A LITTLE over a month is left for the introduction of the first phase of the much-trumpeted national health scheme, but there seems no end in sight to the vicious publicity war, between so-called stakeholders, that has been raging since last year. Every week there is a new feud about Gesy between the warring factions, raising questions of whether the authorities’ interest is the smooth implementation of the scheme or winning the communications game.
There is little doubt the propaganda war is being won by the supporters of Gesy, led by the Health Insurance Organisation (HIO), that has the responsibility for setting up the scheme and administering it. The HIO has the backing of the overwhelming majority of people and have the role of the good guys, as they are championing the noble cause of free universal healthcare and are encountering the opposition of the private doctors, portrayed as the self-serving bad guys.
A divisive climate of ‘us and them’, reminiscent of the period of the 2004 referendum, has been created, with private doctors being the victims of the type of abusive attacks that were directed against the supporters of the Annan plan. They are relentlessly targeted by the media, the political parties and patients’ groups which dismiss them as enemies of the people who put their financial interests above the common good, as if this were unheard of in Cyprus. Even the president jumped on the bandwagon a few months ago, accusing doctors of not wanting to join Gesy because they would not be able to continue their allegedly systematic tax evasion.
A few days ago, after the association of private hospitals and clinics (Pasin) announced that 14 of its members, including the three biggest Nicosia hospitals, would not be joining the scheme but would continue their cooperation with health insurance companies in a private healthcare network, they were labeled the ‘anti-Gesy’ front by newspapers. The “war against Gesy was raging out of control” reported one newspaper, while the leader of a patients’ group accused the private hospital owners of “intimidating society” and being “businessmen in doctors’ clothing trying to make citizens hostages to their financial interests.” Private medicine was “blackmailing the state and society” he told a newspaper.
The patients’ group leader came up with defiant political rhetoric, declaring that “the success of Gesy depends on us.” It was a ludicrous assertion, but indicative of the fact that winning the propaganda war has become more important than building a Gesy that will serve people. Admittedly, the second phase of the scheme – in-hospital care – is not scheduled for introduction for another year, but it should be a major concern for the authorities that the three biggest hospitals of Nicosia will not be in Gesy. Will this not cause a shortage of hospital beds, operating theatres and specialised treatments? Even if the state could afford it, it would not be able to set up new hospitals in a year to meet patient needs, when in-hospital care is provided by the scheme?
The HIO recognises this would pose a serious problem and after the announcement of the ‘anti-Gesy’ front, one of its officials said that the door was not closed to the private hospital owners. “We would go as far as the Council of Ministers to ask for an increase in budgets if it is proved that with Gesy, private hospitals and clinics would not be viable.” This was the first admission that private hospitals may have had a point in arguing all this time that fees the HIO was proposing to pay for treatments were too low, not only threatening their viability but preventing them from investing in new medical equipment. Of course, it could also be argued that the fees private hospitals were seeking would make Gesy unviable. Perhaps some compromise might be reached over the next year, although there is no obvious solution and both sides may have a point.
A more pressing problem is the actual number of doctors that have signed up for the scheme. According to the latest information, a total of some 500 have signed up of whom 360 will work as personal doctors. This would suggest there would not be enough specialist doctors, even though the HIO keeps giving information, reproduced with a triumphant tone by the media, that more and more doctors were signing up to Gesy by the day? On Wednesday registrations of patients with personal doctors (GPs) will begin and there will be clearer idea of the situation. Would they sign up with the ‘personal doctors’ in the scheme or would they complain that choice is restricted? There is a growing suspicion that despite the positive publicity, the refusal of too many private doctors to join the scheme, because of the unsatisfactory terms, could cause major problems in June.
Clever publicity campaigns will not be able to hide this, nor will heroic statements by patients’ groups that the “the success of Gesy depends on us.” The truth is that the success does not depend on patients but on having adequate numbers of doctors, hospitals and clinics. This is what the HIO and the health ministry should be single-mindedly focusing on securing in the next few weeks, because winning the publicity war would be completely meaningless if we end up with a dysfunctional scheme.