Filenews 20 March 2023 - by Marilena Panayi
With events running high and citizens' complaints now part of the daily news, the Health Insurance Organization is making efforts to fill the admittedly large gaps, observed in some cases, in the service of GHS beneficiaries. A bigger bet for the organization at the moment, the coverage of emergencies and emergencies that arise during a twenty-four-hour period and due to the lack of relevant planning by the HIO, patients suffer or are sometimes at risk, trying anxiously to secure the health services they need.
What has come to light in recent months has forced the HIO to speed up its procedures for concluding special agreements with two GHS hospitals and it seems that this effort has begun to pay off. It is recalled, of course, that the relevant dialogue has been going on for a very long time and due to a blockage that occurred due mainly to the financial claims of private individuals, the effort of the organization had been dormant for some time.
At this moment, however – as we are informed – and after some moves made by both the HIO and the individuals themselves, the dialogue has progressed significantly and it seems that within the next two weeks, unless unexpected of course, the relevant announcements will be made.
The HIO's goal is for the two hospitals to undertake the service of emergencies and emergencies, assisting the work of public hospitals, in order not to observe phenomena such as those recorded in recent months and in many cases publicly denounced by the patients themselves and their relatives.
The two hospitals, one in Nicosia and one in Limassol, will undertake, after the signing of the relevant agreement with the HIO, the service of patients who need urgent care and at the moment, in cases where the SHSO is unable to serve them, they suffer or are not served for various reasons by GHS hospitals and resort to the Ministry of Health in order to find a doctor and a hospital, usually outside the GHS, to provide them with the necessary assistance.
These hospitals will have doctors of various specialties and will be a point of reference within the GHS (along with the SHSO hospitals) to serve cases that the other hospitals of the system are unable to undertake, either because they do not have the necessary medical specialties, or because they lack beds.
Based on the planning, of course, which is expected to be communicated to all GHS hospitals in the near future, each hospital will be obliged to exhaust all margins before proceeding with the referral of a patient to the hospitals that will be a reference point for emergencies and emergencies, especially those that occur during the night.
In the hospitals that will serve the emergency cases as decided, there must necessarily be available doctors of the specialties of cardiology, cardiac surgery, neurosurgery, microsurgery and general surgery, since these specialties are usually needed to manage the specific cases. A prerequisite is also the availability of beds at all times, as well as the operation of an Intensive Care Unit.
The HIO's considerations in the previous period included the establishment of a special team that would operate on a 24-hour basis and take over the management of emergencies and emergencies. This consideration, however, has not yet been further studied, since it was considered more appropriate to designate, in the first instance, the hospitals that will serve patients in need of urgent care and then, if it is found that there is still a need, mainly for coordination purposes, all possibilities will be considered.
Another consideration made by the HIO is the application of the institution of on-call duty to the GHS specialists, in order to ensure that even in non-working hours and days, the System will have at least one doctor from each specialty in each province to serve the patients. And in this case, the consideration of such a possibility is referred for the continuation and after first, the two hospitals assume the role of reference points.
Cause of problems is the incorrect distribution of patients in the public and private sectors
Several of the problems that the GHS currently presents are due to the incorrect distribution of the beneficiaries of the System to the hospitals of the SHSO and the private sector. In the pre-GHS era, the largest portion of citizens, around 80%, were served by the public sector. As a result, the many were stacked on the public waiting lists and the few were served almost without any delay by the private sector. With the implementation of the System, tens of thousands of people were transferred from the public sector to the private sector, with the result that at the moment the waiting lists for a visit to a doctor, which were previously a phenomenon of public hospitals, were transferred to the private sector in which, as can be seen, the remaining 20% of the pre-GHS era remained.
In order to solve this problem, it is imperative, on the one hand, that the SHSO takes care to make its services attractive and, on the other hand, that citizens understand that with the new data, their service by public doctors does not require inconvenience and with waiting hours, as was the case in the past.
If GHS beneficiaries are not properly distributed between the public and private sectors, the problem with the huge wait for a doctor's visit will be very difficult to deal with.
For the long waiting time for appointments with a GHS specialist doctor, other factors also play a role. For example, the restrictions imposed by the HIO concerning the way in which specialists are compensated and result, in some cases, in reducing the number of patients that the specialist can serve during a month. This phenomenon, of course, is not observed in all medical specialties and in all doctors.
Finally, an important role is played by the mentality of citizens to choose a doctor, depending on the "name" he has, avoiding new, "unknown" to the general public doctors.
In order to manage the situation, the HIO, as reported by "F", is working on various solutions. Of course, the issue is already characterized as very complex and it may be necessary for the solution of the problem to first take political decisions that will concern both the Health Insurance Organization and the SHSO.
INTERVENTION
It's a matter of mindset
It is a fact that the GHS has recently been in the spotlight, due to the complaints made by the patients themselves. It is particularly striking that among the citizens his mentality began to arise: What is offered by the state is inferior. In the same way that in the past, we treated public doctors, whom we underestimated compared private doctors, we are now, unfortunately, treating all GHS doctors. What I would like to remind you is that about 2,000 of the 2,700 doctors of the GHS are the private doctors whom until three years ago, we considered superior. They lost neither their knowledge nor their qualifications.
