The head of the ambulance service delivered a stark warning in parliament on Thursday over what she described as “years of state inaction and underfunding”, as the House health committee began debating a bill to establish a national ambulance agency under the auspices of the health ministry.

Addressing MPs, ambulance service head, Riana Constantinou, welcomed the bill but said it had come far too late, questioning the prolonged delays in regulating a sector “without order or political protection”.

“What are we really doing? I fear we are far too late,” said Constantinou.

“We are still discussing something that should have been done ten years ago.”

She argued that the ambulance service has been left exposed, while private operators continue to offer pre-hospital care with limited oversight.

“Today, everyone decides to open a business, buys ambulances and offers pre-hospital care services, and we are still discussing whether we should bring order,” she decried.

“We have one of the most highly trained services on the planet, yet this country has no civil protection. What is happening is humiliating.”

Constantinou warned that the introduction of the general health system (Gesy) had placed a disproportionate burden on the public ambulance service, fundamentally altering its role without the necessary reinforcement.

“The service was called upon to lift the entire Gesy,” she said.

“From five thousand patient transports we reached forty-five thousand, with the same personnel. The role of rescue is being sidelined because we simply do not have the time to cope.”

She said the state must decide whether it wants a fully functional emergency service or a transport system operating under constant pressure.

“We should have everything, staffing, training and support,” she stressed.

“This country may measure everything in terms of money, I do not. I care about every patient in this country but we are late, we need to strengthen the Ambulance Service and not make it run like a taxi service.”

Constantinou also raised concerns over the uncontrolled provision of pre-hospital care, saying private ambulances often intervene “in the middle of the road” and then call on the public service to continue treatment from inside their vehicles, creating risks for patients.

The debate followed comments by State Health Services Organisation Okypy, which opposes the removal of the ambulance service from its jurisdiction and its transfer to the health ministry.

Speaking at the same session, Okypy executive director Kypros Stavrides said the organisation did not oppose the creation of a national ambulance body and would support the effort, but stressed that safeguards, evaluation and equal terms were essential.

“From the first moment I took office, I have worked for the good of the Cypriot citizen,” Stavrides said.

“Okypy will consent and strengthen the effort. However, the organisation has invested significant sums in recent years. It has purchased vehicles, staffed the service and implemented structures. All of this should be evaluated and compensated in order to be correct and fair.”

He warned that the creation of a new body should not be a simple transfer of responsibilities but must result in a stronger and more accountable service.

“We should see clear, measurable indicators so that the new body operates on equal terms,” he said.

“Inspection data should be transparent and public and supported by protocols and scientific input, including from doctors.”

Stavrides also referred to patient transfers, noting that the Health Insurance Organisation (HIO) has allocated specific funding for emergencies, which should be taken into account in the new framework.

The debate comes amid criticism from the patient federation Osak, which has expressed concern over Okypy’s request to postpone discussion of the bill.

Osak said the establishment of a national ambulance body was necessary to address a serious gap in emergency and pre-hospital care.

In a statement, the federation recalled that the ambulance service was transferred to Okypy on a temporary basis following the introduction of Gesy, with an explicit commitment that an independent authority would be created within two years.

Nearly seven years later, it said, the service remains under Okypy, creating systemic distortions.

While disagreeing with the government’s decision to place the new agency under the health ministry, Osak acknowledged that the move was “in a more correct direction” and would help address chronic problems in patient transport.

However, it criticised Okypy’s intention to present its own plan for ambulance service management at this stage, remarking that the organisation had “several years to prepare studies and proposals”.