By Brian Lait
Back in September 2019 when Gesy was in its infancy, I wrote an article entitled “Will messy Gesy clean up its act?”
Apart from lengthily commenting on the so-called “teething problems” of getting registered in an organisation kicked around for decades by incompetent bureaucrats and politicians, I asked the simple question: will Gesy survive?
While my present experience is that prescribed medicines can readily be collected painlessly from pharmacies the prices at which many medicines are being charged, or given free, to patients makes me wonder if they are being correctly costed.
What made me raise the survival question two years ago was the amount of money being sloshed around, and I wondered if there would be sufficient income to meet the outgoings. I am still wondering. Back in September 2019 only GPs were talked about in the press, as amounts to be paid to specialists, such as paediatricians or vascular surgeons, had not in any way been publicised. Also, it was not at that time clear how many of the private clinics would join the system.
GPs were to be paid €107 annually per patient registered with them which, with a maximum of 2,500 patients per doctor, would allow a general practitioner to earn as much as €267,500 annually regardless of the number of consultations any patients had with that GP! In August 2019 an announcement would allow a doctor to earn €100 for a 2.5 hour shift on a weekday evening, €480 for an eight-hour shift on Saturdays and €240 for a four-hour shift on a Sunday. The original plan apparently assumed that no-one would be ill during any weekend!
We were told that before the end of July 2019 there were 384 GPs registered with Gesy. With a population of 816,000 (2017 figures) that would average 2,125 patients per GP at a total cost of €87,312,000 before specialists and medications.
With GPs being showered with such rewards, specialists must be positively drowning in cash handouts through the generosity of Gesy, and it seems to me that such sums should be publicised so that everyone can freely and fully grasp what appears to be a bottomless pit of cash. The number of previously private hospitals and surgeons, cardiologists, psychiatrists, etc. now signed up to Gesy would appear to indicate how “profitable” it must be to provide medical services under Gesy.
Several years ago, I could call my cardiologist and get an appointment within a couple of weeks at the outside, since he was not signed up to Gesy. The cost for the appointment was €50 which was covered by my private medical insurance.
The cardiologist is now signed up to Gesy and this year I called in July and the earliest appointment I could get was in November, although this time the cost to me will be €6 as I have a Gesy referral from my GP. But how much will Gesy pay the cardiologist?
Within the last couple of years my wife and I have had a few appointments, and surgery by local anaesthetic with leading Cyprus surgeons. At no time were we asked if we wanted to pay “privately”. On each and every occasion it was assumed that all was on Gesy, and on the one occasion that I had omitted to get a referral from our GP, I was charged the princely sum of €18. But how much did Gesy pay for all this?
And how much are Gesy paying “private” hospitals for overnight stays for Gesy patients? Several years ago the charge was well over €200 per patient per night in a two-bed ward for private patients.
So, can Gesy survive?
It was interesting to read the editorial in the Cyprus Mail on November 4, which prompted this article of mine, which clearly, and rightly, stated that “Without improvement Gesy will collapse”. The lead article went on to say, “Our national health scheme, Gesy, has become untouchable. Any criticism of the way it operates…….is viewed as an attempt to alter its set-up and philosophy”.
The way the editorial was worded suggested very strongly that many of the island’s politicians must have had extensive training within the UK’s National Health Service (NHS), Europe’s largest employer and one of the most wasteful enterprises devised by man, but a political “sacred cow” at which eye-watering sums of money get thrown regardless of its very obvious deficiencies. The rather sad part in the UK is that despite its evident faults, moronic individuals such as the UK’s prime minister actually think the NHS is efficient. As in Cyprus, no political party dare tackle the fundamental problems that clearly exist even to the most myopic observer, and Gesy in its today’s state is still the same political football it was prior to when it was finally baptised in 2019.
I was most interested, perhaps amused, to read that it was Harris Georgiades who caused an uproar by stating “… that certain changes needed to be made to Gesy”. He went on to suggest “… specific safeguards to ensure money spent was accounted for and cited the absurd practice of rewarding GPs for doing nothing – paying them by simply registering patients, some as much as € 250,000 a year”!
That makes excellent sense to me, but why now and after so long Mr Georgiades ? You were the finance minister from February 28, 2013 until December 2, 2019. What were you doing when all this was being set in stone under your watch?
I have private medical insurance, as have a number of friends, for which I am paying a considerable annual premium. There is strong argument that I no longer need it in view of Gesy, but in view of Gesy’s uncertain future I think I’ll hang on to the insurance for a while longer.
Let me finish with a brief comment about Okypy, which is supposedly in charge of public hospitals. Well over a year ago now the new section of Larnaca general hospital was opened, yet it seems that only the first floor (out of six in total) sees any activity at night, while most floors in the old section are still ablaze with light. Further, despite there being no patients or anyone at all in view, the lights on the ground floor are all on at night.
Brian Lait is a retired chartered accountant living in Cyprus