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Our View: Better to delay phase 2 of Gesy than see system collapse

Less than two weeks are left before the introduction of the second phase of the national health scheme Gesy on June 1 but nothing is ready. Health Minister Constantinos Ioannou, who declared two weeks ago there would be no postponement of the start date, is so determined to see inpatient care provided by hospitals and clinics because of the large number of scheduled operations postponed during the coronavirus crisis that he is refusing to see reality.

The reality is that public hospitals are in disarray, the state health services Okypy having failed to introduce any organisational structure, unable to deal with restrictive union practices, doctors demanding higher pay and ongoing complaints of understaffing. To make matters worse, private clinics and hospitals are considering not joining Gesy because the Health Insurance Organisation (HIO) unilaterally decided to lower the rates it had agreed to pay them by a reported 6%.

In fairness, before the minister announced there would be no delay in the start of the second phase, the HIO board had meetings to discuss a three-month postponement. Its income had fallen significantly because of the lockdown – private sector contributions were down 60% because of the furloughing of workers and the government’s decision to suspend increased contributions for phase two for two months. Costs had to be reduced to meet the June 1 deadline so the HIO proposed a 10% cut to the earnings of overpaid personal doctors and is asking private hospital owners (Pasin) to also take a hit so that Gesy is viable.

Has anyone informed public hospital doctors, meanwhile, that their demands for higher pay will not be satisfied because the HIO wants to cut the rates for operations and other inpatient care? Probably not because in the case of public hospitals annual losses, regardless of how big, will be covered by the state for the next five years. Public hospitals have also announced they would hire some 300 experienced nurses, who will be paid 50% more than the average wage of private clinics. State subsidies to public hospitals will undermine competitiveness of private hospitals which, at the same time, are being asked to accept price cuts to make Gesy viable!

But even from a negotiating point of view, the minister and the HIO are in a very weak position. They have announced the start date and are trying to squeeze Pasin on money, aware that without private hospitals and clinics the start of the second phase would not work.

First, public hospitals will have to work at only 60% capacity because of the government decree, so there is no way they would cope with the very high demand for inpatient care. Second, with such high demand for inpatient care, private hospitals would have plenty of work without joining Gesy, at least for the next six months. Third, could Pasin believe the HIO’s assurance that the cut in price would last only until the end of the year, after it had already gone back on the memorandum signed?

There is a large degree of arrogance in the way the minister has acted. He made his announcement irrespective of the fact that nobody was prepared for a June 1 start and expected everything, miraculously, to fall into place on his command. Some said he had taken a “political” decision, not wanting to take responsibility for delaying the start of the second phase. Now he will have to take responsibility for a start, probably without the private hospitals, that has the potential of turning into an unmitigated disaster. What are the chances of the disorganised public hospitals coping with the high demand for inpatient care?

Under the circumstances, the only sensible decision would be to put back phase two until September or October in the hope the HIO’s finances would improve, the private hospitals join Gesy and public hospitals get organised. Ioannou must know this is the only way to safeguard Gesy even if it would mean admitting that he was wrong to push for a June 1 start. Better a delay than a collapse of the system.

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