The procedure to see state hospitals administratively and financially autonomous kicked in on Wednesday, with Health Minister Constantinos Ioannou saying it had been expected that some state doctors would opt to keep their civil servant status instead of signing the three-year contracts offered to them under the new regime.
He said refusal to sign the new contracts would not affect the move towards hospital autonomy.
From the beginning of the year, the financial and administrative supervision of state hospitals has been transferred to the Organisation of State Health Services (Okyy).
Okyy is tasked with the management, control, supervision and development of public hospitals and primary health care centres. State hospital autonomy is an important aspect of the implementation of the National Health Scheme (Gesy).
Last week, all medical and paramedical professionals working in state hospitals were seconded to Okyy.
According to Ioannou, as of Wednesday, officials appointed by Okyy will manage the three state hospital directorates created: one for Nicosia district, one for Larnaca-Famagusta districts and one for Limassol-Paphos-Kyperounta-Polis Chrysochous.
“Until now, the decisions were taken by the health ministry. Now, the administrative decisions, on whatever concerns the operation of the hospitals, will be taken by Okyy,” he said.
As part of the transition, state doctors were transferred from their current employment as health ministry civil servants to Okyy. As with all other health professionals, they will be given employment contracts by Okyy terms. If they do not wish to change their present employment status, they can ask to be seconded to Okyy as civil servants.
“With the posting or transfer of staff to the autonomous organisation (Okyy), they will be offered contracts,” Ioannou said. He said that this would give them the options of effectively retiring from the civil service and renouncing the status of the public servant.
Those state doctors who opt to sign these three-year contracts will instantly see a 14 per cent pay raise, he said.
“It is up to each and every one to decide if 14 per cent is sufficient,” Ioannou said, adding that even if they don’t, they will remain seconded until they properly retire.
“Nothing changes. I must admit that we did not expect a large number of permanently appointed state doctors (to sign the contracts),” he said. “But this does not affect our plans, it does not create any concerns.”
The minister said that the contracts are more appealing to those on open ended or fixed-term contracts.
His comments follow the call by state doctors’ union Pasyki to its around 500 members – both doctors permanently appointed and on contracts – not to sign the contracts. The union called for more discussions with Okyy over the terms of the contracts. There are around 800 state doctors.
Pasyki head, Soteris Koumas, told the Cyprus Mail that the union, that received the contracts some 10 days ago, has replied to Okyy on the terms of the contract and have commissioned a study on its legal and financial aspects.
“According to the law, we have 18 months to decide,” Koumas said, adding that they had only been given until the end of last year to submit their comments, which was not enough time.
He said that some of the contracts’ provisions were vague. Koumas added that it was an insult to all those doctors who have kept state hospitals up and running to be offered a mere €3,000 as voluntary exit incentive to leave the civil service and enter “uncertainty”, as those signing the Okyy contracts, could, at any moment, be made redundant.
But Ioannou said that, over the past two years, there had been several changes that saw the salaries of state doctors and nurses rise. Last year, doctors saw an upgrade in their pay scales and, since the beginning of this year, the entry pay scale of nurses has also been increased.
The minister said that the income of healthcare professionals had also risen since the introduction of pilot programmes for surgeries during afternoon hours and the extension of health centre opening hours.
Doctors also saw their overtime pay rise following an agreement signed recently between their trade unions and the government.
State hospitals, he said, will become more flexible organisations “to be able to face the challenges that come with the Gesy and to at last reach the quality standards we aspire to and we certainly have not seen so far.”
From June 2019, when the first phase of Gesy is expected to be implemented, Okyy will be responsible for the delivery of family doctor services by general practitioners now being employed in the public sector.