Filenews 19 December 2023 - by Marilena Panayi
Cyprus is consistently and significantly below the EU average in terms of health expenditure and consistently even lower in terms of investment in prevention.
At the same time, of course, the new report on health systems in the European Union released on Friday, confirms the benefits gained by Cypriot society from the implementation of the General Health System, since the percentage of unmet health needs of citizens is the lowest in the EU and barely reaches 0.1%, while, As is found in Cyprus, access to health services does not depend on the financial capacity of each household.
In detail and always according to this report:
- The percentage of health expenditure in Cyprus in relation to Gross Domestic Product stands at 9.4%.
- The average health expenditure in the EU relative to GDP stands at 11%.
- In money: In Cyprus, per capita expenditure on health stands at €2,686 compared to an EU average of €4,028.
- The percentage of expenditure in Cyprus related to prevention programmes in the health sector stands at 2.2%, which corresponds to just €59 per inhabitant.
The report highlights the fact that public spending on health from 2019 onwards shows an increase with a simultaneous decrease in private spending (the money spent out of pocket by citizens), with this phenomenon being attributed to the implementation of the General Health System.
Lower health expenditure than Cyprus is recorded by Slovenia, Portugal, Lithuania, Estonia, Latvia, Greece, Hungary, with Romania last.
"Despite steady growth in recent years, Cyprus continues to spend less overall on health than other EU countries, both in terms of current per capita expenditure and as a percentage of GDP," the report said, adding: "The share of the public sector in health expenditure increased significantly with the introduction of the GHS in 2019: From 42% in 2018, to 85.3% in 2021. This is partly due to a decrease in direct private payments, as coverage was extended to the entire population under the new system, but also because spending on supplementary private health insurance decreased as confidence in the new health system increased."
"Given that total expenditure per capita in Cyprus is comparatively low, the relative expenditure per activity is also lower than the EU average in almost all sectors. Higher spending on inpatient care reflects increased spending on COVID-19 care (2021). Spending on prevention is among the lowest in the EU. Similarly, spending on long-term care is very low."
Regarding unmet health needs, i.e. needs that citizens have but cannot meet due to difficulty in access or economic reasons, the report shows that Cypriots have the fewest unmet health needs in the EU. The percentage of unmet needs, according to this European report for 2022, barely reaches 0.1%. As noted, in fact, before the implementation of the GHS, this percentage was 1%.
This percentage remained at low levels even during the years of implementation of the harsh measures due to the pandemic, while in both 2021 and 2022 it is estimated that Cypriots were late in receiving the services they needed due to the restrictions in place. 4% of unmet needs are recorded in Cyprus as far as dental services are concerned.
Public expenditure is higher than in the pre-GHS era in terms of outpatient and inpatient care and medicines. They are, however, lower in terms of dental services and the provision of medical and other aids such as wheelchairs, hearing aids, etc.
The share of private spending on health services stood at 34% before June 2019 (compared to 15% at the time). With the implementation of the GHS, they fell in 2020 to 18% and in 2021 they fell below 10% (of total health expenditure).
"Affordability is not a significant barrier to accessing healthcare in Cyprus," the report said, adding that "direct private payments have been significantly reduced with the expansion of coverage and the increased availability of healthcare providers within the GHS."
According to the report, "the GHS reduced fragmentation and centralized the public and private sectors into a single entity, creating a new and competitive health environment" and at the same time "there was a radical shift from private to public expenditure as a percentage of total current expenditure on health".
Labour shortage in the health sector
In Cyprus the density of doctors is 5 per 1,000 inhabitants, slightly higher than the EU average, while the density of nurses is also around 5/1,000 inhabitants, well below the EU average. The number of active doctors in Cyprus has more than doubled since 2000. While the number of nurses working in the health system, it did not increase at the same rate.
Wider health workforce shortages in inpatient care are now the main constraint on the system's capacity.
In addition, there are serious imbalances in the workforce between the public and private sectors, with most doctors working mostly in the private sector and most nurses in the public sector. Before the implementation of the GHS, many doctors in the public sector had switched to the private sector. As a solution to the pandemic, new doctors and other health professionals had to be hired."
The total number of beds in intensive and non-intensive care units in public and private hospitals in 2021 was 3.1 per 1,000 inhabitants. Although this rate is lower than the EU average (4.8 beds per 1,000 inhabitants), it is considered sufficient to cover the hospitalization needs of the population of Cyprus.
INTERVENTION
Let the Government study the data properly
The practice followed by the Ministry of Finance and the government in general in the field of Health probably does not leave hope for us as a state, at some point, to reach the EU average. From the finance ministry they will surely tell us that they are right when they say that public health spending has increased. The fact that pre-GHS spending was very low and paid out of pocket by citizens is not an argument for the fact that even with the increase in spending we are far behind the EU average. They also need to understand that health doesn't just mean doctor, hospital, surgery, medications. Health means prevention, rehabilitation, palliative care, home care, prehospital care, monitoring of medical practice, training of professionals, etc.
