Filenews 7 March 2021 by Androula Tarameda
He entered politics as a technocrat. As Minister of Health, he lifted the burden of managing the pandemic with the health sector because of the General Health Plan trying to find steady footings, through not-so-smooth conditions.
Konstantinos Ioannou was asked by "F" to make an initial assessment of the one year of the ordeal from the health crisis. He speaks with the confidence of the technocrat about what has happened, as well as planning for the next steps, without politically correcting. He recognises the problems arising from protection measures to tackle the pandemic, is sympathetic to criticism of what is unprecedented happening around us and around the world. He stands in the collective of action that has developed all this time, State and scientific community. He does not hesitate to share with us his finding on politics, after his brief involvement in it: "Many times even simple things become very difficult and complicated when they enter the political table in the wrong way or with the wrong intention." He keeps Cyprus' positive performance in a number of measures to tackle the pandemic, but notes that a return to normality must be done safely.
- It's been a year since the pandemic in our country. What do you keep, as the main political administrator, of this test that is not just about the vital health sector?
-In fact it is more than a year because as you will recall, Cyprus was put on alert long before the first infections were detected in our country on 9 March 2020, and even before the World Health Organization declared the coronavirus a pandemic. However, I would like to say that I have the responsibility of management with regard to the health sector, but management, all this titanic effort, is done collectively, with the involvement of many of my other fellow ministers, under the guidance of the President of the Republic. Now, what I am holding are the very difficult times we experienced when we had to take decisive decisions, which affect the daily life of every citizen and have consequences for all economic and social activity. Things were particularly difficult at first, or when we did not know exactly what it was about, not only us here in Cyprus but at international and global level. It was the showdown with something unknown, unprecedented, invisible.
- What was personally the biggest challenge you wanted to win? What's the bet you want to win?
- There have been many challenges and there are still more. The big bet was and is to save human lives. For all of us in charge of management, the worst nightmare was the images we saw from hospitals in advanced countries, showing people dying helplessly. At this level, then, we avoided the worst-case scenario. Thanks to the very good preparation and the work done, the health system of Cyprus withstood and was able to cope. From then on, the bet before us now is to get out of the vicious circle of uncertainty as early as possible, because you realize that a year later fatigue has occurred at all levels.
-Has the fact that you are not a political person, do not have "party ties" and that you come from the private sector, helped you or made your work difficult?
- You have been following politics for years and I think you will agree with me that many times when you serve things only from their political point of view and even worse only from their party point of view, at some point there is a risk that you will be trapped and lose the substance. If you mean that I have no political ambitions so I do not need to serve any personal future political agenda, then the answer is that this is something that has helped me. In my brief involvement in politics I have found that sometimes even simple things become very difficult and complicated when they enter the political table in the wrong way or with the wrong intention.
- Your work within the Government and with the President, how difficult was it to convince in the direction of strict measures?
- I was given the general mandate because this dictates the Constitution and the responsibilities of the Ministry of Health, but you realize that from then on such serious decisions are not taken on a one-person level, nor does the principle of one man apply. Apart from the sanitary part, the management of the pandemic has many other parameters and therefore the framework of movements was collectively demarcated. It is well known that under the instructions of the President of the Republic, the Government, in cooperation with all political leadership, with the Parliament, the State in general and also in society, has set and continue to make public health, the protection of vulnerable groups, the elderly, the sick, our grandparents, a top priority. So, on the basis of this policy, we have come a long way, and this policy dictated our decisions. Of course, on a daily level, on a number of practical issues, the management of such an unprecedented health crisis has also had its very difficult times. In these moments, the personal involvement and support of the President of the Republic was particularly decisive and helpful. It's something I feel the need to recognize.
-Obviously you have had to make difficult decisions that have not been easy to applaud, and given that we are in a pre-election period your task is even more difficult. Were there times when you thought about giving up?
- Is there anyone who thinks it will restrict a man's individual freedoms and collect applause from above? It's naive. Of course it would be a lie to claim that this whole process was not very difficult. But there's no point now in saying whether or not I thought about giving up. What matters is that we continue the great effort with all our might. Disapproval and criticism are part of the political process, however often it can go too far. From the beginning of my involvement in the commons I had come to terms with the idea that I have to be accountable to the citizens, tolerant of criticism, open to scrutiny. I am a devotee of accountability and in that sense things are very clear to me. After all, when I accepted the honorary proposal of the President of the Republic for ministerialisation, subject to the mandate to implement the General Health System, I was aware of the reactions I would have to face. To be honest, I never thought I'd be faced with the pandemic and issuing restraining orders, but I had no choice. Politics is not just a matter of blame, it has responsibilities. Especially when it comes to the health of the world.
-Your choice to rely on the scientific knowledge and expertise of experts has put you in the crosshairs of criticism of many, what do you answer?
- This particular choice was conscious and to be honest it was also a result of need. We were faced with an unprecedented situation and had a duty to listen to the experts. The Ministry of Health as well as the Organization of State Health Services have excellent scientists, whom we wanted to strengthen by utilizing the knowledge and experiences of independent scientists, as we did. And on this occasion I want to thank them all from the heart.
We expect a large flow of vaccines in the coming days.
- It's a big debate about vaccines. What do you say to those who claim that the wrong manipulations have been carried out and that it will take a long time to vaccinate the whole population?
- We are faced with a reality which everyone recognises, namely that nowhere in the world are there sufficient quantities to meet the very high demand. Cyprus proceeded in time to pre-purchase vaccines, on the basis of the European Union's agreements with companies. As a result, it can be said that the EU strategy for equal access by Member States to the vaccine had good intentions but was short-circuited in the individual strategic choices of some states, what is now called 'vaccination nationalism'. We as the Republic of Cyprus have pre-purchased and ordered twice the quantity of our needs based on population and therefore, the quantities we will receive will be sufficient. Over the next few days we expect a large flow of vaccines that will allow us to speed up our vaccination program. We are exhausting all possibilities to obtain vaccines, provided they are licensed. Suggestions for the introduction of unlicensed vaccines cannot be accepted because the health of the world is not a game.
Work and steady to exit safely
- Our country has recorded firsts in dealing with the pandemic. However, they were not able to intercept or reduce reactions to the strict measures. Whether by parties, professional groups or citizens. When do you expect and under what circumstances to begin real relaxation?
-I will again invoke your professional experience to note that in all matters the spotlight usually turns to negative news. Let me give you an example. There was so much noise about the effectiveness of the AstraZeneca vaccine at the age of over 55. We have been attacked for not following the example of other major countries such as France, Germany and others. Now that these countries are following our decision, with delay, it is not the first topic in the news. This is a complaint, if you will, because as a result of the noise created a suspicion towards the vaccine, fortunately temporary. I can say the same about some of Cyprus' performance in vaccination coverage, reduced deaths, strict controls at airports, tracing, first in rapid testing. Other countries recognise the effectiveness of our strategy but in Cyprus we spend more time discussing the obvious.
As far as the substance of your question is concerned, I have said many times that complaints are expected, requests are legitimate and reactions are justified, at least in the majority of them. When you decide to lock the other one up in his house, he has every right to judge and criticize you. Of course it bothers me when I read extremes about the junta etc because these things create a very bad climate for everyone and an unnecessary suspicion. The last part of your question makes it difficult to answer because I really do not want to create expectations. What I can tell you is that we want our steps to be slow and steady, to lead to exit safely and not to undermine the long-term sacrifices of our society, workers and the business world.
-Invoking the nurses in the ICU and their limits is considered a weakness or inadequacy by the opposition, for your Ministry in the effort to tackle the pandemic. What's your answer?
- In no country in the world are there as many ICU beds that can cover the hospitalizations that a pandemic will cause. This is something that we have seen happen in a particularly tragic way in other countries with advanced health systems. It's just math and infrastructure. And a thousand ICU beds to build won't be enough if we let the virus spread. I would like to remind you of the criticism we have received that we are letting public hospitals collapse and that the health system will not last. None of this has happened because, in order to tackle the pandemic, we have actually supported hospitals with equipment, infrastructure and human resources. It is no coincidence that the covid death rate in Cyprus is well below the EU average.
The time for full self-government is not limitless
- The public hospital has lifted the burden all this time. With weaknesses and shortcomings. You are criticized for leaving them at God's mercy to sell them out. Your answer?
-Let me answer you with this: How can we be accused of leaving hospitals on the one hand and the other of criticising us for waste? If we left them at God's mercy, as they say, then we would grieve on ruins and experience human dramas. I would like to remind you that the total budgeted expenditure on health for 2021 amounts to €1.017 million. and almost 5% of the country's GDP. The Budget of the Ministry of Health amounts to 9.63% of the total State Budget, proof of the government's large investment in health.
- The Directorates of Public Hospitals have recently sent you a letter sounding the alarm. What's wrong and what corrective action can be made?
- And I personally have sounded the alarm many times, as you say. At every opportunity I stress to the Administration and Directorate of the Organization of State Health Services that the time for full administrative and financial self-government is not limitless. The government will continue to support public hospitals, there is no way the opposite will happen. And I think no government is going to abandon them because it will be confronted with the reaction of the world. However, this does not negate the need to modernise hospitals, to change culture and to better serve the citizen, in order to withstand the competitive environment created by the General Health System, which offers beneficiaries the right to choose the doctor and the hospital of his preference.
- The General Health Plan was seen not unfairly as the biggest reform of all time. Almost two years since the start of its implementation many positives and weaknesses. Are there issues with changes?
- I am proud of the GHS, of course there is much to be done, the GHS will always be in a continuous evolutionary process, because it is a living project, very dynamic. So far more than 850,000 beneficiaries have registered and as we speak, there are about 20,000 operations every day, from a visit to a doctor, to the most difficult surgery and drug purchase.
- What about complaints about over-indebted need from doctors?
- There's a clear reduction, but like I told you, it's a process that takes time. The Board of Directors of the Health Insurance Agency is doing a good job, several restrictions have been put in place and in cooperation with doctors and other providers, they are taking corrective action. Time will bring many corrections with the first and most important change of culture by the beneficiaries themselves. The big picture is very positive and I am sure that the GHS will be the legacy of our own generation to the younger ones, which we can be proud of.
