By Nicolas Petros Kaparti
Three years of life will be completed next Wednesday, probably the biggest reform since the establishment of the Republic of Cyprus. The reason is the General Health System whose first phase was implemented on June 1, 2019 and three years later it is confirmed that this is a huge social achievement and that the implementation of the System was an absolute necessity.
During these three years, GESY has gone through infill. The abuses combined with the problems brought about by the coronavirus pandemic have brought the weaknesses and unresolved issues of the system to the fore more than once. Problems that were highlighted at every opportunity by those who never really accepted the mono-insurance "character" of GESY. Moreover, there are not a few occasions when the GESY was the subject of conflicts either on the floor of the Parliament or through public statements.
Speaking to the Cyprus
Times, OAI Deputy Director, Efi Kamitsi, said that "the three years of GESY have shown that the system has brought a lot of advantages for citizens. We knew from the beginning that the reform would not be easy and now it has started to stabilize, because although the outpatient system has been operating since 2019, the service package was recently completed."
At the same time, Ms. Kamitsi indicated that now the System has gained momentum and changes or adjustments are being made to improve it. She also noted that it is an important parameter for the OAI to address abuses in the System and that the Agency is focused on quality health service delivery.
In addition, Ms. Kamitsi said that the OAI "has several mechanisms through which it receives queries and complaints, both from beneficiaries and providers. These are data that we are constantly utilizing, while we are intensifying controls and collaborations with experts abroad, so that the System is upgraded and the difficulties, which will always exist, are addressed."
"The point," Ms. Kamitsi continued, "is to have those mechanisms that help you to make quick adjustments in order to improve the functionality and efficiency of the System. After all, even in countries that have had Health Systems for many, many years, they face difficulties and challenges. Therefore, problems and difficulties are not a Cypriot phenomenon."
"The role of the Agency is to continue to continuously monitor the System, to upgrade, correct and adapt it, in cooperation with all stakeholders," Ms. Kamitsi stressed.
On the occasion of the three-year anniversary of the implementation of the GESY, the Cyprus[/B] Times maps the open chapters of the System, the thorns that exist as well as the changes that are being rolled out, and presents them to you through a detailed report.
Achanges in the way P.I. is paid. and Paediatricians
On the day when the General Health Insurance Scheme blows out its three candles, the Health Insurance Agency proceeds with changing the way Personal Physicians and Paediatricians are paid, as was decided in the original design of the Scheme.
Specifically, now P.I. and Paediatricians will not be paid only on a per capita basis - as was previously the case - i.e. based on the beneficiaries registered in their lists, and now a percentage of their remuneration will be calculated from the provision of other services and on the basis of qualitative criteria and indicators, such as home care of patients and on-call services. Also, their remuneration will now also be related to their "conduct", in the context of issuing patient referrals to specialists, as well as issuing referrals for diagnostic and laboratory tests.
It should be noted that 99% of the doctors accepted to renew their contract, except for three doctors, who terminated their contract due to their departure abroad.
"Battle" to implement on-call clinics in June
From then on, the OAI is making efforts to implement on-call clinics (weekends and public holidays) in June, however there is an obstacle as to where the on-call clinics will be located. In fact, on Thursday, May 19, the HMO asked for two weeks' leeway to re-examine the data and come back for its final response. As such, the OIA will await the final positions of the OCYPY in the first days of June, but until then, it is not sitting on its hands.
Specifically, as was reported in a previous Cyprus Times report, the OAI has already prepared alternative plans in case the attempt to implement on-call clinics at health centres falls through for good. The prevailing scenario (Plan C) envisages the use of the premises of the private clinics contracted by the GHS. It is understood that OAS has already begun contacts with private hospitals to see whether this option is feasible. Of course, as a competent source explained to us, this case is not so easy either, because some private hospitals may see this prospect positively, but there are also some that do not seem to see the operation of on-call clinics in their facilities in a positive light.
In any case, during the implementation of the institution, one centre will operate in each district. In the large Districts (Nicosia-Lemesos) two Personal Physicians and one Pediatrician will be on duty, while in the smaller Districts one Personal Physician and one Pediatrician will be on duty. As far as the opening hours are concerned, this has not yet been "locked", but there are considerations that the on-call doctors' offices will operate for 8 hours on Saturdays and for 4 hours on Sundays and public holidays.
They are officially waiting for the "green light" from Hatzipandela
At the same time, the OAI is awaiting a written letter from Health Minister Michael Hatzipandela for termination of the suspension of the integration of TAEPs, in order to start a dialogue with private hospitals. It will be recalled that several months ago, Mr. Hadjipandela instructed the OAI to stop any ongoing talks for the inclusion of new private hospitals or private CAHs in the System, following the Attorney General's opinion that the provision of inpatient health care to a beneficiary by a contracted hospital through a non-contracted physician is illegal. The whole issue was settled after Presidential intervention and since then the OAI has been on hold.
According to information from the Cyprus Times, the Minister of Health has already verbally expressed his intention to withdraw this directive, however it seems that he wants to have a "supervisory role" in the whole process of integrating private CACs into the system. Therefore OIA cannot proceed with any negotiation until it is also given the "green light" in writing.
Moreover, as revealed the Cyprus Times in a previous report, the whole issue is not viewed positively by OKYPY, considering that the inclusion of private TAPs in the GESY will affect its turnover, given that much of the inpatient care services provided in public hospitals is provided by First Aid. Indeed, this information from the Cyprus
Times has not been contradicted by the OASY.
Chapter abuses
In recent months, the OASY has been developing an action plan to address abuses in the GHC. The capital abuses is a constant topic of discussion on the health front and the OAI is trying through various mechanisms to curb the phenomenon. To date, the Agency has investigated dozens of cases of doctors, pharmacists and other providers and has proceeded with suspensions and termination of contracts, recommendations, administrative fines in over 43 cases, while rejecting claims whose value exceeds 3 million euros.
In fact, the OAS Board of Directors has set June 1 as GHS Day, during which the Agency will conduct an annual review of the System and provide information on planning for the future.
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