The health insurance organisation (HIO) recognises that abuse of Gesy by providers and beneficiaries is one of the most serious problems facing the national health system and is taking steps to address the issue, officials said on Thursday.

They were speaking at a press conference on the occasion of World Health Day that is marked on April 7 every year.

Gesy is the biggest social reform introduced in Cyprus since independence in 1960 and has been embraced by beneficiaries as it offers access to quality health care to all, they added pointing to a 2021 survey carried out by IMR/University of Nicosia which showed that 82 per cent found services offered as very satisfactory and 80 per cent believed that it has improved their quality of life to a great extent.

Acknowledging the difficulties and challenges, the HIO said abuse of the system by providers and beneficiaries are among the biggest problems in Gesy’s smooth operation.

To address this issue, the HIO has drawn up a plan of action and, with the appointment of additional staff, will be stepping up action.

Measures include restrictions, guidelines, and protocols in order to submit or approve applications by providers, in giving medicine and carrying out in-hospital care.

There will be stricter penalties to those who break the law, both providers and beneficiaries, as well as regular reviews of services offered, and quality assessment of the referrals given by personal doctors to see a specialist or for clinical lab tests.

The HIO will be launching an information campaign to cultivate a culture of correct use of Gesy, while clinical guidelines will be drawn up in cooperation with the UK’s national institute for health and care excellence, the Cyprus medical association and the University of Cyprus.

Moreover, remuneration of personal doctors will be based on a mixed system that will take into consideration quality performance indicators, rather than just the number of patients, referrals for clinical and other exams will be checked and there will be on-the-spot checks by external associates.

Despite the problems, Gesy remains financially viable, with figures for 2021 pointing to stabilisation. The total number of registered beneficiaries with personal doctors stands at 920,000, while the number of providers exceeds 6,100. Total visits, units and claim have stabilised.

In its campaign against abuse of the system, the HIO has so far investigated “tens” of cases of doctors, pharmacists and other providers and has suspended or terminated contracts, issued recommendations and administrative fines in more than 43 cases. It has also rejected claims in excess of €3m.