Cyprus medical association (CMA) on Monday slammed the health insurance service organisation (HIO) for “shoddy planning”, reiterating they had warned about the inadequacy of the Gesy budget prior to its implementation.

In a two-page written statement, the association responded to what it called “misinterpretations” by the HIO of the recently published audit-office report which alleged illegalities and tax evasion within the national health scheme (Gesy).

“If the conclusion of the HIO representatives from the report of the audit service is solely the continuous reduction of the reimbursements of health care providers, then the problem with the general health system is even greater,” the statement said.

CMA wrote they had pointed out the inadequacy of the €1 billion budget, in relation to the proposed coverages, which would affect Gesy’s quality and efficiency, but they were labelled “opponents” of the health scheme.

“Now the only solution to the inadequate budget and shoddy planning is to continually reduce the value of the services provided and attempt to humiliate the medical community,” the association wrote, adding its members will not tolerate the continued victimisation of the medical community.

“We will demand by all means the preservation of the dignity of doctors [private and public] and their scientific value,” as those in charge misrepresent that all doctors are breaking the law and exploiting patients, CMA said.

The medical community was stressing the need for safeguards and had made proposals, but “some people dismissed it as scaremongering”.

“We stressed the need to link the medical protocols and guidelines drawn up by the scientific societies (as far as their role allows) with the procedures of the system, which unfortunately have not been implemented to the point where abuses could be avoided, taking into account the quality of the services provided,” the statement said.

The association demanded “the immediate adoption of substantial measures to enhance the efficiency and quality of the system”.

HIO, the implementing body of the Gesy, has a “responsibility towards patients and society at large”.

In the context of this responsibility, it ought to know “the real battles are fought every day in our surgeries and hospitals”, urging officials to visit health facilities.

“Our long-standing goal is to ensure the uninterrupted provision of quality health services to our patients and to defend the scientific dignity of our physicians, factors that are inextricably linked and not opposed to each other,” it added.

The scathing AG report was published on February 4, covering the period from July 2019, when Gesy was launched, to December 2021.

It showed that 67 specialist doctors earned more than €300,000, of whom many had not filed a tax return for the years 2018 and 2019, while those who had filed a tax return for the years 2017, 2018 and 2019, their declared income was “clearly lower than what they received from the HIO.”

It also identified 11 Gesy doctors who each earned over €500,000 in 2020 – with one topping the charts at €870,742. Two gynaecologists in 2020 jointly received a fee of €1.4m for outpatient care alone.

Furthermore, 92 of the total of 774 personal doctors are over 70 years old with the oldest doctor being 83. Of them, five were unknown to the tax department for many years.

The numbers show an abuse of the system, but also the possibility of tax evasion in previous years, according to the report.

Among other irregularities, it also found that 28 per cent of GPs had over 2,000 patients registered, which was set as the maximum number of patients a doctor can have.

Following its publication, the head of the patients’ association Marios Kouloumas accused HIO of failing to control the national health scheme, asking for an independent body to be brought in to evaluate Gesy.