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Our View: Gesy placing too many limitations on private doctors

The Council of Ministers approved the regulations regarding the services that will be provided by private doctors participating in the national health scheme (Gesy) last Tuesday. The regulations put paid to one of the five conditions set by the Cyprus Medical Association for doctors joining Gesy – the ability to continue to practise privately. Doctors that register with Gesy will not have this right and practising privately while registered with the scheme will constitute an offence.

The dispute over this matter is indicative of the difficulties in implementing a universal healthcare system from scratch. The government and the Health Insurance Organisation (HIO) banned Gesy doctors from practising privately because of the risk they would not treat all patients equally. A doctor would be inclined to give priority to a private patient who would be paying three or four times as much as a Gesy patient for an examination. This would create two classes of patient it is claimed with some justification, and the government wanted to rule it out.

Doctors, on the other hand, quite rightly argue that they are not employees of the state or the HIO and therefore the employer-employee relationship, which would allow the former to set such a condition did not exist. They were selling services to the state and the state could not stop them from selling their professional services to whomever they wanted. In the business world this would be regarded a restrictive practice, preventing someone from freely practising their trade. Of course, the government could argue that it was not forcing anyone to register as a Gesy doctor, but those who signed up would have to give up seeing patients privately.

Another argument used by the doctors is because they are not employees of the state, like state hospital doctors, they have no guaranteed income, paid holidays, 13th salary or paid sick leave and therefore are entitled to try to maximise their earnings by also treating patients privately. In theory, they could see private patients, after they finished their Gesy-related work, but such an arrangement would be difficult to police. But if a doctor sees all his Gesy patients for the day, on what rational or economic grounds can they be prevented from seeing other patients privately? There may be foreign residents that are not entitled to use Gesy. Should they be barred from seeing a private doctor of their choice?

These restrictions do not exist in other countries that have universal healthcare and the government is acting in a heavy-handed way despite its good intentions. In its attempt to make Gesy fair to the patients it is treating private doctors very unfairly.

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