Gesy is really, really messy

Finance minister has described Gesy as a ‘black hole’ of funds. He’s right

By Brian Lait

Gesy, the long awaited and much discussed Cyprus health scheme officially kicked off on June 1, 2019 with much fanfare. Legislation for Gesy was passed as far back as 2001 and finalised in 2017. So, even before it came to life it was a political football, and has remained so ever since. I venture to suggest it will continue to be so until Cyprus has a president who has the brains to see the entire system is in need of reform, and who has the balls to ensure that reform is rapidly carried out. Nothing is likely to happen soon, however.

On the run up to its start top officials as late as May13 “were concerned that the scheme might not be ready for its June 1 launch”.

On the eve of Gesy’s launch, the then Health Minister (Constantinos Ioannou) boldly stated: “Gesy is not ideal but it’s going ahead”. He also said: “The ideal would be to be completely prepared. As the ideal is not possible, we are proceeding with what’s possible.”

And that was after 18 years !

Gesy is run by the Health Insurance Organisation (HIO), and on July 26, 2019 the HIO stated “….that a number of issues related to the registrations of persons entitled to Gesy have been concluded….” It took my wife and I some two and a half months to get registered, for example.

In September 2019 I wrote an article entitled “Will messy Gesy clean up its act ?” Little information has been made available as to what doctors and specialists get from Gesy, but back then I calculated that a general practitioner (GP) could get up to €267,500 annually without even seeing a registered patient. Based on the 2017 population figures the Republic had 816,700 persons, and this could mean as much as €87,312,000 being paid to GPs alone. My question at that time was “Will Gesy survive ?”.

On January 1, 2020 the Cyprus Mail had a leading article: “Gesy the biggest hurdle facing government in 2020.”

On November 4, 2021 the leading article was: “Without improvements Gesy will collapse”.

On November 30, 2021 the Mail’s leading article’s title was: “Gesy is simply unsustainable without reform”.

On November 14, 2021 I wrote a further article entitled “Is Gesy still mighty messy ?” It was interesting to read that around then the politician Harris Georgiades caused an uproar by stating “…that certain changes need to be made to Gesy” and he went on to cite “…..the absurd practice of rewarding GPs for doing nothing – paying them by simply registering patients, some as much as €250,00 a year”. All the more interesting as he was the finance minister when all this was set in stone under his watch !

In my November 14 article, I suggested that with such money being paid to GPs, specialists must be almost drowning in money. I proposed then, and must repeat now, that what is being paid to surgeons, etc. as well as hospitals for nightly patient stays, should be openly published. The public is paying contributions for all this to happen, so they should see how the cash is being spent.

On February 4, 2022 a report by the auditor-general, covering July 2019 to December 2021, was published and the press report was headed: “Audit office exposes Gesy gravy train, one doctor paid €870,742”. Some examples quoted within that report, which accused the HIO of “violating the law and philosophy of Gesy” (denied by the HIO) are:

 

• 11 Gesy doctors each earned over €500,000 in 2020;
• 28 per cent of GPs had over 2,000 patients registered;
• 1,514 specialist doctors within Gesy claimed €116,762,682 for 2020 – an average of €77,122 per doctor;
• Of those specialist doctors, 67 claimed over €300,000 and dozens did not file tax returns for 2018 or 2019.

 

The main thrust of the report was that actual expenditure was exceeding projected spending and income.

A few weeks ago I required (pressing, but non-urgent) treatment from a specialist. My first choice had no space until October; my second choice had nothing until September. My third choice saw me within a week. At no time was I asked if I had private medical insurance. Indeed, it was emphasised by one and all that I must turn up with a GP referral.

On February 17, 2022 it was reported that the then Finance Minister (Constantinos Petrides) had said: “Gesy will collapse unless action is taken.”

On October 11, 2022 the Mail reported that the then HIO chief (Stavros Michael) was “determined to tackle Gesy budget and contracts”.

On November 3, 2022 the HIO chief said “Gesy budget must be reined in.”

Getting tired, if not bored, dear reader?

Then let us fast forward to 2023 and, guess what the newly appointed health minister said?

On March 11 this year the new Health Minister, Popi Kanari was reported as saying: “ Gesy was a necessary development in the country’s health sector…but we must also improve it significantly because there are distortions, there are problems and omissions, and the ministry will set timetables towards their resolutions and improvements.”

Ho hum! Sort of sounds familiar, although the new Finance Minister Makis Keravnos is in deep trouble, because he described Gesy as a “black hole” of funds that endangers public finances. The HIO chief (Andreas Papaconstantinou) slammed Keravnos for such a remark and said that he should either retract his statement or come to the table with facts to support his argument.

They might all start with the auditor-general’s report of February, 2022 I detailed above, about which we have not heard another word.

What I have detailed in this report, which is nothing but a litany of political failures over decades, should be troubling to any Cyprus resident entitled to health care under Gesy. Let me finish with some conjecturing which, unfortunately, will not solve the sad state that Gesy has been allowed to sink to within a very few years of its baptism. Only strong leadership will do that, and I see no sign of that, even on the horizon.

Like the National Health System in the UK (Europe’s largest employer and one of the world’s most wasteful enterprises devised by man), the Cyprus government of whatever political stripe it may be cannot afford to not have Gesy. However, as I stated in my November 2021 article “No political party dare tackle the fundamental problems that clearly exist even to the most myopic observer, and Gesy in its today state is still the same political football it was prior to when it was baptised in 2019.”

 

Brian Lait is a retired chartered accountant living in Cyprus