EVERY YEAR the auditor-general’s report on the health ministry raises serious questions about the sending of patients abroad for treatment. This is because there is no consistent policy or standard procedure for sending patients to other countries. According to the auditor-general, inadequate records are kept – in some case there are no invoices, just receipts – little attempt is made to control costs, hospitals abroad seem to be randomly chosen, the national health service of EU member-states is not always used and payments are often made by embassies rather than the health ministry.
The situation is a complete shambles. For instance, the government paid Germany some €5.2m for treatment to Cypriot patients from 2013 to 2015 using the country’s national health system, and in the case of Greece used private medical centres at a cost of €3.2m for 2016 alone. Perhaps more patients were treated in Greece, where state healthcare is under great strain, privately but this highlights the absence of policy. For instance, why are patients sent to Israel which is not part of the EU and Cyprus cannot benefit from national health service rates? To make matters worse a variety of Israeli hospitals are used which means the Cyprus government is unable to negotiate competitive rates.
The health ministry’s permanent secretary, the report said, received complaints about the bill from a London children’s hospital that charged €8,395 for an endoscopy and two nights’ stay plus another €5,578 for an additional four-night’s stay and the use of intravenous antibiotics. This may be because the health ministry, according to the auditor-general, did not always make use of the right of Cypriot citizens to receive medical treatment in an EU country at its national health service rates but approved private healthcare instead.
We can only speculate that some patients are granted preferential treatment, for the familiar reasons. The system is shambolic exactly for this reason – it allows the politicians and ministry officials to dispense favours through the discretionary powers they are afforded. Without fixed procedures, they can send who they choose to private hospitals, claiming special reasons. Then there are the kickbacks from the hospitals, which may explain why so many different hospital in so many countries are used. If the health ministry had an agreement with two hospitals in a country and negotiated competitive rates the scope for backhanders would be extremely limited. The health ministry claimed it did not have the staff to negotiate prices with the hospitals abroad, said the auditor-general’s report.
There is little doubt that the way the system works gives great scope for corruption and costs the taxpayer much more than it would have done if there were strict rules and procedures in place, with a limited number of hospitals abroad that Cypriot patients could use. It seems that this too much to expect as it would limit the favours dispensed by the politicians.