The latest evaluation report on Cyprus’ national health scheme Gesy said that in the past three years direct healthcare expenses for patients were reduced from 50 to around 15 per cent.

Released by the health ministry on Wednesday, the report provided a comprehensive assessment of the scheme’s performance. It noted, however, that some areas still need improvement.

According to the report, Gesy has made “significant strides” in ensuring equal access to healthcare services, empowering beneficiaries to choose their preferred healthcare providers.

While it acknowledged the achievement of equitable access for the general population, it also identified instances of unequal access within specific demographics.

Concerns arise regarding lengthy waiting times for appointments with certain specialist physicians, with approximately 85 per cent of referrals experiencing delays of up to 30 days, and in some cases, up to six to eight months.

Moreover, the report also mentioned instances in which some private hospitals may have avoided admitting patients with complex conditions or elderly individuals, deeming such cases economically unfeasible, particularly when referred by Gesy.

Issues surrounding the overutilisation of healthcare services have also been raised in the report. It was attributed to the provision of free services leading to patient-driven decisions without considering potential financial burdens.

Additionally, according to the report, the lack of a proper healthcare culture and sufficient patient education contributes to pressures on the system, as patients often assume the role of physicians, determining their required healthcare services independently.

Another pressing issue highlighted in the report is the proliferation of clinical laboratories, blood collection centres, and diagnostic imaging facilities, which poses the risk of induced demand. The report warned that, if left unaddressed, this trend could strain the healthcare budget in the long term.

Meanwhile, confusion persists regarding the responsible entity for conducting medical examinations within Gesy. The report said that the uncertainty surrounding this aspect hampers effective targeting and fosters misguided expectations, potentially allowing opportunistic providers to exploit the situation.

The report further pointed out the limited degree of control over the necessity of medical procedures within the scheme. Despite this, the organisation has intensified its efforts and mechanisms, implementing over a million rules in its information system and conducting numerous investigations into provider behaviour within the system.

The report also drew particular attention to the apparent gap concerning patients over the age of 70, especially in post-hospitalisation care management.

As such, it highlighted a significant number of elderly patients who, particularly after surgery, are unable to self-care adequately. According to the report, in several instances relatives pressure hospitals to prolong patient stays beyond clinically justified periods until specialised care facilities are secured.

Drawing safe conclusions regarding the quality of provided services proved challenging, the report said.

“There is considerable discussion on the subject, typically limited to personal experiences.

“The situation is unique since before the implementation of Gesy, two entirely different systems operated, where one pertained to the public system for individuals eligible based on income criteria, while the other involved healthcare provision from the private sector to those able to afford it,” he report said.

“Therefore, the population experienced two entirely different situations. Some people strongly benefited from the Gesy implementation, while others are less satisfied since they share the same provisions as all other beneficiaries.”