LESS than a year into its second term, the unravelling of the Anastasiades presidency appears to be gathering speed. In the early hours of Friday, the Cyprus Medical Association announced that it would urge doctors not to join Gesy because of the government’s insistence on barring them from practising privately and the refusal to increase the budget. Despite two meetings at the presidential palace, earlier in the week nothing was resolved, but the government remained convinced on Friday that private doctors would sign up to Gesy irrespective of CyMA’s position.
It is testament to the shoddiness with which the Anastasiades government approaches important issues that five months before the introduction of Gesy everything is up in the air. And this is because of poor and inadequate preparations and a failure to have proper consultations with the stakeholders apart from people employed in the public sector before the Gesy blueprint was finalised. In the end, we have a healthcare model designed by pen-pushing bureaucrats and clueless politicians, both with a clear prejudice against private health, conveniently ignoring the fact that all improvements in healthcare in Cyprus were brought about by the private sector.
The fact that the second stage of Gesy, of in-patient care, will commence without autonomous, self-sufficient hospitals, that will be subsidised by the taxpayer, is indicative of this prejudice. A five-year time-frame has been granted to state hospitals for autonomy, despite the fact that the government’s consultants had underlined that Gesy should not be introduced before hospital autonomy was achieved. There was a very good reason for this. Prices for medical procedures imposed by the Health Insurance Organisation could be acceptable to state hospitals that would have their losses covered by the taxpayer, but could make private hospitals and clinics economically unviable.
This is only part of the problem. When the prices for medical procedures are too low, private hospitals would not have the surpluses to invest in new treatments and modern equipment and the banks will certainly not lend money to a business not making a profit. How will improvements be made in healthcare treatment without profitable private hospitals and clinics, which traditionally have been the drivers of medical progress in Cyprus. Almost all new treatment methods have been introduced by private hospitals and state hospitals have followed suit. Cancer care is provided by the Bank of Cyprus Oncology Centre and, now, also by the German Oncology Centre in Limassol, both private initiatives.
State hospitals always lag behind the private ones because they are badly-managed, inefficient, disorganised, heavily unionised, technologically backward and bureaucratic entities that are oblivious to market conditions. And they will continue to be so for as long as they are subsidised by the taxpayer, which might be for another 10 years. The problem will be that state hospitals will drag down the whole healthcare system, assuming that Gesy is actually introduced and does not degenerate into chaotic mess within a year or two of its introduction.
If the government had not treated Gesy with such superficiality, turning it into a campaign issue for President Anastasiades’ re-election and allowing the parties with their big-state mentality to shape it, things may have been different now. A government that gave the matter the seriousness it merited – this is a scheme with a billion-euro annual budget – would have, first and foremost, recognised the contribution of private medicine to healthcare and would not have treated private doctors with such disdain, as if the state would be doing them a favour by allowing them to join Gesy.
This is what clueless politicians and bureaucrats at the Health Insurance Organisation that see the private sector as an enemy might think. They conveniently ignore the fact that Cyprus’ best doctors have private practices because their services are in demand and they earn a lot more money than a state hospital would pay them. In a rational world in which the HIO and the government wanted Gesy to guarantee a high standard of care for everyone, they would have done everything they could to attract the top private doctors to Gesy, even if the latter were only prepared to work two days a week for it, instead of demanding they gave up their lucrative private practices to join.
The government’s unreasonable insistence on doctors giving up private practice will result in the top doctors staying out of Gesy, something that is not in the best interest of the patients, whose interests the politicians claim to be serving. The same applies to the private clinics and hospitals – if the prices they will be paid for medical procedures and actions are too low they will not work with the HIO either and patients will suffer.
It is becoming obvious that good quality healthcare was not high on the list of the priorities of Gesy’s architects. For Anastasiades, it is enough to take credit for setting up a national healthcare system. The quality of service is of no concern, which is why the government has made it so difficult for top doctors to join.