Both public and private hospitals with university clinics. Training of resident doctors both in OKYPY and in the private sector. The only and necessary condition: Each hospital involved must meet all the conditions and criteria set by law.
The responsibilities, responsibilities and roles will be distinct between clinical and academic doctors, just as the roles of hospitals and medical schools will be distinct and clear.
Patients will have a role in decision-making and a say in their participation in research programs, with the right, in fact, to refuse or stop a procedure.
The proposed bill for university clinics, with a total of seven changes that the Ministry of Health has already made and is expected to submit within 24 hours to the Parliament, clarifies the scene to a large extent.
At the same time, it also responds to the concerns of the mainly private sector, while putting an end to the discussions between stakeholders on whether the public and private sectors will be treated in the same way in the context of this reform.
The possibility of participation of both public and private hospitals in the operation of university clinics, as well as in training for medical specialties, as long as they meet the prescribed conditions, was clarified by the Minister of Health himself, Neophytos Charalambidis, during yesterday's discussion of the relevant bill in the Health Committee of the Parliament.
For the training of resident doctors, the Minister of Health said, the requirements of the legislation and the interstate agreement with Greece will continue to apply, with Neophytos Charalambidis, however, leaving open the possibility of new changes, saying that "a future change of the agreement that currently exists with Greece is something that could be discussed in a way in which it will not then be necessary to amend the legislation".
The issue was raised with particular emphasis by the president of the Pancyprian Association of Private Hospitals, Marios Karaiskakis, who argued that the current provisions of the bill, despite the recognition of the role of the private sector, essentially lead to the exclusion of private hospitals even from undergraduate university education.
In the same direction, the president of the Pancyprian Medical Association, Petros Agathangelou, spoke in favor of common, strict and objective criteria for public and private hospitals, linking the reform to the upgrading of medical education and the prospect of greater autonomy of Cyprus in education for specialties.
The Dean of the Medical School of the University of Cyprus, George Hadjigeorgiou, supported the need to pass the legislation, pointing out that the state delayed regulating clinical education after the opening of medical schools. He clarified that he does not oppose the participation of private universities or hospitals, but insisted that the quality criteria for classifying a structure as a university clinic or university hospital should not be lowered. In particular, he expressed opposition to an earlier proposal to remove the requirement for the existence of an Emergency Department from a university hospital.
Representatives of private universities and medical schools welcomed the promotion of the bill, informing that they have no comments on the changes made by the Ministry of Health.
Hospital doctors continue to disagree
As expected, the representatives of the doctors of public hospitals expressed significant reservations, clarifying, however, that they do not oppose the creation of university clinics.
The president of the Doctors' Branch of PASYDY, Moses Lambrou, warned that the general principles of the bill are not enough to deal with daily operational problems. He raised issues of administration, distribution of responsibilities, staffing, remuneration for educational work, financial viability and composition of the Joint Monitoring Committee.
At the same time, he disagreed with the inclusion of the issue of the training of trainees from private hospitals in the same bill, considering that it is a separate process that should not delay the institutionalization of university clinics.
The president of PASYKI, Sotiris Koumas, warned that the university designation alone is not enough to improve the quality of services, if it is not accompanied by real strengthening of hospitals.
Reason and role in patients
On behalf of the patients, the Patient Ombudsman, Marios Charalambidis, asked for the consolidation of the consent of the patients for their participation in training or research programs as well as the right to withdraw it.
The honorary president of OSAK, Marios Kouloumas, called for "a truly patient-centered framework, without compromises that will degrade the quality of care".
The Minister, commenting on these positions, stated that: "Information and consent are provided in the context of clinical training, protection of privacy and the possibility of refusing participation without any impact on the quality or continuity of care". At the same time, he added that the organized patients will also participate in the joint committee that will operate within the framework of the law.
The sequel will be seen in the memos
Yesterday's meeting was held in mild tones with no sign of a willingness to clash. Of course, the participants reserved their position on the changes made by the Ministry of Health, when they have in their hands the updated text of the bill. With these facts and as it was said at the end of the session, the next step for the bill is to send the revised text to the Parliament and the stakeholders involved. A period of approximately seven to ten days will follow for the submission of written comments, before the Health Committee proceeds with the article-by-article examination. The aim is for the debate to begin on October 29 or early November, in order to pave the way for the promotion of the bill in the Plenary.
Change in the bill on the remuneration of resident doctors
A change in the bill for university clinics, in order to settle the issue of the remuneration of resident doctors for the teaching of medical students, was announced by the Minister of Health, Neophytos Charalambidis, during yesterday's meeting of the parliamentary committee on Health.
The issue was raised by the representative of the Cyprus Guild of Trainees and Other Young Doctors, Theodora Pozotou, underlining that the trainees are working doctors, who offer clinical services every day and should not undertake additional educational work without corresponding remuneration.
In response to her intervention, the Minister of Health stated that the relevant article of the bill will be amended in order to address the issue.
Ms. Pozotou also called for a clear consolidation of the role of the trainees in university clinics, the definition of their working conditions and the clarification of their medical responsibility. As she pointed out, although they are doctors, they are still in the process of acquiring a specialty and their responsibility cannot be automatically equated with that of specialist doctors.
At the same time, she suggested that explicit provision be included for the obligation of university clinics to train residents, in addition to medical students.
Referring to the interstate agreement with Greece, she argued that greater autonomy of Cyprus in education for medical specialties is desirable, but it requires appropriate educational structures, adequate trainers and reliable evaluation, without hasty decisions.
