Hot on the heels of news that a doctor was facing criminal charges for allegedly sending fictitious invoices for payment, it emerged on Thursday that another medic has been removed from the health system Gesy, and that eight others have been suspended pending investigations.

Police are also investigating another case in which a 72-year-old patient claims her Gesy doctor filed for compensation for an operation which never took place. The legal services are now reviewing the case. There are currently about a dozen cases of fraud being investigated, reports suggested on Thursday.

In the case of the doctor who is to be prosecuted, local media reported that between July 2020 and May 2021 invoices were submitted for €7,300 to cover injections, some of which were allegedly never even administered, and others were done needlessly so.

Concerns over tax evasion have also engulfed the health care system. It transpired on Wednesday that a number of doctors had filed tax returns that showed them claiming to earn less that what Gesy operator, the Health Insurance Organisation (HIO) had paid them for their services.

It was arguably the auditor general’s scathing report released last week which lit the fuse, with the health care system seemingly riddled with illegalities and shortcomings.

Chairman of the HIO Andreas Papaconstantinou said that one doctor has been fired from Gesy, marking the first case of a medic being removed from the network. Papaconstantinou said that the doctor was fired about one to two months ago, after investigations discovered that they were behaving strangely.

“When a doctor declares administering an injection each time they see a patient, you can tell that something odd is going on,” he told state broadcaster Cybc. Papaconstantinou was also quizzed on the finance ministry’s castigation of the HIO on Wednesday over its failure to submit the tax returns of Gesy doctors.

He conceded that there were delays due to the complexity and amount of paperwork but said it would be completed by the end of the week. “As we have said many times before, one of the good things about Gesy is its potential to eliminate tax evasion, but to do that the organisation must respond by submitting the information we asked for a year ago,” Finance Minister Constantinos Petrides said on Wednesday.

Meanwhile, the Cyprus Medical Association (Cyma) on Thursday said it was concerned at the allegations made against the HIO by the auditor general’s report, many of which “were not a surprise”.

“It is the harsh reality which, unfortunately, has been overshadowed by communications manoeuvring and tactics,” Cyma said.

The association, during a news conference led by its president Dr Petros Agathangelou, touched upon key points made by the AG’s report, such as key services not being covered by the HIO despite its obligation to do so.

Agathangelou said there were many issues the association itself had asked the government to take into consideration or resolve. It said that many of its suggestions made prior to the implementation of Gesy were not adopted, and that its current criticism is not meant to dent the system but to protect it. It also suggested a lack of oversight by the HIO.

As far as offending doctors were concerned, Cyma said the number was small, less than 0.01 per cent and said the vast majority of doctors should not be tarred with the same brush for abusing the system. “Cyma condemns the abuses where they are proven and the authorities must address the issues,” Agathangelou added.

He said the auditor-general’s report refers to 67 doctors out of 3,000 in the system, who are paid extremely high amounts

“Therefore, they are the exception and not the rule,” he said.

“Many problems arise that most of our members face and which they share with us such as the inadequacy of complete supervisory control,” Agathangelou said.

Cyma A also pointed out that the health care expenses for 2021 reached €1.8bn, far outstripping the projected €1bn, while 2022 loomed large with an estimated €2bn.

He said that despite the increased expenditure there are basic services which are still lacking.

He said Cyma had submitted a list of proposals with 17 points related to corrective measures, to President Nicos Anastasiades but their implementation was being delayed ostensibly due to the pandemic.

“But the pandemic cannot be an alibi for the chronic problems that affect the health system,” he said.