By Poly Pantelides
OUTPATIENT numbers at the state’s overworked hospitals dropped by half overnight with yesterday’s introduction of new charges, the health minister said.
Petros Petrides said state hospitals were reporting “a conspicuous reduction in patients” with staff in Nicosia General Hospital’s Accident and Emergency (A&E) department seeing half of the patients they would ordinarily attend to. It now costs €10 to visit the A&E.
“This was expected as patients visited hospitals en masse over the previous few days for lab tests and exams,” Petrides said.
Between Monday and Wednesday, the last remaining days where state healthcare beneficiaries could get lab tests and prescription medication for free, there were twice as many hospital visitors as normal, the minister said.
One state hospital that would normally see up to 800 visitors a day, dealt with an influx of an additional 400 on Wednesday, Petrides said. Another one whose staff normally serves up to 1,200 patients, welcomed almost 2,000 on Wednesday, he added.
Health care changes include new income criteria for beneficiaries and the introduction of hospital fees for visiting doctors, the A&E department, for lab tests and prescriptions. They have been in the making for months, and have been agreed with Cyprus’ troika of lenders. Most of the changes are designed to prevent abuse of the overburdened state health care system.
Nicosia General Hospital’s Chief Executive Officer, Petros Matsas said that whereas some 80 people had visited the hospital’s A&E department from Wednesday afternoon until midnight, less than 40 people had visited by 12pm on Thursday.
Yesterday. “The hospital saw a 40 per cent reduction in general compared to the previous days, same with the Makarios children hospital,” he said. “It’s calm. We hope it stays this way,” he added.
While the new system might have proven beneficial to hospitals in terms of lowering patient lines, many outpatients complained to television cameras about the cost, even though the system is means tested and designed to be affordable to those on low incomes.
Matsas said hospital staff were on standby to help outpatients yesterday as many did not understand the new system. He said however that many had come prepared having already purchased the stamps – showing the due fees had been paid – which now need to accompany prescriptions and lab tests’ requests.
The stamps can be purchased at eight different spots within the hospital as well as the main entrance’s registration point, he said. They can also be bought at post offices. Meanwhile, hospital screens informed patients of changes. Those were mostly in Greek but there will also be in English from next week, Matsas said.
A young woman who had visited the hospital from the Nicosia mountain village of Kakopetria said that she had been informed of the changes in the system via the media. “It’s been straightforward,” she said. She was waiting to pick up a medicine prescription. A woman whose husband had to be admitted in the A&E department said that most people she had seen yesterday had been brought in by ambulance.
At about 12.45pm on Thursday, she was one of less than a handful of people at the almost empty waiting room at the A & E. “Accident and emergency departments had ended up functioning as outpatient clinics, and many times people would come to use them who were not even beneficiaries,” Petrides said.
But with the introduction of a €10 fee to use hospital’s emergency services, the health ministry’s hope is that the department’s workload will drop.
The Green Party’s George Perdikis reported a few glitches in the system, such as some post offices not having the stamps – despite claims they would all be stocked up – or older people not fully understanding the changes.
“I hope the health ministry is on standby to resolve any omissions observed,” he said.
Ruling party DISY MP Stella Kyriakidou recommended a three month review of any problems in the new system. She recommended, for example, alternative solutions for frequent visitors, such as children who need to regularly consult an array of doctors.
HOW IT WORKS
ALL BENEFICIARIES of state subsidised health care need to pay €3 to see a general practitioner, €6 to see a specialist doctor and €10 for using the state hospitals’ oversubscribed accident and emergency department. Payments are on the spot and a receipt must always be issued.
Certain groups, including those who receive state benefits will continue being able to use accident and emergency departments free of charge on display of official identification.
People will now need to pay a nominal fee of 50 cents for drug prescriptions and lab tests. Although capped at €10 per transaction, the health ministry hopes nominal fees will discourage people from ordering lab tests they do not need, and might help address long waiting times for test results. Stamps for lab tests and prescriptions are available in state hospitals and postal offices and may be bought in advance.
They have a value of 50 cents, €1.00, €2.00 and €5.00, to represent the fees paid by patients who must stick them on the back of prescriptions and lab test orders. Patients then deliver the paper-plus-stamp to the relevant official (e.g. at a hospital pharmacy) and get their medicines or their lab tests done.
Beneficiaries of the new unified system – with one health card across the board – are civil servants and their dependents in return for a 1.5 per cent contribution of gross salaries, as well as those who receive state pensions.
Five-member families may voluntarily contribute the same 1.5 per cent of their gross salaries to ensure coverage. Some sufferers of chronic diseases will be automatically entitled to healthcare. For those not asked to make contributions, there will be sliding income criteria starting at €15,400 yearly for individuals, to €30,750 yearly for four-member families, plus an extra €1,700 per additional dependent.
The definition of “dependent” has changed to include anyone up to the age of 21, or who is dependent on parents, including students and soldiers.
Most private sector pensioners will continue being eligible for state healthcare based on income criteria, and even non-beneficiaries will have access to the system, on charges that are set to rise by 30 per cent but are still attractive compared to the private sector.
Non-beneficiaries may also use state hospitals, paying €15 to visit general practitioners and €30 to see specialist doctors. Cypriot and EU citizens who permanently reside in Cyprus are eligible to apply for a health card entitling them to subsidised state health care only if they have paid in at least three years’ social insurance (contributions do not have to be continuous), and have complied with all their tax obligations.
Existing health cards issued by the health ministry will be phased out over the year. Health cards issued by other government bodies, such as social insurance will remain as is. This applies to political refugees who are issued health cards by other bodies. Health cards previously issued to Turkish Cypriots have already expired, and new ones need to be issued at the health ministry in Nicosia directly. Current health cards with no expiration dates (the date in those cards is 09/09/9999) and cards issued by the health ministry to chronic illness sufferers will be cancelled at the end of October.
Current health cards with expiration dates will stop being valid at the end of January, 2014. To obtain a new health card, beneficiaries must visit a citizen’s service centre.