Filenews 15 November 2020 - by Marilena Panagi
The new reality also obliges a new hierarchy of needs. The Ministry of Health is on alert since for months, it has been called upon to take decisions but also to manage the huge financial costs that the coronavirus epidemic has brought with it. By 30 September, €32.4 million had already been paid, while the total cost already paid by the Ministry of Health with the measures to date amounts to €45.4 million and certainly continues.
Most of the expenditure concerned contracts for hundreds of thousands of laboratory tests, the purchase of consumables and other protective equipment and, of course, the purchase of services by the private sector, which undertook the care of patients, whom the public hospitals, because of their role in tackling the pandemic, were unable to serve.
The economic costs are undeniably high and the Government looks forward to the Structural Funds of the European Union. To this end, as stated by presenting the budget of his Ministry for the year 2021 to the Parliament by the Minister of Health Konstantinos Ioannou, there is already a hotline with the relevant European directorate.
"The onset of the pandemic in March brought us face to face with a new reality in which we had to adapt and cope from one moment to the next. We have faced huge risks to public health and, by extension, to public finances," he said, adding that, "the costs borne and continue to be borne by the state to deal with the effects and reduce the pandemic are enormous."
The pandemic did not, however, affect only the funds of the Ministry of Health. The blow was and remains serious for the General Health System fund, which lost a large part of its income due to the restrictions and consequences of the suspension of operations."In order to address various liquidity problems that may have been created by the pandemic in the implementation of inpatient care by the Health Insurance Agency, the Council of Ministers decided on a series of measures to support the situation created, taking additional costs, which had not been foreseen in its budget, such as the purchase of specialised medicines for serious diseases whose inclusion in the second phase of the GHS was postponed for a quarter and whose costs amounted to €19.5 million. millions," the Health Minister explained to Parliament.
In addition, the Ministry of Health undertook "the possible grant of up to €70 million, subject to conditions and funding until 31 August or in some cases until the end of 2020, of various services that would normally be offered through the GHS".
The implementation of the GHS, of course, as Konstantinos Ioannou pointed out, helped in the whole effort to manage the pandemic, "since a series of measures and protocols made it easier to deal with suspicious and positive incidents". Electronic prescribing to chronic patients, "without the need for an on-site visit to dispensaries and hospitals, the possibility of administering chloroquine to treat positive events, these were some actions that decongested the health system, minimizing the risk of dispersion and offering immediate service to patients during the first wave of the pandemic". At the same time, 'the mandatory inclusion of all medical operations in the GHS system now offers the possibility of secondary control and, by extension, corrective measures'.
"In the midst of a global pandemic, the Ministry of Health has made enormous efforts to enable the implementation of the second phase of the GHS, without any delay." The suspension of a large number of surgeries during the restrictive measures last spring, "reinforced the government's decision to proceed with the inclusion of inpatient care on 1 June 2020, so that our fellow citizens who were on waiting lists could receive their services within the GHS. For example, since 1 June 2020 some 28,153 surgical procedures have been performed'.
In addition to the pandemic, however, health spending is generally running and the Ministry of Health is "called upon to cover them", noted the Minister responsible, going ahead with the analysis of his Ministry's budget for the following year. "Budgeted expenditure for 2021 represents 4.69% of GDP," he said, stressing that "overall health expenditure in Cyprus is estimated at 9.63% of the total state budget (2020: 8.91%) and explained: "the total estimated expenditure for the year 2021 amounts to €1.017 billion. compared to €962 million included in the approved budget for the year 2020", while the estimated revenue for the year 2021 is €284.52 million compared to €186.04 million for the year 2021. 2020 (increase of €98.48 million or 52.93%).
In particular, the largest increases "relate to the sponsorship of the CFSP by €70 million. (2021: €120 million, 2020: €50 million) and in the article of the State Contribution to the GHS by €16.8 million.
It is worth noting that the total expenditure of the budget includes the salary costs of the seconded staff to the YSP which for 2021 is estimated at around €263 million and corresponding provision is included in the budget revenue.
"Development expenditure for the year 2021 amounts to €13.37 million" and regular expenditure to €1.004 million, compared to €936 million, for the year 2020.
It is noted that with the self-government of public hospitals and the assumption of the costs of providing health services by the Agency of State Health Services, from 2020, provisions for expenditure such as equipment, medicines, erections and improvements of buildings, medical consumables, mental health expenditure, etc. are not included in the budget of the Ministry.
With regard to the allocation for the "Cyprus Treatment Plan Abroad", amounting to €18 million, which is used for diagnosis or treatment in cases where appropriate diagnostic or therapeutic means are not available in the public and private sectors of Cyprus, the Minister of Health pointed out that "it is reduced compared to the provisions of recent years" due to the rationalisation procedures adopted and "brought obvious results , in the sense of care of a comparatively higher number of patients at lower costs'.
In the same way, "and by applying similar procedures, the allocation of €13 million for the health care plan in Cyprus has been rationalized and reduced, amounting to €13 million for 2021, while for the years 2022 and 2023 a provision of €10 has been included, since the medical services currently covered by the Ministry of Health will now be covered through the GHS".
With regard to the strategic objectives of the Ministry of Health for the three years 2021–2023, the budget put before the House includes:
- Restructuring of the Cyprus Health System.
- Strengthening and Upgrading e-Health.
- Strengthening the active and effective presence in European and international events.
- Promote the promotion of health and disease prevention throughout life.
- Development of Research, Technological Development and Innovation activities.
It should be noted that "with the self-government of public hospitals, the Ministry of Health has been released from the process of organising and providing health care services and is focused on formulating a strategic health policy and strengthening the supervision and supervision of the System".
The restructuring of the Ministry of Health, according to the Minister, "is expected to proceed with the completion of an ongoing study and will diversify activities related to the effective management of the country's health system".
Electronic Health, University Clinics, Patient Advocate
Actions are already under way, which relate to health reform in general and are not directly linked to either the two major reforms concerning the General Health System and the self-government of public hospitals. The establishment of university clinics, the creation of a National Pharmaceutical Authority in accordance with the recommendations of the World Bank and the legislative institutionalisation of the institution of the "Patient Advocate" are currently being promoted.
With regard to 'electronic health', 'promoting the implementation of a number of IT systems such as the extension of the integrated health information system to public hospitals, the digitisation of patients' files, the exchange of information through information systems such as hospitals and the GHS but also across borders, etc.'.
At the same time, "strategies continue to be implemented, such as for the promotion of breast-feeding, the treatment of rare diseases, Diabetes, smoking prevention, the treatment of HIV infection, acquired immune deficiency syndrome (AIDS), tuberculosis and antimicrobial resistance".
In addition, the Ministry of Health, "has proceeded with the revision of the National Cancer and Rheumatic Disease Strategies for the years 2019-2023 and subsequently their implementation by the National Committees set up". It also promotes "the preparation of strategies on other important public health issues such as the completion of the National Thalassemia Strategy, and the National Strategy for the Eradication of Hepatitis III".
Early detection and diagnosis programmes are under way, such as "the population early detection programme for colon cancer and the population early detection programme for breast cancer". At the same time, in cooperation with the stakeholders (OA, Directorate of Mental Health Services and Nursing Services), the Ministry of Health promotes the implementation of the screening program for the diagnosis of autistic spectrum disorders, the start of which is expected in 2021.
Finally, programmes to incentivise HIV-positive patients and support specific population groups, such as replacing the infertile couples subsidy scheme, with the inclusion of more subsidies, are implemented.
