A feud – with signs of a turf war – has been brewing between the bureaucracy at the health ministry and the Health Insurance Organisation (HIO) over who should handle air ambulances sending patients abroad.

By law, this function should come under the responsibility of the HIO and therefore be a service provided by the national health system or Gesy. The HIO is the agency that runs Gesy.

Despite the law, the air ambulance function continues to be handled by the ministry of health. The HIO wants to take it over. Health Minister Popi Kanari agrees that jurisdiction should be transferred to the HIO, and she has said so in public.

Meantime the Audit Office has chimed in, opining that the service should remain with the health ministry.

In a recent post on X (formerly Twitter), Auditor-general Odysseas Michaelides said he did not have confidence in the HIO given their track record in managing their finances.

Socialist party Edek likewise argued that the health ministry should keep handling the air ambulance service.

As things stand now, a peculiar situation emerges, as the HIO pays the bills when patients get sent abroad for specialised treatments or surgeries – but it has virtually no say in the decision-making process. The HIO has no input on the selection of patients, nor does it exercise control over the related costs. It essentially rubberstamps what health ministry bureaucrats send it.

Although the HIO leadership wants to abide by the law and take over the air ambulance service, it says it lacks trained personnel and know-how.

In early February last year – before the elections – the HIO’s acting general manager wrote to the health ministry about the issue. He corresponded with Christina Yiannaki, the ministry’s permanent secretary.

The HIO official proposed that, for the time being, the civil servants in the health ministry handling the service be seconded to the HIO.

Replying ten days later, Yiannaki slammed the door shut on the request.

“I would like to inform you,” she wrote back, “that a political decision has already been taken so that the ministry of health continues to have exclusive jurisdiction over the dispatch of patients abroad – at least for now and certainly until the HIO is able to resolve a host of other problems arising relating to abuses, the need to upgrade the quality of services offered, the carrying out of internal and external financial audits…”

In short, despite the HIO being, by law, the designated agency handling the air ambulance service, the health ministry continues to oversee it because of a ‘political decision’ taken sometime during the previous administration of Nicos Anastasiades.

However, the matter is very much alive, as organised patients’ groups lobby hard for the air ambulance service to come under Gesy – and the HIO.

The Cyprus Federation of Patients‘ Associations (Osak) have been calling for a meeting with President Nikos Christodoulides to discuss this very issue. They want a service that is reliable and always available around the clock.

Speaking to daily Phileleftheros days ago, head of Osak, Charalambos Papadopoulos, said: “We will accept nothing less. We demand implementation of the law, meritocracy, and proper services for all members of the public who require specialised services, without invoking the lack of funds or the need for savings. Human life above all.”

Papadopoulos then took a dig at the health ministry and the way it has run the air ambulance service for years.

“To date, the subsidised patient’s sector at the health ministry has served tens of thousands of patients. The issue is that certain shadows hang over it. Who exactly are the patients who benefited?

“Which patients received immediate service, and which patients had their requests denied or delayed? Why did we create Gesy in the first place, and why does Gesy still not provide these valuable services? Why do we allow a programme to be exploited by party bosses, MPs, officials, senior civil servants, journalists? If anyone today denies that this programme is rife with clientelism, they’re lying to you.”