrative changes such as requiring GPs themselves to fill in forms of renewals of prescriptions for patients eligible for free medicine. 

Sources said that there used to be a second doctor in the past, and the flow was speedier. Recent attempts to engage an additional doctor have been unsuccessful. No one applied for two successive calls for applications, although the sources said that attempts to engage a doctor continue.

The Health Ministry’s spokesperson did not reply directly to questions on whether a second doctor would be employed at the health centre, saying instead that “Primary HealthCare is currently enhancing and introducing new services, in Gozo and in Malta, thus it is also working on boosting the HR requirements”.

Members of the staff expressed apprehension at the prospect of another summer in the present health centre. The seasonal spike in patients, as well as the tendency of staff members to take vacation leave in summer, increases the burden on serving personnel. At peak times between July and September the glut of patients strains nerves and services towards breaking point.

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