Cyprus Mail

2019 – Gesy: a health system is born 

ONE OF the most welcome development this year was the introduction of the much-awaited national health scheme, Gesy.

I must admit I had given up hope, which is a rare thing for me being ever the optimist but after monitoring in recent years all the spats between everyone involved – parties,  government, state doctors, private doctors, nurses, insurance companies – coupled with broken promises, delays and missed deadlines, the introduction of the National Health Scheme, like the solution of the Cyprus problem, seemed like a unattainable dream.

Finally, on June 1, Gesy became a reality but came with a warning from the health ministry and Gesy operator HIO, the Health Insurance Organisation, “there will be problems but fear not, we’re here to fix them”.

Though the system was not without its glitches and despite the moaning and whining by those still opposing Gesy, many relying on state-provided healthcare were finally able to receive the services they had been deprived as a result of the economic crisis and the mile-long patient waiting lists in public hospitals.

So far, around 90 per cent of the population, some 770,000 people, have registered as beneficiaries while around 1,800 physicians – 451 GPs, 170 paediatricians and 1,170 specialists – offer their services under the system. In total, 662 pharmacies and 165 labs have joined Gesy.  A huge improvement considering that under 100 doctors had initially joined, who had to serve thousands of beneficiaries, which led to patients waiting for weeks for appointments and staff working long hours to meet demand.

It is undeniable that the financial crisis had taken its toll on state hospitals since many who could not afford to visit private doctors for consultations or procedures had no other option than to turn to the public sector. This, coupled with cutbacks, a freeze on hiring and doctors walking out, had led to a chaotic situation in state hospitals with waiting lists getting out of hand, and many just deciding not to go to the doctor to avoid the hassle of having to wait for hours just for a consultation or spending their morning in long lines to get their prescription drugs.

Come Gesy, all one needs to do is make an appointment with their family physician (GP) and take it from there.

But one thing we’ve seen is that some patients and physicians seem to have found the opportunity to abuse the system through unnecessary lab tests, checks and medical procedures. The former just because they are available free of charge or at a fraction of the amount they would have paid in the past, the latter to beef up their claims to HIO for compensation.

Too many demands for lab tests and excessive prescriptions had initially choked the system and led to drug shortages in pharmacies.

A private physician working as GP was so fed up with the constant demands for lab tests by his patients, he raised the issue on social media, arguing he was forced to be “an executioner of demands instead of a doctor.”

Recently revelations were made that some doctors, private and state ones, had asked ridiculously high amounts from the HIO as compensation for the services they provided under Gesy with one cardiologist demanding in total €407,000 for five months.

Government sources however said they knew of these cases and were under investigation while arguing that many doctors do work many hours, until very late in the evening, due to the increased demand after the long wait by patients for the introduction of Gesy.

Another issue remaining unsolved is state doctors’ pay and incentives for them to remain in public hospitals and not opt to join the private sector whose pay is in some cases double than theirs.

Consultations with state health services organisation (Okypy) over incentives to public sector specialists continue while two unions, Pasyki and Pasesi, staged a warning strike earlier this month, and Pasydy doctors warning they would too take measures in the case of a non-agreement. The incentives offered by Okypy, will mean between €1,000 and €1,500 extra per month on top of their salaries and other benefits but unions are after an amount roughly equivalent of an extra salary each month.

Some accuse the doctors of only caring about the money, while they are saying this would prevent more of their colleagues leaving the public sector for the private one and thus ensure the smooth operation of state hospitals.

Next June, Gesy will be in full swing with the introduction also of outpatient care, with HIO trying to get private hospitals join.

Just before Christmas, parties met to discuss Gesy’s progress and the need for changes. Despite concerns expressed, reassurances were given that none of them has asked for its philosophy and architecture to be changed.

It remains to be seen what the future has in store for Gesy but weighing the pros and cons it seems that its introduction was a move to the right direction. What we need to do, is for all of us to use Gesy wisely to help ensure its viability.

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