HIO submits figures showing that Gesy payouts and referrals fell in 2021

The number of referrals to specialist doctors by GPs has fallen significantly since Gesy was introduced, while specialists are also getting a lot less per visit, according to data submitted to the audit office.

The data provided by the Health Insurance Organisation (HIO) – the entity that runs Gesy – showed that specialists were paid on average €100 per visit in June 2019, just as Gesy was launched.

That has since fallen considerably to €66.30 per visit as of December 2020 and for 2021 it averaged between €61 to €64.

Another key trend was that of referrals, with 68 per cent of patients’ (aged over 18) visits to their GPs in January 2020 leading to a referral to other professionals within Gesy. This figure was slashed to 38 per cent by December 2021 and throughout the year averaged between 39 per cent to 47 per cent.

The stark figures are particularly notable within the wider context of the ongoing row over Gesy, with a meeting on Tuesday between the health minister and the HIO marking a step towards reigning in the Gesy “gravy train” and ensuring its viability.

Health Minister Michalis Hadjipantelas tabled proposals among which is a motion to cut the number of patients elderly doctors can have enrolled.

That particular point gained notoriety following revelations by the audit office that an 83-year-old doctor had about 2,500 patients enrolled, far exceeding the 2,000 permitted under current legislation.

There are now efforts to set limits according to a doctor’s age, daily Phileleftheros reported, so that a doctor over the age of 80 would only be permitted to have 25 per cent the number of patients compared to younger doctors. For those aged over 70, the figure may be about 50 per cent.

The reasoning goes that younger doctors are being strangled of opportunity.

Elsewhere, there are efforts to get an independent and outside body to evaluate claims made to Gesy and having a rolling review of documents submitted, in an attempt to stamp out abuse.