Filenews 4 November 2023 - by Marilena Panayi
The Health Insurance Organization is preparing two-tier referrals to specialist doctors, which at the same time is seriously considering the possibility of promoting a regulation through which it will be ensured that free appointments are maintained in the daily schedule of specialists, so that they can serve emergencies without delay.
These were also discussed during the broad meeting held in September at the Ministry of Health on waiting lists and the HIO had undertaken to investigate whether their implementation is feasible.
The HIO, according to information provided by "F", has already proceeded with the preparation of its preliminary planning and is preparing, after the meeting that will take place on Monday to discuss the long waiting time for an appointment with a GHS doctor, to initiate the necessary procedures to finalize its plan and put it before the Board of Directors for the necessary approvals.
According to the draft currently being drafted, referrals will be of two categories. They will be labelled differently within the software so that medical specialists can recognize them when scheduling their appointments, and will be two-speed service. The 'urgent' and the 'non-urgent'. For the execution of emergency referrals, the HIO, if the design is adopted, will also determine a specific period within which patients should be served by the doctor of their choice, and this process within the GHS software will be constantly monitored.
In order to implement this procedure, of course, proper preparation is required. For example, it is necessary to prepare protocols and guidelines on the basis of which the doctors issuing the referrals will classify them as urgent and non-urgent. For the preparation of the guidelines, international data will be taken into account, while consultation with GHS doctors will follow, who will determine when an incident is considered urgent and under what conditions. For the categorization of each referral, the responsibility will lie with the doctor who issues the referral, with the HIO now looking for the safeguards that need to be implemented in order to avoid possible abuses.
Speaking to "F", HIO Director Ifigenia Kamitsi said: "This is a change which, once we have completed the planning and been approved by the Board of Directors, will be implemented after proper preparation and certainly in cooperation with the GHS doctors. Final decisions have not yet been made on how the referrals of the two categories will be implemented, but our aim is to move forward with the procedures without delay, although it will take some time to complete the relevant guidelines."
The aim, said Mrs. Kamitsi, "is in this way, the categorization of referrals, combined with free appointments in our doctors' program, to facilitate patients who face problems that need urgent service, without suffering until they manage to arrange their visit to the doctor."
Ms. Kamitsi also referred to other changes promoted by the HIO and aimed at facilitating GHS beneficiaries.
"These changes concern our personal doctors. It has been decided that GHS beneficiaries will be able to see on the system's website the number of beneficiaries registered in the list of each personal doctor. To be more correct, the beneficiary will be able to be informed whether his doctor or the personal doctor in whose list he wishes to be registered has 500 or 1000 or 2000 beneficiaries, approximately and certainly not with an exact number since this may conflict with the personal data of doctors".
At the same time, "it has been decided that GHS beneficiaries will also be able to be informed about which doctor replaces their personal doctor in his absence." "We must mention that the vast majority of personal doctors always appoint, when needed, a replacement doctor to serve their beneficiaries. However, because in many cases we receive complaints that beneficiaries are not informed about this, the organization has decided that the name of the doctor replacing the personal doctor will be visible on the beneficiary's personal page in the GHS".
The HIO's planning regarding the categorization of referrals will be presented by the organization during Monday's meeting, along with the data drawn from the GHS software and concern beneficiaries who, as it is found, visit two doctors of the same specialty for the same health problem and may thus contribute to the increase of waiting times.
Some afternoon clinics have already increased
As part of the wider effort to reduce waiting times for appointments with a GHS specialist, during the September meeting, it was decided, among other things, to extend the opening hours and days of operation of afternoon clinics in the public sector.
The State Health Services Organization, as we are informed, has for several weeks extended the days of operation of outpatient clinics to some medical specialties, but so far, there has been no further information or relevant announcements. The SHSO will most likely inform the Minister of Health and the other stakeholders about its actions during Monday's meeting.
The Minister of Health, Popi Kanari, expects all competent bodies to submit their recommendations in order to discuss and take joint decisions in order to promote the procedures that need to be done before the implementation of any measures decided.
It is recalled that in addition to the categorization of referrals to specialists, the analysis of data on double appointments and the expansion of the SHSO afternoon clinics, in September it was also decided that the Cyprus Federation of Patients' Associations and the HIO will promote an information campaign for citizens, since, as GHS doctors claim, in several cases GHS beneficiaries arrange unnecessary appointments, thus burdening their schedule and to inconvenience patients who really need to be seen by a doctor.
INTERVENTION
Don't forget the limitations
In Cyprus, meetings are almost always held, suggestions are recorded, decisions are taken and then everything is shelved and any measures decided remain in the realm of "will" be implemented. The long waiting time for an appointment with a GHS specialist doctor is perhaps the most significant distortion currently presented by the GHS, in terms of service and access to health services for beneficiaries of the system. We have mentioned this several times in recent months. If this problem is not solved, then it will not be easy to correct the remaining gaps, which have also been identified. I would remind you that among the decisions was the study and lifting of some restrictions applied to the GHS that inconvenience doctors and patients. We are also awaiting information on this issue.
