ROWS about Gesy (national health scheme), involving the government and different interest groups of the health sector, have become a regular feature of public life. A few weeks ago, the Cyprus Medical Association released a report claiming that the remuneration of doctors with private practices that joined the scheme would be extremely low. There is also the ongoing dispute between hospital doctors and the health ministry over pay and conditions, while pharmacists were demanding assurances that their interests would not be harmed when they became part of the Gesy. Nurses had their pay demands satisfied, some time ago, and have caused no trouble since.
In the last week, the Paediatricians Society of Cyprus has called on its members not to join the new health scheme, while claiming that parents would not be able to select the specialist doctor of their choice under Gesy. They were backed by the Union of Private Doctors that accused the health ministry of “bad planning” warning that the “reaction of the paediatricians is only the beginning.” The Union claimed it was “fed up with generalities and responses of a communications nature.”
The health minister Constantinos Ioannou issued an immediate response, while on Thursday the Organisation of Health Insurance, which will administer the scheme, accused doctors of resorting to “lies and inaccuracies, misinforming citizens and creating a climate of panic,” in an attempt “to undermine the planned reforms.” Ioannou posed a rhetorical question. “Is it possible that with the implementation of Gesy, interests are hurt that are not related to the health of patients?”
Everyone knows the answer. Ever since the first decisions regarding Gesy were taken, all affected parties have been at pains to safeguard their financial interests. Hospital workers, government doctors, private doctors, insurances companies, clinic owners, unions have all been bickering with the government to ensure the big changes to the health sector would boost their income. Everyone wants to cash in on Gesy, as if the objective of a universal healthcare should be the profit of all healthcare providers. Perhaps this is inevitable given the failure of the government to promote the message that everyone would have to make small sacrifices for universal health cover.
It is indicative of the superficial way, in which Gesy has been handled by the government that seems to think that public euphoria and party support is enough for the implementation of the scheme. The politicians seem to think that because the scheme enjoys universal support everything will fall into place in June next year when the first phase will be introduced. And if it does not, the people will not be critical because they want it so much.
At the pace things are moving, it is highly unlikely the June 2019 deadline will be met. The costing of the state hospitals, which will supposedly become self-sufficient at some point in the future, is nowhere near completion, so nobody has any idea what the total cost would be. Asked about the cost, last year, finance minister Harris Gerogiades said he did not know what it would be, adding that if more money was needed, monthly contributions could be increased. It was a flippant response that nevertheless betrayed the minister’s scepticism about the funding of the scheme.
The reality, less than a year before employees and employers start paying monthly contributions for Gesy, is that nobody knows what the total cost will be. The level of monthly contributions were approved by deputies, without knowing what Gesy will actually cost, even though the percentage paid will increase after the first year of operation. Will it be enough or would Gesy become a big hole in which the taxpayer is expected to pour in money, without asking any questions?
Meanwhile, according to press reports, in autumn an information campaign will be launched to explain to people how Gesy would work. A sizeable proportion of the stakeholders have refused to get on board, but the information campaign will commence regardless. All this is indicative of the superficiality with which the government is treating Gesy, which appears to have become a communications exercise and an excuse for scoring publicity points. The health minister responding to doctors with the emotive argument about them not caring about the patients is a case in point.
It would be much more reassuring if the minister was focused on the nitty gritty of the health scheme rather than engaging in the exchange of accusations with doctors. Gesy is by far the most ambitious and difficult project ever undertaken by the Cyprus Republic. Governments and technocrats have been making plans and working on it since the Papadopoulos presidency, many tens of millions of euro have been spent so far, but the Anastasiades government still appears to labour under the illusion that its introduction would materialise thanks to the will of the people, instead of engaging in meticulous and thorough preparation.