Audit reveals excessive overtime payments at Nicosia hospital

A doctor at the Nicosia general hospital earned €187,000 in overtime pay in 2022 – two-and-a-half times his regular salary – according to a report released on Monday.

The Audit Office published its special report on the Nicosia hospital for the year 2022. One of its key findings related to the amounts paid to doctors there for overtime work – €4.6 million as part of horizontal incentives, plus €2.2 million as part of vertical incentives.

“This despite the fact that the [hospital’s] goal of €305 million in total revenues, as set out by the Health Insurance Organisation, was not attained,” the dossier stated.

The Health Insurance Organisation [HIO] is the agency tasked with running the national health system or Gesy. The Nicosia general hospital is part of Gesy.

Horizontal incentives are those which are provided to all; vertical incentives are provided based on performance.

The most striking case of overtime pay concerned a physician who, over and above his €76,000 salary made €187,000 in overtime during the year.

Meantime the deputy head of a clinic, on an annual salary of €76,000, earned an extra €230,000 in overtime and allowances – or three times more than his wages.

In addition, Audit Office tracked 68 medical staff, five nursing staff, three phone operators and one first responder having received allowances and overtime far exceeding their monthly wages.

Elsewhere in the report, a significant decline was noted in patient visits since the introduction of the national health system. In 2019 the hospital had processed 203,000 outpatients; that number dropped by 31 per cent in 2022.

In 2019 there were 203,000 outpatients; 133,000 in 2020; 134,000 in 2021; and 139,000 in 2022.

Likewise, there was a drop in the number of surgeries: 7,255 in 2019; 5,351 in 2020; 4,948 in 2021; and climbing back up to 5,726 in 2022.

The report also flagged problems in the operation of the hospital’s Accident & Emergency Department – delays in examining patients, or not keeping records of the call times of specialists.

In one glaring instance, a doctor was found not be working full time (7.30 am to 3pm) on days where she did overtime work at the outpatient clinic (from 3pm to 6pm).

Moreover, the same female doctor was assigned to work at the hospital’s outpatient clinics on a specific day of the week, when she was supposed to examine up to nine patients between 9.30am and 2pm.

But from an investigation carried out by the hospital itself, and later confirmed by the Audit Office, it transpired that the doctor did not keep her schedule at the outpatient clinics. Instead of examining patients there on the designated day, she would see patients during the course of week, and without logging this info about the change in appointments in the hospital’s computer.

In several instances, the doctor would see only one to three patients a day.

“We also established that her shifts were signed off on by a close relative of hers, who was her superior,” the report notes.

Regarding her shifts at the A&E, a sample analysis showed that on seven particular days, 16 patients who visited the A&E after 3pm were kept waiting until 8.30am the following morning to be examined by a specialist.

“This indicates the doctor did not examine the patients, but she still applied for and got compensated for the shifts in question, to the tune of €780 per shift on weekdays and €1,310 on Sundays and holidays.”

Worse still, her superior (a family relative) at the hospital would sign her performance evaluation – expressly prohibited by the regulations.

The report makes no mention of any sanctions – administrative or otherwise – taken against the doctor.