Almost a third of those who had an outpatients appointment at Mater Dei Hospital last year failed to turn up, official figures reveal.
Out of the 378,800 patients given an appointment at various outpatient departments last year, over 106,500 did not attend and failed to inform the hospital, according to figures tabled in Parliament.
The pathology outpatients' department had the highest number of no-shows with about 35 per cent not turning up, and ophthalmology, the eye department, had the lowest - 17.34 per cent. The rest of the departments, such as surgery and medicine, had an average missed appointment rate of about 30 per cent.
Nationalist MP and family doctor Jean-Pierre Farrugia believes the high number of missed appointments might be closely linked to the long waiting lists. The urology outpatient department, for example, had a waiting list of about 11 months, he said.
"Sometimes such a long time passes between the time a patient is notified and the appointment itself that the patient would have solved the problem by going to a private doctor," he said.
Some patients tried to bypass the system by turning up at the hospital's accident and emergency department, preferring to wait for hours instead of months, Dr Farrugia said.
Labour MP Michael Farrugia believes that allowing family doctors to directly order tests at Mater Dei instead of referring their patients for an appointment can be a possible solution. Dr Farrugia, a family doctor, believes this system will cut down the red tape at the hospital.
"Why does a patient need a referral to outpatients to have a thyroid function test when it can be done by a GP? Why does a doctor have to send his patient to the outpatients simply to change the dosage of his pressure pills?"
Directly ordering the tests would ease the load on the outpatients department and shorten the waiting time for the appointment, he said. However, it was important to include an audit system to make sure there was no abuse.
Missed appointments cost money. A recent UK study revealed that more than 6.5 million missed appointments between 2007 and 2008 cost the health service about £600 million. The study linked the patients' failure to turn up to the long waiting time and pointed out that a reminder system might improve the situation.
One doctor working at Mater Dei's surgery department said calling up the patients beforehand might cut the numbers slightly but pointed out this was not a crucial factor.
There were many cases who did not turn up because they felt unwell such as the elderly, for example. Others simply went for the first appointment to be seen by the consultant and then missed the follow-ups that would be done with the clinical team. "They would prefer to be seen by the consultant and will go to his private practice."
Another doctor working at an outpatients clinic said some patients failed their appointment simply because they did not care less.
"Some people shop around for doctors; they go to different general practitioners who, in turn, make their own referrals and this ends up in multiple appointments."
One doctor was surprised by the figures and described them as "excessively high". He admitted that people did miss their appointment but pointed out he found it strange that the clinics in the outpatient departments were always full of people.
A Health Ministry spokesman said such figures worried the authorities because all clinic appointments should be fully utilised.
"This can be achieved if and when all patients with booked appointments understand it is their duty to inform the hospital that a scheduled appointment is no longer required so slots can be freed for the benefit of others," the spokesman said.
Education was the key to missed appointments, many of which happened because the time was not convenient to the patient or because they forgot or visited a consultant privately, the spokesman added.