President Nicos Anastasiades instructed the Health Insurance Organisation (HIO) on Friday to introduce effective mechanisms to prevent abuses of the general health system that pushes up costs and undermine the quality of health care.

The blunt message was delivered at a special meeting convened at the presidential palace in the wake of stark warnings from both the finance minister and the auditor general that runaway spending as a result of abuse risked Gesy’s viability.

The government has touted the scheme – introduced in 2019 after decades of discussion – as one of its biggest achievements and pledged to protect it.

This was reiterated on Friday, by the president in a tweet and by the deputy government spokeswoman in an official announcement about the meeting.

“The President of the Republic stressed once again his determination that Gesy, peoples’ biggest social conquest, be protected,” Niovi Parisinou said.

But Gesy – and especially the HIO which runs it — have come under increased scrutiny amid revelations from the auditor-general of over-spending and incompetence in what some doctors and other providers allegedly see as a gravy train.

The HIO has acknowledged that abuse of Gesy by providers and beneficiaries is one of the most serious problems facing the system and assured it was taking steps to address the issue.

On Friday, Anastasiades told officials the government was determined to address problems with Gesy, especially abuse of the system, a development that leads to an increase in health expenditure and hurts the level and quality of health care, Parisinou said.

In a written statement after the meeting, Parisinou said the president had stressed the need for the HIO to implement effective monitoring mechanisms so as to minimise abuse of the system.

“It was agreed that a specific time plan be drawn up for the implementation of the monitoring mechanisms which will be discussed at a new meeting the President of the Republic will call after Easter,” she added.

Public health expenditure in 2021, including spending to tackle the coronavirus pandemic, rose to 7.4 per cent of GDP, up by 1.4 percentage points over the 6 per cent of GDP in 2020.

The meeting also discussed the provision of inpatient care to Gesy beneficiaries in hospitals contracted with the HIO but by doctors who are not part of Gesy. This was one of the issues blasted as illegal by the auditor general which had then been referred to the attorney general for a legal opinion.

Parisinou said that the president had asked that a circular be sent immediately terminating this practice, once and for all.

Also discussed at the meeting was progress in the procedure to make public hospitals autonomous and financially viable, as well as implementation of the development projects of the state health services organisation (Okypy).

Here the president asked for a plan of action on the basis of a specific time frame that would cover mechanisms to monitor the organisation and operation of public hospitals.

Other issues discussed were patients’ electronic files and the accident and emergency departments at hospitals, she said.

A decision was also taken regarding the number of physiotherapy sessions offered to children with cerebral palsy. The number of sessions had been slashed, prompting families to protest and the health minister to directly request from the HIO that is resolve the issue.

Taking part in Friday’s meeting were the finance and health ministers, the undersecretary to the president, the deputy attorney general, the auditor general, the permanent secretaries of the finance and health ministries, the presidents of the HIO and Okypy and other officials.

Edek, whose president Marinos Sizopoulos has taken a critical stance towards Gesy, responded to the announcement saying it confirmed its demand for the need for action to correct distortions so as to allow correct implementation and philosophy of Gesy.

Beyond what was decided on Friday, more needs to be done, it said. This includes ensuring patients have a free choice of doctor and hospital, for personal doctors to be paid by their list of patients and not per visit, for easier access to specialist doctors through lower co-payments and for patients’ medicines and tests to be covered by Gesy even if prescribed by a non-Gesy doctor.