The Health Insurance Organization officially informed the parliamentary Health Committee yesterday of its intention to review the way personal doctors are compensated.
The parliamentary committee discussed the status of the participation of personal doctors in the GHS and the recommendations of the World Health Organization's report on the General Health System of Cyprus.
The representative of the HIO, Petros Neophytou, stated that the Organization is working on proposals in contact with scientific societies, with the aim of "transitioning from 80% to 20% to 70% to 30%". The change will increase the weight of the part of the remuneration linked to performance criteria, compared to the compensation based on registered beneficiaries.
The HIO accepted that the criteria with which it started were mainly quantitative, with the aim of limiting abuses. According to Mr. Neophytou, the introduction of quality indicators aims to improve services, along with the rational use of GHS resources.
In the same discussion, the disparity in the specialties of personal doctors was raised. The representative of the HIO linked it to the staffing needs at the start of the System and stated that specific specialties are now required for new registrations. Regarding the limit of patients per doctor, he said that the Organization had initially recommended a smaller number, while pointing out the possibility of beneficiaries to change personal doctor if they are not served.
It is reported that during the implementation of the GHS and following an agreement between the Ministry of Health – HIO and doctors, the limit of 2,500 beneficiaries per personal doctor was set. This decision was largely attributed to the small number of doctors who were available at the time and held the competent specialties to join the System as personal doctors.
The representative of the personal doctors and representative of the Pancyprian Medical Association at yesterday's meeting, pathologist Andreas Ioannou, explained that "The specialists that existed at the time were pathologists and were around 80, there were a few colleagues specializing in general medicine and the rest were doctors without specialization who went through accelerated special training. Now we are around 650 personal doctors, we are around 150 pathologists and almost as many in general medicine, doctors without specialization and of course paediatricians."
The president of PASYKI, Sotiris Koumas, focused on the operation of public health centers. He argued that the primary care structures of OKYPY did not receive the necessary support in terms of staff and infrastructure. He linked staffing difficulties to the transfer of doctors from the public to the private sector and cited as an example the health center in Linopetra, where, according to him, spaces are used as warehouses. His remarks bring back the question of whether public structures can fully develop the services provided for in primary care planning.
The Cyprus Federation of Patients' Associations, for its part, called for the personal doctor to have a more active role in the prevention and continuous monitoring of the patient. Its spokesman, Dimitris Lambrianidis, argued that the institution should not be limited to prescribing and issuing referrals. He said that the beneficiaries show confidence in personal doctors, but they need better information on how to use their services. The Federation was in favour of linking evaluation and remuneration with qualitative criteria, in addition to the number of registered patients.
During the debate, there was also a reaction to the criticism of MPs for the issuance of referrals. Mr. Ioannou rejected the characterization "referrals", which they attributed to personal doctors MPs and defended the work of personal doctors. "It is an insult, at least for the 150 specialist pathologists I represent, to characterize us as referral specialists. There are colleagues who give everything to get the job done."
