By Angelos Anastasiou
The health ministry’s ability to meet the demanding deadlines with regard to the phased implementation of the National Health Scheme (NHS) is doubtful, Auditor General Odysseas Michaelides noted in his 2013 annual report, made public on Thursday.
In it, Michaelides said that the audit service “expresses concern over the ability to comply with the timelines, given serious reaction to the government’s bill already voiced both by political parties and other stakeholders (medical staff).”
Without going into the politics, Michaelides said the audit service considered “a necessity,” the preparation of an action plan to address developments and achieve the overall goal of implementing the NHS within the defined timelines.
In May, the government and the troika of international lenders (European Union and International Monetary Fund) had agreed on implementing the NHS in three stages over one and a half years – primary-care services to be rolled out by July 2015; specialised medicine and outpatient services, and referrals to go live by the end of 2015; and full implementation of the NHS by mid-2016.
But critical milestones before any of the above can be considered include the reorganisation and autonomy of public hospitals, as well as the cost breakdown of health services, both due to be completed by November 2014 but already behind schedule.
“Instead, our service has noted that priority was given (mostly by the Health Insurance Organisation) on issues of procedural nature that required the hiring of consultants, at a cost of several millions,” the auditor general said.
Although the plan agreed in May 2014 mandated that laws governing the autonomy of public hospitals would be passed by November, a cabinet decision in September reversed a previous decision from April 2013 laying out the basic principles on which the Health ministry and Legal Services would draft the bill.
And with regard to costing health services, the auditor general noted that the ministry has “started gathering and reviewing financial and statistical data in order to carry out cost analyses, expected to finish towards the end of 2014.”
“Costing health services is imperative, irrespective of NHS implementation, so that the state can be aware of the cost of each service offered by public healthcare facilities, both for purposes of accurate information management, and for comparison when purchasing services from the private sector,” Michaelides said.
Meanwhile, the report warned that the Health ministry has not prepared and implemented any control mechanism with regard to the issuance of medical cards.
Therefore, “in order to ensure medical cards are only issued to those eligible, and to avoid the risk of mismanaging public funds, the ministry should immediately proceed to implement a relevant control mechanism.”