By Charalambos Pattihis
Both the competitiveness and growth of a country and the welfare of its citizens depends on guaranteeing their health and safety.
Although public expenditure on health increased during the years 2007-2011, there were no improvements in the quality of healthcare provided. During the economic crisis and especially between 2012 and 2014, public healthcare spending declined, and combined with declining private incomes resulted in more people utilising public hospitals, further exasperating the situation.
According to World Health Organisation (WHO) statistics for Cyprus total expenditure on health increased from 5.8 per cent to 7.4 per cent of GDP between 2000 and 2012, a percentage that remains below both the EU average and the global health index.
Total expenditure on health services in 2012 is estimated at €1.257 billion, of which €578.4 million accounts for the public health system and €678.7 million for the private sector. The fragmented provision and financing of health services between public and private health providers, often without control, the ageing population and the increasing costs of health technologies and drugs are challenging the sustainability of the existing health system, rendering the introduction of the National Health System (NHS) a necessity in view of the economic crisis.
The swift implementation of the NHS is imperative and as such the efforts of the government and the ministry of health are currently moving in the right direction. Any opposing views from various organised groups or individuals are of course fully respected, but it is imperative that we place the common good above all else.
A National Health System will yield the following benefits:
It will significantly improve the quality of health services through the modernisation and implementation of innovative processes in healthcare, as well as funding through the exchange of best practices at both an international and European level. The principle of the “family physician” and the subsequent freedom of choice (or not) of the patients, hospitals, specialist physicians and pharmacies will introduce a new competitive model that will be based on the quality of the health services provided and not solely on the price.
It will help strengthen the competitiveness of the economy as a healthier population is able to produce more wealth.
It will stop the inequality between different groups by covering all groups of people, including the unemployed and those on low income, strengthening social cohesion.
The public and private health care sectors will be joined in a better coordinated system thereby putting a stop to the exploitation and abuse of the overall health system. Rational costing and monitoring and control in public hospitals will reduce waste, while patients will be able to opt for the use of secondary or tertiary health care without a referral from a family physician, in exchange for a predetermined fee covering the visit and any other services resulting from that visit unless of course the beneficiary is hospitalised.
According to various financial scenarios, it is expected to save on costs amounting to approximately €300 million for the period of 2016-2025. Moreover, the ensuing competition between hospitals in the public and private sectors will help reduce costs and improve the quality of health services overall.
The implementation of the NHS will mean that the Cypriot citizens entitled to healthcare in other member states of the European Union, in accordance to the provisions of the European regulations and directives, will consist of beneficiaries in accordance with Article 16 of the General Health Law. As such, the implementation scope broadens as the criteria to be met are not limited to those currently dictated by the Medical Institutions and Services (Adjustment and Fees) Act.
It will help with the introduction of a system for detecting and combating counterfeit medicines.
In a more concise and cohesive manner, the NHS meets the four pillars that characterise the universal health systems worldwide, such as: equal access and coordination, high quality and effectiveness, economic viability and effective control.
Equal access and coordination provides full coverage of the population, equal access to both the private and public sectors, free choice of provider by beneficiaries, the creation of conditions for the coordinated development and cooperation between the private and public sector, and the introduction of procedural standards regarding private physicians to facilitate correct “guidance” of the beneficiary through the system.
High quality and effectiveness necessitates the creation of competition between providers, the implementation of minimum requirements for the participation of providers in the system, and the application of quality incentives through compensation to providers
Economic sustainability is ensured by a stable and broad contribution base (workers, employers, government), pre-defined budgets per class of provider and the application of a spherical budget
The final pillar – effective control – is provided by utitlising an integrated information system and operational procedures for monitoring and for the exporting of health indicators, a unique management organisation and by the ministry of health focusing on policy issues, control and the regulation of the health sector.
Charalambos Pattihis is chairman of the Cyprus Pharmaceutical Manufacturers’ Association