Filenews 24 February 2022 - by Marilena Panagi
Ghs specialists increased by 19% in 2021, while the number of beneficiaries of the System (although the calculation on the basis of which the System was designed reached 850,000), by December 31, 2021, it had risen to 910,000, presenting an increase of 9% compared to 2020.
At the same time, a significant decrease was recorded in the number of referrals issued by personal and specialist doctors, while the remuneration of doctors showed a decrease compared to the previous year.
The Minister of Health and the Health Insurance Organization analyzed the data and are now studying the possibility of purchasing services from a specialized firm, which will undertake the monitoring of all entries in the GHS software, with the aim of having a continuous and detailed control of the requirements, tests and actions performed by all providers, always aiming at the reduction of abuses.
In this context, the decisions taken on Tuesday concerning the change of the way of remuneration of personal doctors of the GHS and the change of the conditions for signing or renewing contracts are also included, with the addition of the obligation to present a tax statement by all providers who contract with the HIO.
In terms of statistical data, the HIO's report to the Audit Office for the year 2021, shows a decrease compared to 2020 and stabilizes the System in terms of its use by providers and beneficiaries.
In detail, while in 2021 the number of special doctors increased compared to 2020 and specifically, from 1647 GHS specialists reached 1,808 in December 2021 and at the same time there was a significant increase in the number of beneficiaries (about 100,000 more), the average remuneration of doctors per visit, showed a decrease.
Specifically, and according to the data submitted by the HIO to the Audit Office, the average fee per visit for medical specialists in June 2019 was €100.23. In December 2020 it fell to €66.30 and in December 2021 it showed an additional decrease and fell to €61.09. In 2021, fees per visit on a monthly basis for medical specialists ranged between €61.09 and €64.
In addition, in December 2020, medical specialists submitted an average of 133 claims (for the month). In December 2021, the average receivables fell to 126 (on a monthly basis). The highest number of requirements per specialist was recorded in July 2020 with 178 requirements.
As far as ghs staff doctors are concerned, a significant decrease was recorded in the referrals issued in 2021, compared to 2020.
Specifically, in January 2020, personal doctors for adults appeared to issue a referral to other providers of the system in 68% of the visits they received. In December 2021, this figure fell to 39% while for paediatricians it fell from 19% in January 2020 to 15% in December 2021.
It is important to mention that in 2021, the percentage of referrals for personal doctors for adults shows stabilization and the fluctuations recorded range between 39% and 47% without reaching in any case the percentages of January 2020 (68%).
With fewer patients the elderly personal doctors
The age of the GHS's personal doctors is probably put under the microscope, since after the auditor general pointed out and the reports of the last few days to an 83-year-old doctor who has more than 2,400 beneficiaries registered in his list, the voices for a revision of the regulations are growing. In fact, yesterday, the President of the Republic, Nicos Anastasiades, took a position on the matter, saying that "it must be allowed to reduce the number in order to be able to serve them, so that young doctors can also take their share. Otherwise we will condemn the young scientists for the benefit of the older ones that some of them retired and with the GHS they came back and even get income that they never received".
The position of the Minister of Health, Michalis Hadjipantelas, was similar, while as we are informed during Tuesday's meeting, the possibility of setting different numbers was studied as a maximum number of beneficiaries in the lists of doctors depending on their age. Specifically, it is being studied that doctors over 80 years of age are entitled to have in their list, only 25% of the number that younger people are entitled to and doctors over 70% are entitled to only 45%-50%.
The discussion, however, was preliminary and did not result in any decision. The HIO, however, in its report to the Audit Office, stressed that its position is that "the reason why the Organization did not set a ceiling on the ages of doctors, is the legislation that provides that the HIO, registers and / or contracts with doctors who hold the relevant certificates of registration and licensing from the competent Bodies, namely, the Cyprus Medical Council and the Pancyprian Medical Association. The Agency's position in relation to the granting of a licence to practice a profession is that this should always be judged taking into account both the age of the doctors and their ability to practice the profession. The Agency will take the initiative to discuss the issue with the Ministry of Health and the PIS."
In June, the on-call clinics operate
An effort will be made to reach an agreement with the State Health Services Organization
One of the most important decisions taken on Tuesday was to promote the planning that has already been almost completed by the HIO and concerns the operation of on-call clinics in the GHS. As the Minister of Health Michalis Hadjipantelas said yesterday, "it was agreed that from June 1, 2022, on-call clinics will be put into operation. If a citizen has a problem in the evening or on a holiday or weekend and cannot locate his personal doctor, he will be able to visit them and there will be surgeries for both adults and children."
According to information provided by the "F", the HIO is expected to try in the first stage to conclude some kind of agreement with the Organization of State Health Services, so that some of the health centres of the CySO will be granted (with rent), which will be used during non-working hours as on-call ghsy clinics.
This possibility had been discussed between the two Organizations in the past, but the dialogue was interrupted due to the pandemic and to date has not resumed.
President asks for tidying up
Tidying up the GHS and more control, demanded in his statements to "Alpha", the President of the Republic, saying characteristically that "what is needed is tidying up and for this reason I had done not one but 5-6 meetings with the HIO and indicated to them that a monitoring and control unit is needed".
"The Auditor General's findings show that unfortunately we did not reach the point, but do not forget that it was only in '19 that the plan began," Nicos Anastasiades said, adding: "I want to make something clear. As long as I am in the Presidency of the Republic, I am not going to accept this conquest of the people, this determination of the political forces, to allow it to collapse, because some people may not mean that they have to tighten up the measures. What is not solved is cut. That is, if there is, I don't want to say it, because there is a lot of pride in the administration as well. But tolerance has reached its limits."
There was, he said, "a lot of pride from the HIO administration and stubbornness in the implementation. But when you notice that somewhere it is suffering and what you built is in danger of collapsing, you have to take immediate action. There is no more room for manoeuvre and it is not now that we are discussing it."
OEB also requires tighter control
"The GHS is a one-way street, it has been implemented and cannot fail", said the general manager of OEB Michalis Antoniou, speaking to "F", stressing however that "there are problems that we have been identifying for a long time and must be solved".
"Almost all GHS health service providers are under the umbrella of OEB", said Mr. Antoniou and added, "the HIO, its board of directors can operate on the basis of what is stipulated by law. Whether to introduce a new control mechanism is not something that the HIO will decide. Perhaps there should be some legislative regulation for this and we as OEB and with the know-how we have, could help in this direction and submit our suggestions".
Under no circumstances, he said, "will we sharpen the spirits. Our positioning is simple, clear and documented. The GHS cannot fail and this cannot be disputed. So we are trying with all the means we have to make recommendations that will help constructively.
