Filenews 10 July 2024 - by Marilena Panayi
"The provision of medical services to the patient is not determined through statistical and economic criteria that are hidden behind the caption of abuses," orthopaedic doctors told the Health Insurance Organization.
They state their strong opposition to the HIO's practice of imposing numerical restrictions on referrals of patients to physiotherapy and stress, in a letter to the Organization, that "the tactic of restrictions deprives patients of the quality of health to which patients are non-negotiably entitled through the GHS".
For its part, the HIO seems to highlight the serious indications of abuses in referrals to physiotherapists, while organized patients express their deep concern about the situation, arguing that it is imperative to properly study all data and take decisions that will lead to the redistribution of health services and their provision to the patient groups that really need them.
The letter from the Cyprus Society of Orthopaedic Surgery and Traumatology was sent to the HIO only a few hours after the announcement of the imposition of a fine on an orthopaedist who had exceeded the limit set by the Organization in issuing referrals per doctor. It was notified, in fact, both to the Minister of Health and to the Federation of Cyprus Patients' Associations, whose doctors are asking for intervention.
The doctors, addressing the HIO, accuse, among other things, the Organization of practices that lead to "only self-interested decisions" that are "taken only on economic criteria and not on scientific ones".
"Since the first day of operation of the HIO, the Cyprus Society of Orthopaedic Surgery and Traumatology has been tirelessly by your side to support you, as a consultant and partner, in regulating issues related to orthopaedic surgery. (…) From the result, it seems, unfortunately, that this cooperation is one-sided, since our opinion is taken into account only when it is used and, indeed, often on purpose, paraphrased for the benefit of the HIO and not for the proper provision of medical services to the patient. In the above spirit, about a year ago, you raised the issue of the numerical limitation of referrals for physiotherapy. This found us strongly opposed since the treatment of the orthopedic patient is inextricably linked to physiotherapy. We ended up in our temporary retreat of being put experimentally, although this restriction is feasible, and discussed again. In our last two meetings we raised the issue with you again, since it was found that the percentage you set is not satisfactory for the proper treatment of patients. Your position was absolutely negative and authoritarian for any settlement of the issue without presenting us with any scientific study or protocol justifying your stance and the numbers you set, obviously having economic criteria and not scientific ones."
"The issue of the number of physiotherapy treatments per patient per year, the age at which a patient is or is not entitled to undergo physiotherapy and the list of diagnoses that you have drawn up for physiotherapy beneficiaries, as we have repeatedly informed you, does not correspond to the treatment that according to the guidelines patients must follow and needs to be revised. You repeatedly deny this, with the result that patients suffer daily with the issue of physiotherapy."
Commenting on the doctors' protests and in statements to "F", the representative of organized patients on the HIO board, Miltos Miltiadous, said that "the Patients' Rights Observatory of the Federation very often receives complaints from patients about these restrictions and at the same time as OSAC we have asked several times in the past publicly for the evaluation of all horizontal restrictions, most of which had been implemented in the early stages of the GHS with the aim of containing the anarchy that was to some extent observed at the time. It is no coincidence that the Federation had taken the lead in establishing patient registries and offering the right services to all patients who really need them."
As an OSAC, he said, "we believe that the HIO should proceed with a thorough study, an analysis of the real data, identify where there are real abuses and accordingly evaluate the restrictions imposed from time to time."
