Research Center
Cyprus Economy

HEALTH: Cyprus GHS rollout faces new threat

20 April, 2019

While the Health Insurance Organisation (HIO) is pushing forward with the first phase of the General Healthcare System for 1 June, a group of private hospitals formed an alliance against what they believe is a system doomed to fail.

HIO has been collecting signatures from doctors and health workers who have expressed an interest to join the GHS, while conducting consultations with private health institutions, aiming to convince them to jump on board.

In a setback, the Cyprus Association of Private Hospitals (PASIN) announced the creation of what it called a Free Network of Private Medicine – which some perceived as an anti-GHS move. 

Dr Savvas Kadis, the president of PASIN said that “22 private institutions and 590 doctors have agreed to stay out of the GHS and set up a platform aiming to protect the viability of private health institutions and the high level of quality services offered by private medicine”.

The ‘Network’, according to Kadis, "is an initiative of experienced health professionals who, looking at how things stand today, have decided to continue to practice medicine with autonomy and freedom of outside the proposed GHS, which we find to badly designed”.

Kadis believes the landmark GHS will fall apart soon after its launch.

“It will become obvious from the first days of its operation, that it is not fulfilling its primary goal, that is to allow patients the free choice of doctors and hospital. 

He said private hospitals participating in the platform, fear that they will become part of a badly managed GHS with any autonomy they are currently enjoying, going down the drain.

“We will not be able to function in a competitive environment, which is the driving force in medicine. The way the overall budget is designed will see private hospital’s income reduced by 40%.

This would mean having to opt for cheaper and lower quality consumables and equipment, which at the end of the day means we will be lowering the quality of services offered to our patients.”

Kadis argued that what the association is suggesting is a mixed system where private and public medicine will co-exist. He said that such a system could work either by co-payment, that is the patient paying for whatever is over and above the service financed by the HIO, or with the involvement of insurance companies.

Acting President of the HIO, Andreas Papaconstantinou, told the Financial Mirror that the organization has not closed the door to private hospitals.

He said there is a willingness "to go to the Cabinet and ask for an increase in funds if proven that by joining the GHS private health institutions will not be economically viable".

He revealed the HIO had asked to see their balance sheets so that a better proposal could be put on the table, but the private institutions refused to do so.

Papaconstantinou said private medical institutions and doctors were given an indicative base rate that was open to discussion.

“Our assessment showed that indeed private hospitals would see their income drop by 25% with the initial planning. We were, and still, are open to discussion. We expected that we could have come to an agreement which would see HIO obtaining a 15% discount on services offered by private institutions.”

Papaconstantinou said that with the above proposal, private hospitals will not to lose out.

“Quite the contrary, they will be able to benefit as they will be in a position to compete with public hospitals, having the opportunity to increase their patients.”  

He added: “We are ready to talk with the private hospitals, but we are not ready to sacrifice the philosophy behind the GHS, which puts the patient first.”

The authorities appear confident that the GHS will be in a position to launch its first stage on 1 June as 500 private doctors have been enrolled with the GHS, 360 ​​of which will serve as General Practitioners. The HIO expects that some 1200-1300 doctors will be at the GHS’ disposal as of 1 June.

Meanwhile, the Pancyprian Federation of Patient and Friends' Associations feels that an intimidation game is being played on behalf of private doctors and hospitals, “in an effort to tarnish the GHS while keeping citizens hostage for their own financial gain”.

Marios Kouloumas, head of the Patients Associations urged people not to pay attention to these threats.

"We are being blackmailed by the businessmen with the white shirts, a phrase that does not belong to me but to a former leader of the Cypriot doctors… We are facing a merciless war against society,” claimed Kouloumas.

Turning up the heat, the Cyprus Medical Association, in a joint statement with the Medical Council of Cyprus, said that the HIO has turned to non-specialised and junior doctors to fill in staffing gaps in the GHS, which they described as "dangerous".

 The two associations stated, "this is unacceptable and dangerous since it clearly undermines the quality of healthcare services while burdening both doctors and supervisors with unbearable responsibilities and adverse working conditions".

HIO officials have said that junior doctors will undergo a training programme prepared by the Ministry of Health, the HIO and the Pancyprian Medical Association. Those who fail to complete the programme will not have the right to treat patients who turn to the GHS.

Regarding specialists, the HIO argues "there are doctors who are at the end of their specialisation programme, that is, they are expected to finish by the end of May or mid-June. We cannot deny these doctors the right to register at this time. However, if they do not successfully complete their speciality then their participation in the GHS will be cancelled ".