Filenews 4 March 2025 - by Angelos Nicolaou
No more grace period for doctors to comply with their clinical waste management obligations.
Now all doctors must enter into an agreement with a licensed waste management facility on the basis of their legal obligations, in order to avoid phenomena such as syringes, blades, surgical scalpels and other hazardous waste of health units ending up in the trash. Infectious waste from doctors' offices, due to serious risks to the environment, citizens and workers in the cleaning service and waste management plants, must end up in licensed waste management facilities.
Speaking to "F", Chrystalla Stylianou, Senior Environmental Officer, said that "it is a very positive development that, finally, the obligations of doctors under the "Waste Laws" (in order to properly manage hazardous medical waste), are interconnected with the Regulations of the General Health System (GHS) and the contracts of doctors with the Health Insurance Organization (HIO) and all those who are health service providers will be obliged of the GHS to maintain agreements for the collection and management of the waste they produce".
According to Mrs. Stylianou, the whole effort had begun 5 years ago. A great deal of effort was made with meetings, thousands of letters and inspections. In 2023, after our actions, we managed to have about 800 doctors contracted with waste managers," he noted. He pointed out that "with the letters that the HIO is now sending to doctors, we believe that everyone will contract."
This was preceded by a compliance audit campaign of doctors and medical centers regarding the management of hazardous medical waste in 2024 by the Department of Environment. Doctors and healthcare providers, such as private practices, are obliged under the "Waste Law" to manage their infectious and toxic waste in accordance with legal requirements and deliver it to licensed facilities. It is noted that the inspectors of the Department of Environment have the ability to take strict measures in case of non-compliance, such as extrajudicial arrangements up to €4,000 or criminal prosecutions through the Attorney General.
According to the legislation, doctors who maintain personal practices, as well as employees of medical centers, are required to enter into a cooperation agreement with licensed hazardous waste management companies and register in the Electronic Waste Registry (EHR). Doctors must declare annually the amount of waste they produce, while medical clinics and polyclinics have the responsibility to ensure that the waste of the doctors working in them is properly managed.
All medical specialties, except some such as anaesthetists and forensic pathologists, are considered producers of hazardous waste and are obliged to comply with these procedures. Exceptions are doctors who operate in organized structures and do not practice in private clinics.
The Department of Environment recalls the seriousness of compliance with legislation on medical waste management and stresses that compliance is necessary to protect public health and the environment.
Hazardous medical waste of an infectious and/or toxic nature arising during perinatal care, diagnosis, treatment or prevention of disease in humans must be collected separately according to its type and stored in appropriate conditions until delivery to licensed management facilities and not placed in black/blue bags together with municipal waste.
In this context, medical healthcare providers, as producers of hazardous medical waste of infectious and/or toxic nature, have an obligation to ensure the proper management of such waste through an arrangement with licensed medical waste management facilities, with which they must maintain a written cooperation agreement.
HIO: Sanctions if not complied with by March 3
The HIO sent letters to all medical service providers in the GHS on 13/2/2025 regarding their legal obligations for the management of clinical waste. The Organization, on 23/9/2024, was informed by the Department of Environment that there was no compliance with the obligations of doctors arising from the "Waste Law". In particular, they were informed that they have not entered into an agreement with a licensed waste management facility and do not have registration in the Electronic Waste Registry.
The HIO allows compliance until March 3. Furthermore, it warns that in case no agreement is concluded with a licensed company, the Organization will proceed with the issuance of a decision based on the data in its possession.
According to the relevant Regulation of the General System, both the personal doctor and the specialist doctor have the necessary equipment and consumables and are housed in appropriate building facilities for the safe and effective provision of health care services. The Regulation states that minimum equipment and building requirements include, inter alia, arrangements for the storage and disposal of clinical waste. Also, according to the Regulation, doctors provide health care services in accordance with the provisions of the "Registration of Doctors Law", the "Doctors (Associations, Discipline and Pension Fund) Law" and the provisions of the Regulations issued pursuant thereto, as well as any other applicable legislation concerning doctors.
The HIO in the letters notes that, "prima facie, it appears that you have acted in violation of Regulations 5/4 and 6, since you have not so far secured the necessary arrangements for the storage and disposal of your practice's clinical waste in accordance with applicable law."
Article 63 of the Law draws that in the event that the Organization, during the investigation of a complaint, a complaint or on its own initiative, finds a violation of any provision of the said Law or the Regulations, internal regulations or decisions issued pursuant thereto, it has the power, inter alia, of the following:
(a) order or recommend to the offender concerned that he bring the infringement to an end within a specified period and avoid its repetition in the future or, where the infringement was terminated before the Agency took its decision, establish the infringement by decision.
b) Impose an administrative fine, depending on the nature, gravity and duration of the infringement, the amount of which may not exceed €30,000.
c) Decide that in case of continuation of the infringement, an administrative fine of €340 to €3,400 will be due for each day of continuation of the infringement, depending on its gravity.
