Filenews 9 July 2023
Assurances that the improvement moves promoted by the Ministry of Health for the decongestion of the Accident and Emergency Departments (TAEP) will bring the desired results, is given by the Minister of Health, Dr. Popi Kanari, in an interview given to the Cyprus News Agency.
She explained that a special expert from abroad, invited by the competent Ministry, suggested additional improvements, which according to her will be launched in the near future.
Dr. Popi Kanari analyzes the ways in which ICUs will be decongested, emphasizing on the issue of waiting lists and ways to solve challenges.
On the controversial issue of waiting lists, she says her ministry is focusing on the root of the problems and "not on temporary solutions".
It believes that the implementation of what has been included in the roadmaps handed over by the HIO and SHSO to the President of the Republic in the previous period, with the aim of tackling distortions and abuses, will greatly contribute to upgrading the GHS, offering quality services and addressing the distortions that have occurred in the four years of operation of the system.
In the interview she gave to CNA, Ms. Kanari also mentions for the first time what is included in the road map handed over to the President of the Republic by the Cyprus Public Health Organization.
In relation to the deadline for the autonomy of hospitals, which expires in June 2024, the Minister of Health estimates that the SHSO will ask for an extension, while regarding the actions of her Ministry regarding irregularities in the health system, she says that when complaints are submitted, they deal with them with due severity.
Besides, as she announces, within the next week the long-awaited bill that will regulate the Operating License, Control and Supervision of Ambulances will be submitted to the Council of Ministers for approval.
Changes in the landscape for better quality services to patients
In relation to the content of the roadmaps handed over to the President of the Republic, aimed at tackling distortions and abuses, the Minister of Health states that the HIO's roadmap includes the extension of the hours of on-call clinics, the inclusion of additional groups of health professionals within the GHS, the introduction of quality criteria, the updating of protocols and the development of new ones. the inclusion of new innovative medicines in the list of pharmaceutical products of the GHS and the rationalization of providers' compensation.
Moreover, for the first time, she refers to the Roadmap delivered by the SHSO that it includes, among others, the systematic monitoring of building upgrade projects included in the Recovery and Resilience Plan, the immediate implementation of decisions concerning the improvement of the quality of services offered by TAEP, the coverage of outpatient clinics with additional specialties, to reduce waiting lists and the issue of Administrative Autonomy of public hospitals, such as further utilization of existing services.
She believes that the implementation of what has been included in the roadmaps "will greatly contribute to upgrading the GHS, offering quality services and addressing the distortions that have occurred in the 4 years of its operation".
Immediate examination of complaints about irregularities
Asked if any actions are being taken by her Ministry to eliminate possible irregularities in the health system, in order to have full transparency, Dr. Kanari explained that when complaints reach the Ministry in an official way, their examination is done immediately and effectively, noting that "when citizens, officially and branded, Without fear, they file complaints, we deal with them with due severity."
She pointed out that the investigation of any information, either in the form of a complaint, named or anonymous, is an important tool in the hands of the Ministry of Health, underlining that "when there is evidence, we are given the opportunity either to proceed to a full investigation (the Ministry of Health has inspectors for various issues of service provision), or after consultation with other affected bodies, such as the HIO and the Cyprus Medical Council, to take the necessary and appropriate measures or to give this information to the police for their own actions."
Referring further to the issue, she said that the Commissioner for GHS Supervision, who receives complaints from citizens, is a partner of her Ministry in this effort, to defend quality in the health sector and provide the best health services to citizens.
Pro referrals create waiting lists
Commenting that Cyprus has one of the highest proportions of doctors in relation to its population in the EU, but nevertheless there are waiting lists almost everywhere, Kanari said that waiting lists for the provision of services by specialist doctors within the framework of the GHS are observed either in cases of medical specialties, where the number of doctors is limited (eg allergists, endocrinologists), or in cases where the number based on existing data is sufficient and waiting lists are due to increased referrals from Personal Physicians.
According to the Minister of Health, "the treatment of the issue of waiting lists is based on a multilevel approach", pointing out that "in the part concerning the contribution of the SHSO to addressing the issue of waiting lists in specific specialties, the service of patients through outpatient clinics should be immediately promoted, which will at the same time enable the Organization to increase its revenue".
Analyzing the ways in which waiting lists will be addressed, the Minister of Health said that The HIO has publicized the shortages of doctors of specific specialties, as part of an effort to cover the need from Greece.
Regarding the waiting lists observed in other specialties, Dr. Kanari said that these are estimated to be due to overreferrals, as well as to the fact that patients do not make the most of the services offered by personal doctors.
"The possibility of referral to medical specialists without any criteria and the absence of clinical guidelines are the main reasons for the increased needs, with patients who could be treated at the Personal Doctor level," she said.
As she added, "the training of Personal Doctors – focusing on specific diseases, where based on existing data they concern most referrals – and the preparation of clinical guidelines will be able to reduce the number of referrals and correspondingly reduce waiting lists."
She also noted that in order to ensure the possibility of covering emergencies, the HIO, on the basis of the Roadmap given to the President of the Republic, promotes until the end of 2023, the introduction of protected daily time for emergencies and respectively a relevant directive is being prepared to enable the issuance of referrals as urgent.
Equivalent, she added, "are the challenges faced in the case of radiodiagnostic centres, with the same reasons and for which corresponding solutions are being promoted."
She also said that the real needs of our country in Specialist Doctors and radiodiagnostic examinations will be evident in the context of the Capacity Planning project, explaining that through the project the real needs of today will be revealed, but also in the future for planning purposes.
In addition, said Ms. Kanari, "the Ministry of Health focuses on solving challenges identified regarding the current phase of the GHS, on the basis of the root of the problems and not on temporary solutions."
Within days, staffing of TAEP with doctors
Asked if there is any development in relation to the decongestion of the TAEP and whether it is expected that the TAEP will be strengthened with medical staff in the near future, the Minister of Health said that some measures have begun to be implemented, with a specific timetable, noting that within days the TAEP are expected to be staffed with doctors, in which there are shortages.
In relation to the measures that have already been implemented and what to expect in the coming period, she said that the nursing staff has been trained so that cases are properly triaged.
At the same time, she said that the "fast track" procedure has been implemented at Nicosia General Hospital.
In addition, she added that the secretarial staff is responsible for coordinating, but also to deliver to doctors the laboratory analyzes and X-ray examinations of patients, so that the opinion is made faster.
According to the Minister of Health, "instructions have been given so that the results of patients' examinations in the Emergency Departments are sent within 40 minutes".
At the same time, she said that sixteen protocols of procedures for TAEP have already been developed and the implementation of additional protocols is being promoted.
She said that instructions were given for discharges to be given by 11 am, so that more patients could be served, adding that "in order to better serve patients who are discharged to hospitals, special areas will be created, where each patient will be able to wait for his own people.
In the meantime, Dr. Kanari said that for its part, the SHSO has undertaken to make spatial upgrades to as many TAEP as necessary, in order to increase beds, but also to have space for the implementation of the "fast track".
In addition, she added that "a special expert from abroad, who was invited by the Ministry of Health, visited the Emergency Departments, and was informed about the improvement moves we are promoting and whether they will bring the desired results. She suggested some other improvements that will be launched in the near future, once the necessary equipment has been secured."
She expressed the assessment that with all these processes, which have been put on the path of implementation, the results "will be positive".
Filling a gap in ensuring the provision of rehabilitation services
Regarding the bill, which regulates the establishment, operation, control and supervision of Recovery and Rehabilitation Centers and which the Ministry of Health recently reintroduced in Parliament, the competent Minister said that the purpose of the bill is to regulate the establishment, operation and control of Recovery and Rehabilitation Centers, which provide patients and people with disabilities with recovery and rehabilitation services. to enable them to reduce the duration of their hospitalization, to achieve and maintain their independence, to return to the various aspects of their lives and to integrate and/or reintegrate into society, with the greatest possible physical, mental, social and professional abilities.
This, according to the Minister of Health, "using modern means and methods of recovery and rehabilitation, in accordance with the respective established guidelines, protocols and documented practices".
As she explained, "the bill comes to fill a gap that existed in ensuring the provision of high-quality recovery and rehabilitation services and regulating their licensing, in view of the integration of these services into the General Health System."
Within the next week, the law on ambulances will be approved by the Cabinet
Asked by CNA to refer to the other pending bills related to the health sector, as well as where their procedures are currently and whether some of them are expected to be forwarded immediately to Parliament for voting, Dr. Kanari said that the Blood Donation Amendment Law and the Law on the Quality of Water for Human Consumption have already been submitted to Parliament.
She said that the discussion of the Blood Donation Law has already been completed and is expected to be forwarded to the plenary for a vote.
At the same time, she announced that within the next week "another very important bill will be submitted to the Council of Ministers for approval, regulating the Operating License, Control and Supervision of Ambulances".
Within July the final meetings for University Clinics
She also noted that in July she will begin final meetings with trade unions, doctors and all stakeholders in order to proceed with the issue of the bill for the creation of University Clinics.
Finally, the Minister mentioned that her immediate priorities are the promotion of bills concerning the provision of Palliative Care in Clinical Laboratories, Radiodiagnostic Centers and the National Clinical Documentation Center.
Adoption of strict conditions in case of extension of deadline for autonomy
Moreover, when asked by CNA if the Ministry of Health is considering extending the deadline for the autonomy of hospitals, since in June 2024 the deadline expires, Ms. Kanari expressed confidence that "the SHSO will ask for an extension", explaining that during the more than two years of the pandemic, public hospitals were forced to put surgical and pathology clinics into inactivity, in order to respond to the emergencies that arose, missing opportunities to raise funds.
Personally, she said, "taking into account the data available at the moment, I expressed my willingness to support the extension of autonomy, when it is submitted by the SHSO."
However, she noted that strict conditions should be adopted for proper monitoring of compliance with the conditions that will be set, with a specific time horizon.
