Cyprus Mail
Cyprus Health

Health sector crisis going from bad to worse, state doctors say

Nicosia hospital

MORE and more state doctors are leaving the public sector and replacements have been slow to step forward due mainly to the appalling salaries and conditions, their union (PASYKI) leader Sotiris Koumas said.

Koumas said the wave of state doctors that were opting to move to the private sector “is huge” with the most recent being an oncologist from the Nicosia general hospital.  “At this rate and with our attitude to resolving different things, our hospitals will certainly collapse,” he told the Cyprus News Agency.

Stories on the bad working conditions at hospitals have been rife recently. One of the most recent concerned a gynaecologist at Paphos hospital who collapsed, reportedly after pulling 24-hour shifts when as colleague was on sick leave.  Last month, no gynaecologist was present to deal with about 80 patients at Paphos and urgent cases had to be referred to the private sector.

Although Koumas appealed to the health and finance ministries to resolve the problem, he said up to three or four years ago, doctors had wanted to work in the state sector. Then the financial crisis hit, wages were cut and workloads increased and the public sector became less appealing.

“Depending on the pay scale, the cuts were between 20 to 25 per cent,” former director of the Larnaca hospital pathology department told the Cyprus Mail.

“Day after day, working conditions get worse. We’re called to put in lots of overtime, to treat a large number of patients,” Koumas said.

Doctors can no longer love their profession and are always on edge due to stress, he added. Particularly during summer season when colleagues want to go on holiday, doctors might be on 24-hour call for as many as 15 days in a row, he told CNA.

While official working hours are 7.30am, to 3pm if a doctor is on call they may come back to the hospital and still be at work the next morning. Additionally, if a doctor has a huge workload – as is the case these days – with several patients that have appointments, the doctor may end up leaving at 6pm instead of 3pm.

Data provided to the Cyprus Mail by the Cyprus Employers and Industrialists Federation (OEV) shows the monthly salary of a junior doctor is €2,121 after tax.

The starting salary of a senior doctor can range from anywhere between about €2,374 and can reach up to €3,599, after tax.

Koumas however said these starting salaries were by no means an incentive.

“A doctor spends 12-years studying, gets at least two degrees and then has a €2,400 salary? In these conditions? They’re much better off working in the private sector even for the same wages but with far better working conditions.”

Comparatively, in Germany, the average starting salary for medical graduates is €49,000 (almost €3,800 per month) according a post on Young Germany website dated last year.

In June, President Nicos Anastasiades himself stepped in and ordered the immediate recruitment of 28 doctors.

Now two months later, the state hasn’t been able to find enough people to step into these roles.

While some of these positions have been filled in, efforts to fill in these gaps are being exerted the health ministry said. It could not immediately say how many of the jobs had been filled.

“With these work conditions and salaries, why would anyone want this job?” Koumas said.

Additionally, it won’t even serve to solve problems with understaffing “because it depends on the criteria we use to staff certain departments.”

“There are 125 positions for assistant directors approved. If they are in the budget why can’t they pay for positions for first level medical employees?”

In the private sector, one source told the Cyprus Mail that solo practitioners have been hit the most, compared with private hospitals and clinics.

“It varies. For instance, private doctors in Paphos, Larnaca and Famagusta are affected more than those in Limassol and in Nicosia.”

“For young people, it’s much harder. The older doctors already have a circle however those just starting out have it tougher,” the source said.

While all specialties by and large may have seen their workload drop in the private sector, some may have it less bad than others.

According to the same source, doctors that deal with chronic diseases such as diabetes or heart problems have been affected less than for instance plastic surgeons, pediatricians and gynaecologists.

People have stopped paying for medical insurance, more unemployed people can get free healthcare from hospitals and thus, the workload in state hospitals piles up.

“Private clinics are doing better in 2016 than they were in 2013, 2014 but it’s still not where it was pre-crisis,” the source said.

One medical student studying in Germany who wished to remain anonymous told the Cyprus Mail when she did her work experience at the Nicosia general hospital she was shocked.

“It’s unbelievable. Doctors are seeing dozens of patients a day, one after the other. They don’t have the time to get a coffee or lunch, the queues are so long. How are they supposed to give a proper diagnosis under these work conditions?

“Especially after seeing Germany where everything is so organised and properly done, seeing the chaos here really shocked me.”

Asked if bringing in doctors from other countries – Greece for instance, where language is no barrier for the job –  could alleviate the situation, chairman of the Cyprus Medical Association Petros Agathangellou said this would merely be a patch-up treatment.

Even though the health ministry had tried this in the past, there hadn’t been much response for all the above reasons.

The situation simply screams for the need of the much coveted National Health Scheme (NHS), Agathangellou said and before bringing in doctors from abroad, what needs to happen is better restructuring – the autonomy – of hospitals.

Additionally, buying services from the private sector would be a preferred option, he specified.

“We don’t need doctors from Greece, we need a formula of cooperation…. we have scattered units and we need to put them together.

“Why bring doctors from Greece if what we have in Cyprus is enough?”

With a properly implemented NHS a lot of these problems can be done away with. Of course, many vested interests lie behind people trying to postpone it, he said.

“We’ve been talking about the NHS for years. What we’re doing is telling patients we have the diagnosis and relatives are asking ‘well what are you doing about it?’”

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