“One of the measures we have recently taken concerns the separation of referrals into urgent and non -urgent measures that ensure urgent incidents are served immediately.”
In the “Eye of the Cyclone” is once again the General Health System (GESY). The subject of discussions this time is the decision of the Administrative Court, according to which the law of GESY allows doctors who do not belong to the system can prescribe medicines within the GESY. And we may, as they all show, go to change the relevant legislation, but there are no voices that continue to put in the Health Insurance Agency (OSD) in order to accept the court’s ruling. This is out of the philosophy of GESY and outside the OSD plans, the chairman of the BoD responds to “P”. The Agency, Stavros Michael, at the same time implying that almost six years after the implementation of the GSEY, instead of being prevented and helping to resolve the problems that exist, issues of the past in an attempt to bring new storms to the GESY.
Mr Michael, explain to us why according to OSO, doctors who do not belong to GESY can prescribe within the system.
GESY was built on the basis of a specific philosophy and the prescription of drugs within the system by doctors outside GESY will alter its philosophy. We are talking, in other words, about altering the fundamental architecture of GESY, and if we accept it, it is like adopting the change in the framework on which its function is based. The debate on how the GSEY will work was made years before the system is implemented and I do not think that issues and positions that have been heard and discussed in the past must be raised at the moment, which have been given clear answers. Any change in the philosophy of the system will have a serious impact on the GSEY and therefore on beneficiaries, other providers and the wider community.
What is the risk?
What kind of effects are we talking about? What are you afraid of happening if the law changes?
I will be very clear. In the case of the implementation of the court ruling, very serious distortions will be created. Currently, a single IT system, which was built on the basis of the philosophy and the main axes of the Operation of the GSEY where the prescription or the provision of any other services by doctors outside the GSEI cannot be applied. Still, we will not be able to control prescription by doctors outside the system, which increases the risk of abuse. How can the body control doctors outside the GESY, since they will not be obliged to follow the rules, restrictions, protocols, guidelines applied by OSD? Secondly, the provision of equal access is abolished. Two -speed patients are created. On the one hand, there will be those who have the financial means to pay doctors outside the GESY, and on the other who do not have the financial opportunity and visit doctors affiliated with the Organization. It’s like we have two parallel systems, without being able to control the cost of spending on medicines.
Is there a risk that doctors leave from GESY?
This is also an issue that can also arise with negative impacts on the system. Due to the relationship between the doctor -patient, a portion of his patients may choose to see him privately, as they will be able to take their medicines through GESY. At the same time, it is not excluded that the pressures begin so that they can issue references to analyzes, diagnostic tests, etc. This will lead to a reduction in the adequacy of special doctors in GESY. Incentive, that is, for the exit of doctors from the system and the creation of discrimination against the doctors who are integrated into the GESY and follow its rules, as opposed to those outside.
Certainly there are problems, there are distortions, there are issues that we need to resolve and we have to focus on them. To focus on how to improve GSEY, how to better serve the beneficiaries, how to upgrade the services provided through the system today to each patient, and not discuss from the beginning of how the country’s health system should be. This discussion has been taken and we must move forward! We need to focus on solving the problems of GESY and strengthening it and not creating news.
Bet the quality
What actions does OSO take to improve quality?
In order to qualitative the services offered, we operate multilevel with specific actions, such as the application of qualitative criteria and performance indicators to the remuneration of personal doctors (PI), application of a performance indicator on long -term references to the remuneration of specialist doctors, application of quality criteria, hospital remuneration, Quality Indicators, Applications for Compensation for Medical Acts, Applications for Conducts for specific medical operations, qualitative evaluation of referrals issued by PI to EI, Development and Apply Clinical Guidelines for PEA referrals, conducting educational programs to personal doctors in relation to the implementation of the guidelines.
Lists
Waiting lists in some specialties is an issue that concerns you?
Waiting lists are also an issue that concerns us and which we have considering thoroughly for the better service of the beneficiaries. One of the measures we have recently taken concerns the separation of referrals into emergencies and non -emergencies that ensure urgent incidents are immediately served. It is useful to note that in some specialties the number of doctors is very small, so demand cannot be met. This is not only in Cyprus but also internationally. On the other hand, we see increased waiting time for specific doctors as they are the first choice for beneficiaries, at a time when there may be an appointment, more immediate, to another doctor of the same specialty.
One of the arguments of those who promote prescription in the GSEY by doctors outside the system is that some patients in this way will move to them and thus reduce waiting times.
I find it unthinkable and unacceptable today, from some circles, as a solution to the waiting lists of the decision of doctors to privatize. I will remind you that equal access to health services is an inalienable right to every citizen and this right is non -negotiable. And, of course, by scratching the GESY, it will be at the expense of society as a whole. Recall that 95% of Cyprus doctors are affiliated with GESY. Therefore, we do not believe that the small percentage of doctors outside the system will solve the problem with waiting lists. Because, even if some doctors leave the system, not all their patients will certainly follow them.
As an organization, we often accept “suggestions” for the problems of GESY. Rest assured that we are the first to see the problems and try to find solutions. The fact that the organization is suffering from severe underutilization does not help at all the difficult task it is called upon to carry out daily. The OSD human resources work with zeal, exaggerates itself. We hope that with the offspring we have been waiting for in 2024, as well as some new positions approved for 2025, we have reached a more adequate degree of staffing of the OSD.
When you say that OSD is under -staffed, how many employees are currently missing from the organization?
The first study of how many people would need the body was for 250 people. The staff currently has 121 people! According to the recently staffing study, taking into account the needs that arose with the services we took over and those we will now undertake, such as patient missions abroad, we should have been at least 300 people!
Patient missions
You referred to patients abroad and I can only ask, after two weeks have passed since the day the proposal was rejected for Mrs Christina Giannakis to come to OSD. What actions have been taken to be ready to take the service in six months without any further delay?
Procedures are proceeding and staff of the Agency are in constant contact and work closely with the relevant Department of the Ministry of Health for Education and Training purposes. OSD staff go to the ministry to be properly trained for the necessary procedures. In addition, there is close cooperation on issues related to the transfer of the software used by the Ministry for the purpose of executing the relevant procedures. As well as for the transfer of patients’ files, the finalization of the legal framework and all other individual procedures. The staffing of the Agency is also in this regard is crucial for the smooth transition of responsibilities and the effective operation of this service within the organization.
So will you take the missions?
Yes. We will do what is humanly possible to transfer the service to OSD in October, with the primary aim of seamless and effectively serving the beneficiaries in need of this service.
Legislative gaps
Apart from the staff and proper staffing of the OSH, is there anything else that is now absent from the organization’s “arsenal”?
There are, of course, many issues we have before us and which we are called upon to address daily, of which the lack of legislation on specific issues. When you do not have a legal framework on the basis of which to operate, at all levels, by the licensing and supervision of a provider, then things are complicated with serious impact on the quality of the services offered. Indicatively, to mention the rehabilitation services, the radioactive centers, the ambulances. In the absence of legislation, control is extremely difficult and the state should raise these issues that primarily concern public health and safety.