On Thursday, the Parliamentary Health Committee examined the irregularities identified in the operation of the General Health System (GESY), with its members highlighting the need to ensure the quality of health services provided and requesting clarification on the status of personal physicians (PPs) within the GHS. 

Currently, there are 640 private practitioners, 150 specialists in internal medicine, 150 general practitioners, and 80 physicians in other specialties, according to Andreas Ioannou, spokesperson for the Pan-Cyprian Medical Association (PIS).

The OAY is moving forward with the introduction of quality criteria, said the Organization’s spokesperson, Petros Neophytou, adding that “with regard to quality criteria, the OAU is an insurance organization.”

Kypros Stavridis, Chief Executive Officer (CEO) of OKYPY, strongly disagreed with Mr. Neophytou’s statement, noting that the OAY “should not consider itself a social security organization that manages a budget.”

In his opening remarks, the Committee’s Vice Chair, DISY MP Charalambos Pazaros, said that there are errors, distortions, and weaknesses in the General Health System (GESY) that need to be addressed. 

He also noted that there is a great deal of inequality regarding the issue of personal physicians (PPs), which, as he said, “is driving many doctors into the private sector.” He asked the OAU if there are any plans or incentives to enable GPs to practice their profession.

At the same time, she pointed out that the Regional Health Authorities (TAEP) in all districts are facing “significant pressure.”

Litsa Drousiotou, a Member of Parliament for the Alma Movement, referred to the weaknesses of the General Health System (GESY) identified in the World Health Organization’s report on the system. The role of the Primary Health Care (PI) is not to issue referrals, she noted, referring to “referral-issuers.” The goal is for the patient to receive the right care at the right time, she said.

AKEL MP Marina Nikolaou asked the OAY about its intentions regarding the status of primary care physicians.

AKEL MP Konstantinos Konstantinou requested data on patients’ telephone and in-person contacts with primary care physicians. He asked whether there has been a recorded decline in the quality of services provided by private clinics.

AKEL MP Panikos Xiourouppas said that private practitioners “send patients all over the place to various specialists.” 

ELAM MP Andreas Papacharalambous said that the average of 2,500 patients assigned to certain primary care centers must be reduced.

Yiannis Laouris, a member of parliament for Direct Democracy, asked whether the OKYPY intends to reduce the rights of primary care physicians.

Sotiris Koumas, President of PASYKI, said that primary care centers are the cornerstone of the General Healthcare System’s (GESY) success. Rural health centers are managed by OKYPY, he noted, referring to a “peculiarity” that “for some reason is not being discussed or addressed as it should be.” 

Mr. Koumas agreed with Charalambos Pazaros that many doctors are being “pushed” toward the private sector. He also noted that public hospitals and emergency departments are being “stripped bare.” On certain issues, there was a lack of proper planning, and the public sector was used as a stepping stone, he added.

Apostolia Andreou, speaking on behalf of the Pan-Cyprian Equality Union, noted that there are weaknesses in primary care. The remuneration of primary care providers must be linked to the quality of the services they provide, she noted.

Dimitris Lambrianidis, speaking on behalf of OSAC, said that family doctors are the most important people for the success of the General Healthcare System (GESY). We want personal physicians who build relationships with their patients and guide them on prevention, he emphasized. The institution of personal physicians needs to be upgraded, he pointed out.

Andreas Ioannou, speaking on behalf of the Cyprus Medical Association (PIS), noted that before the National Health System (GESY) began operations, there were around 80 specialist internists and around 30 personal/general practitioners, adding that today there are 640 private practitioners, 150 specialists in internal medicine, 150 general practitioners, and 80 doctors in other specialties. 

“There is inequality in the training of private physicians,” he emphasized. Not all doctors have the same knowledge, yet they are expected to do the same work, he pointed out. He disagreed with the term “referral specialist” used by Litsa Drousiotou. There are 170 physicians, each with approximately 2,500 patients, he noted.

Moses Lambrou, speaking on behalf of PASYDY, said that patient satisfaction must be based on the quality of the services provided. The OAU must examine to what extent the level of primary care can be monitored, he said. 

Marios Charalambides, the Patient Ombudsman, requested the OAU’s position on the issue of waiting lists. He also asked for an update on the replacements for primary care physicians.

The representative of the Ministry of Finance stated that the WHO report advocates a mixed reimbursement model for primary care physicians, noting that the Ministry agrees with this approach and its expansion.

Konstantinos Hatzigiannis, speaking on behalf of OKYPY, said that the General Health System (GESY) does not provide for reimbursement for existing primary care programs.  

Antonis Kontemeniotis, speaking on behalf of the Ministry of Health, said that the Ministry has reviewed the WHO study. He noted that the study does not document abuse but rather offers recommendations.

DISY MP Giorgos Pamporidis noted that most of the problems identified highlight patients’ reluctance to claim what they are entitled to. The problem is not the 2,500 patients that certain PI have, he said, adding that a culture of providing high-quality services must be instilled in doctors. 

The PI has no role as a collector, he noted, pointing out that the OAY has an important role to play. Incentives must be provided to create associations of doctors that will provide holistic services, he emphasized.

Petros Neophytou, speaking on behalf of the OAU, said that the GESY has achieved some important goals, assuring that ensuring and enhancing the quality of services provided are among the pillars of the OAY’s strategy. 

The OAU asked the WHO to prepare a study on the GESY, he said. “We came from a system that had no PI; we started from scratch,” he noted. 

The goal is to transition from an 80%-20% to a 70%-30% split in the reimbursement system by 2027, Mr. Neophytou said. The majority of primary care physicians are doing a pretty good job, he added. Some unqualified doctors have also joined the group of medical practitioners, he noted, adding that “this distortion has an expiration date.” 

“We are investing in the training of physicians and reassessing their performance indicators,” he added. Patients have the option to choose and change their personal physician; this is a strong asset in their hands, he emphasized. 

We are moving forward with the introduction of quality criteria, Mr. Neophytou stated, adding that “with regard to quality criteria, the OAU is an insurance organization.”

Kypros Stavridis, Chief Executive Officer (CEO) of OKYPY, strongly expressed his disagreement with Mr. Neophytou’s position regarding the OAY’s responsibilities.

“Just because we called it the Health Insurance Organization, it should not consider itself an insurance organization that manages a budget. It must view itself as the organization that manages the General Health System and ensures that the provision of services within the system is of the highest standard,” he emphasized.

Responding to Mr. Stavridis, Mr. Neophytou clarified that “the reason I used the term ‘insurance organization’ is not to deny our role in overseeing the General Health System, but rather to explain why, in addition to quality indicators, quantitative indicators are also applied to limit abuse.”

Speaking after the Committee meeting concluded, its Vice Chair, DISY MP Charalambos Pazaros, said that “we must have a General Health System that is fair, sustainable, and functional—one that serves the patient first and foremost.” 

“That is precisely why we have a responsibility to defend it—not as a static creation, but as a system that must be corrected, improved, and developed,” he emphasized. 

Mr. Pazaros added that he would prepare a legislative proposal for the Plenary Session regarding the number of patients each primary care physician is entitled to have, noting that “no one can handle 2,500 patients.”

ELAM MP Andreas Papacharalambous stated that “a doctor cannot handle 2,500 patients and adequately know the personal details of all of them. So the time has come to reduce that number.” 

At the same time, he emphasized that “there must be a system that rewards quality and prevention, and there must be a regular annual checkup.”

Litsa Drousiotou, a member of parliament for the Alma Movement, stated that “taxpayers pay more than €2 billion a year for the General Healthcare System (GESY), and yet we have waiting lists, we have services that aren’t integrated into the National Health System (GESY), and we have serious problems with the quality of the services provided.”

“The GESY is a major reform, but that doesn’t mean we ignore its weaknesses. It means we identify them and correct them,” he concluded.

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Source: CNA