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The meeting of the Parliamentary Audit Committee was held in a heated atmosphere, at which the findings of the Auditor General's Annual Report on the Health Insurance Organisation and the operation of the GHS were presented, while at the end of the meeting the Audit Service announced that it would proceed to send its findings to the police.
For his part, the Finance Minister said, among other things, that "those who are fighting the GES are those who refuse to implement the legislation. With mathematical precision, they are leading this great conquest of all to collapse," in response to a question by AKEL MP Giorgos Loukaidis. who spoke of a "method on the part of the Finance Minister", which "aims to damage the viability of GESY", referring to a unilateral decision by the Ministry of Finance to cut more than 103 million from GESY, at the same time as claiming another 50 million. In addition, the Health Minister said that a meeting of the OAS Board of Directors is scheduled for Tuesday in his presence, with the main topic being the abuses in the GHS and ways to reduce them.
In addition, the Health Minister said that a meeting of the OAS Board of Directors is scheduled for Tuesday in his presence, with the main topic being the abuses in the GHS and ways to reduce them.
Today's meeting of the Parliamentary Audit Committee was held in the presence of the Minister of Finance and the Director General of the Ministry, the Minister of Health and the Director General of the Ministry, the Accountant General, as well as representatives of the Department of Taxation, the Legal Service, the Commissioner for the Supervision of the GHS and representatives of the Health Insurance Agency (HIA).
The debate in the Committee evolved with several moments of tension and confrontation, both between the President, Zacharias Koulias, and the Parliamentary Representative of AKEL, Giorgos Loukaidis, on the occasion of questions to the Auditor General, and between the Minister of Finance, Constantinos Petrides, and representatives of OAI.
During his statement, the Auditor General, Odysseas Michaelides, referred to the finding of a series of irregularities that emerged during the examination of the operation of OAI and GESY by the State Audit Service. He referred to "non-transparent contracts" of the OAI with private hospitals and an irregular way of calculating the unit price of service charges, which results in different charges per hospital for the same medical procedures. He argued that the OAI should establish a framework of cooperation and invite private hospitals to contract with it if they agree, instead of entering into contracts with each one separately.
He also stressed that OAI refused to provide a "comprehensive package of services", contrary to what is required by law, and made particular reference to the issue of the Accident and Emergency Departments of private hospitals, which are contracted to the GHS but have not provided beneficiaries with the services of the ICPs.
He also referred to the costs of hospitalising patients abroad if the necessary services are not provided within the country, explaining that, by law, the OAS is obliged to cover them. "Until now, the OAI has not covered these costs, which are paid by the Ministry of Health." The Director General of the Ministry of Health, for her part, said that in 2021, an expense of €23 million was covered for the hospitalisation of 1,000 patients abroad.
Michaelides also referred to a list of services, costing €120 million, which OAI is requesting to be paid for by the Ministry of Health. According to the Auditor General, it was unjustified to ask the Ministry to cover the cost of dialysis services, the AIDS clinic, the social centres in remote areas (Polis Chrysochous and Kyperounda), the thalassaemia centre, the paediatric neurology clinic of Makareio or the mental health clinics of public hospitals.
A separate reference was made to the problem highlighted by the Attorney General, which concerns the billing of services to beneficiaries of the General Health Insurance Scheme by hospitals contracted with OAI.
The Auditor General gave examples of doctors who should be audited. He referred to the fact that 20% of personal doctors have incomes in excess of €200,000, as in the case of an 80-year-old personal doctor with 2,488 beneficiaries on his list, a doctor who received €870,000 in 2020 for outpatient care, a pair of gynaecologists who received €700.000 each for outpatient services, and five doctors with incomes of more than €600,000 in 2020 who did not file tax returns from 2019.
"We expected that OAI would do analyses and focus on checking cases that present an increased risk of malpractice," Michaelides said. He stressed that an adequate audit system and safeguards to contain health spending were lacking, as "there should be a team of doctors who examine randomly and not just after complaints."
He also added that sampling-based audit systems "should have deterrent penalties" rather than simply rejecting a charge when a problem is identified.
"The GHS cripples the MoH. Finance", says Constantine Petrides
The view that "the GHS is the only policy of the state that cripples the Ministry of Finance" was expressed by the Minister, Constantine Petrides at the Committee meeting, adding that he agreed with the report and recommendations of the Auditor General.
Referring to the Mercer study, the Minister said that "the GHS should cost about €1,200 per citizen or €2,300 per employee. According to the estimated costs for 2022, it will cost in 2022 €1,670 per citizen, €3,222 per worker." He added that the actual health costs not included in the OAS budget are €2,300 per citizen and €4,400 per employee.
Petrides said that "the taxpayer pays two and three times the health costs" because the GHS legislation is not properly implemented. "If we wanted to be strict as a government at the moment, we would have to increase contributions by 20%-30% to provide the services that fall short," he said.
"Those who are fighting the YESY are those who refuse to implement the legislation. With mathematical precision, they are leading this great achievement of all to collapse," the minister stressed, responding to a question by AKEL MP George Loukaidis.
Constantinos Petrides said that the aim is to implement the legislation on the operation of the OAI to the letter, adopting the opinions of the Attorney General, defending the global budget. He said that under another law, services not provided by the GHC will be offset against the state contribution.
He said the ministry is asking to have "in the first year information from the OAI on the data concerning the provision of services under the GHC" and stressed that audits must be carried out. "This is a great social achievement, but the data is very worrying, but when there is a will from everyone, things can be corrected," he concluded.
Meeting at the Ministry of Health. Health for corrections based on Attorney General's opinion
In a statement after the meeting, Health Minister Michael Hadjipandela said that for some time now his Ministry has been in consultation with the OAI on the corrections that need to be made to the health system, as a consequence of the abuses, to note that on Tuesday a meeting of the OAI Board of Directors is scheduled in his presence, with the main topic being the abuses in the GHS and ways to reduce them.
As Hajipandela said, after deciding on how to reduce these abuses, they will have a meeting with the Auditor General, who will be informed of the decisions, but to take into account any other suggestions.
In relation to the GHS legislation, he said that his Ministry in consultation always with the Attorney General, who is his legal advisor, have agreed that any new contracts signed with private hospitals from now on or any other contract renewals will be signed, the Attorney General's opinions and approval will be taken into account before the contract is signed.
"So this big issue, that is the application of the law in private hospitals, we believe that it will be resolved in the way we have decided, in consultation with the Attorney General," he said.
Asked to comment on the Finance Minister's reports of the collapse of the GHS if the abuses continue, the Health Minister admitted that "there are abuses", noting that these abuses will try to stop them from Tuesday, when decisions will be taken.
Asked if cases will be sent to thePolice, he said that "after pressure from the Ministry of Health, some have been taken to the Police, so water has been put in the groove so that those who are breaking the law will go to court," he added.
"It is misleading to say that the OAI is not controlled by anyone," Th. Antoniou
"It is misleading to say that OAI is not controlled by anyone," said the President of the Agency, Thomas Antoniou, saying that ministries, workers' representatives, patients, OEB, KEBE and trade unions are involved in the decision-making by the Board.
Responding on behalf of OAI, he dismissed complaints that OAI contracts with private hospitals are illegal.
He stressed that people from the Ministries of Finance and Health are represented on the OAI Board, which did not disagree. "The contracts," he said, "were also co-signed by the former Health Minister, Constantinos Ioannou."
Antoniou also said that illegally the Finance Ministry was cutting off €50 million from OAI for various expenses, such as hospitalisation of patients abroad.
He also said that next Tuesday he will have a meeting with the Health Minister as well as the Finance Minister, adding that they will put the matter to rest and try to find solutions because they owe it to the Cypriot citizen.
Placements of MPs
Committee chairman Zacharias Koulias stressed during the debate that all necessary checks and corrections should be made in the operation of the OAI, while calling on the Audit Service to submit its findings to the police.
DISY MP Savvia Orphanidou said after the meeting that "the Democratic Rally was and will always be a champion of the General Health System, which is considered by all as the greatest social achievement and we must all ensure that it is and will remain sustainable, within the framework of the global budget set by the legislation."
For this reason, he concluded, "challenging waste, mismanagement the absence of a control system, abuses, perverse methods of paying doctors within the system cannot be accepted, nor that the taxpaying citizen pays two and three times for the same thing", but distortions that "will lead either to undermine the quality of services or to increase contributions and ultimately to collapse" must be corrected.
AKEL Parliamentary Spokesman George Loukaides referred to "a methodical approach on the part of the Finance Minister", which he said "aims to damage the viability of the GESY", after noting that today he was informed of the unilateral decision of the Ministry of Finance to cut more than 103 million from the GESY, at the same time as it claims another 50 million cuts.
He denounced the government's "methodologies" and called for the revocation of the unilateral decisions taken, saying that "apparently because the GESY was and remains viable and robust, those in power seek to injure and undermine its viability and prospects by such decisions, namely unilateral cuts from the contributions that the Ministry of Finance should and must, by law, pay to the GESY."
EPP Parliamentary Spokesman, Marinos Sizopoulos, said that his party believes that immediate action is needed to correct this situation before it is too late, adding that "the government's responsibilities are too great."
He said "since OAI is not cooperating in order to properly implement the law and properly manage the taxpayers' money, it must proceed with decisions, possibly, to replace the OAI Board of Directors as well."
Ecologist MP Stavros Papadouris said that the Auditor General's Report has identified abuses in the operation of the OAI and the Auditor General will proceed with complaints to the Attorney General's Office. He also argued that the intention of the Ministry of Finance to cut a total amount of €150 million from the OAI is justified, as these are payments that cannot be covered by the OAI and are eventually passed on to the Ministry of Health, he said.
"The GHS is a social achievement," he added, stressing that "the audit that is being done today is not to change it, but to support the existing framework as a mono-insurance system." He conveyed the assurance of the Ministry of Health that the GESY will not be changed and concluded that where corrections need to be made, where they need to be made, and where there are responsibilities, they should be attributed.
"We support the GESY as a social conquest of our people, which we will secure with the mono-insurance system," said DIPA MP Alekos Tryfonidis after the meeting. He added that corrections must be made because of the shortcomings we have also found through the Auditor General's report, which gives evidence of illegalities, abuses, inequality of remuneration and treatment of hospitals, absence of quality criteria, medical protocols and tax evasion by some doctors, he said.
"We demand as the Democratic Party - Coalition of Democratic Forces, such as the Ministry of Health, Ministry of Finance, Auditor General and OAI to find solutions so that an effective internal audit department can be built," he added and concluded that they will demand that all these plans and designs be presented with a specific timetable before the OAI budget is passed.
Source: ΚΥΠΕ
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