Serious legislative and regulatory gaps in the oversight of facilities where medical procedures are performed, fragmented responsibilities among the relevant agencies, and questions regarding the effectiveness of oversight were raised during the session of the Parliamentary Health Committee on Plasmapheresis, with Members of Parliament seeking answers regarding the legality of the centers’ operations and patient safety guarantees.

During the session, the case of a center in Larnaca was discussed; according to a spokesperson for the Ministry of Health, plasmapheresis procedures were being performed there using six machines, without the facility having the required operating license, and the two doctors in charge did not, according to the findings of the inspection, possess the required specialty.

The case has led to two complaints filed with the police, one in 2023 and another on January 14, 2026, while the second investigation is in its final stages, though no definitive conclusions have yet been reached.

At the same time, the relevant authorities recognize the need to clarify the legal framework to ensure that medical procedures are performed in appropriate facilities, by qualified personnel, and under conditions that allow for the immediate management of potential complications.

The Chair of the Health Committee, DISY MP Savia Orfanidou, requested information regarding inspections of the centers, healthcare professionals, and medical equipment, as well as a list of all centers where such problems may exist.

“What about the issues that have arisen? What is the police’s position? Will the centers be shut down or not? We want answers to everything related to this specific issue,” she said.

Two complaints regarding the center

The spokesperson for the Larnaca Police Directorate, George Charalambous, stated that the Medical Services had filed two complaints regarding the operation of this particular center without the required license.

The first complaint was filed in 2023, investigated, and forwarded to the Legal Service. As he explained, difficulties arose regarding the application of the relevant legislation, as it had to be determined whether the facility could be classified as a hospital, particularly in light of the criteria regarding the provision of medical care.

According to Mr. Charalambous, the second complaint was filed on January 14, 2026, by the Medical Services, noting that the new investigation found that the center was operational and that there was equipment on the premises being used for the relevant procedures.

“The investigation is in its final stage, and a new assessment will follow, on the basis of which specific recommendations will be formulated,” said Mr. Charalambous.

He clarified that the case is not yet closed and that additional evidence may come to light.

As he noted, the main issue under consideration is whether this particular facility falls under the definition of a nursing home under current legislation and, by extension, whether an operating license is required for its activities.

The Ministry of Health reported that, following the on-site inspection, instructions were issued to immediately suspend the center’s operations and a complaint was filed with the police, and following a letter and repeated inspections, it was determined that the center had voluntarily ceased operations.

The spokesperson for the Ministry of Health clarified that the equipment was approved and complied with current legislation; however, his position is that this specific treatment should be performed in a hospital.

He also explained that the facility was not subject to the same regular inspections as licensed private clinics.

“A Huge Gap” in Overall Oversight

The Patient Advocate, Marios Charalambides, warned that the involvement of seven or eight different agencies, each with different responsibilities, creates gaps in the overall assessment of the safety of health services.

As he noted, some aspects are overseen by the Cyprus Medical Association, others by the Medical Council, and still others by the Police, while different agencies are responsible for equipment and operating licenses.

“This creates a huge gap, as no single agency can comprehensively verify whether a service is operating legally and safely,” he noted.

He emphasized that the suitability of a machine or a doctor’s license is not sufficient on its own to ensure the safety of a treatment, calling for coordination and a mechanism for comprehensive oversight.

At the same time, he raised the issue of regulating advertisements for services promoted as “alternative therapies,” warning that such promotion may create misleading impressions and expectations among the public.

Furthermore, the President of the Pan-Cyprian Medical Association, Petros Agathangelou, who called for a clear definition of responsibilities, the procedures to be followed when a violation is suspected, and the mechanisms for imposing sanctions.

He also raised questions about the framework governing the procurement, the installation, and the use of medical devices, emphasizing that it must be specified who is authorized to use a device, in what setting, and for what purpose.

Dr. Michalis Rovaniás, on behalf of the Medical Council, stated that the review of a professional’s qualifications and registration is a separate process, noting that in certain matters, the scope for intervention is limited by current legislation.

A representative of the Legal Service, in turn, stated that the Service is collaborating with the relevant departments and directors to develop appropriate measures to address the issue.

“It cannot be performed by just anyone”

The spokesperson for the Cyprus Nephrology Society, Alexia Panagidou, said that plasmapheresis is a specialized medical procedure that requires properly trained personnel and specific conditions for its safe performance.

As she noted, the method is performed internationally by specialized physicians, primarily neurologists and hematologists, in accordance with international guidelines.

“As a rule, these are patients with a severe clinical presentation who require hospitalization and continuous medical monitoring. The treatment may cause side effects, and therefore requires appropriate facilities, specialized nursing staff, and the ability to immediately address complications,” he said.

He added that “this is not a method that can be safely applied in just any private facility, with limited staff and without the necessary medical support,” noting that its potential use in a private facility requires that all necessary conditions be met.

Doxa Dimitriou, spokesperson for OKYPY and Director of the Nephrology Clinic, stated that at the Organization’s hospitals, hemodialysis is performed in only two units, in Nicosia and Limassol, which serve the needs of the other hospitals.

As she explained, patients are referred to these specific units only when there is a relevant medical indication, and the treatment requires a specialized physician and nurse, as well as continuous monitoring of the patient’s vital signs.

By way of example, he mentioned thrombotic thrombocytopenic purpura, a serious condition that can affect even young people, emphasizing that a delay in starting treatment can put the patient’s life at risk.

Furthermore, he noted that OKYPY hospitals have specialized staff who can be called in immediately, even at night, while the procedure is performed only when there is a medical indication and scientific evidence.

OAY: Reimbursement Only at Licensed Facilities

A spokesperson for the Health Insurance Organization stated that, for the purposes of the General Health System, plasma removal is reimbursed only when performed at licensed hospitals or day care centers.

“The Organization does not reimburse this procedure under any other circumstances,” it noted, clarifying that plasmapheresis is covered for medically necessary purposes and not for wellness reasons or as part of alternative approaches.

According to the OAU, there have been documented cases of the procedure being performed under the General Health System (GESY) at clinics that meet the prescribed requirements.

“The nature of the service should be examined, not just the name of the facility,” says PASIN

The President of the Pan-Cyprian Association of Private Clinics, Marios Karaiskakis, agreed that the regulatory framework needs improvement, noting that licensed hospitals are subject to specific standards and regular inspections.

He raised, however, the issue of facilities providing services without a license, emphasizing that the actual nature of the activity must be assessed—not merely whether a facility has beds or is designated as a nursing home by its operator.

As he noted, when medical care is provided and procedures are performed that require organized infrastructure and monitoring, it must be determined whether the facility falls under the category of a day-care unit and whether it holds the required license.

He emphasized that the safe performance of plasmapheresis requires appropriate medical and nursing support, as well as the ability to immediately respond to emergencies, including the activation of an emergency resuscitation protocol.

Mr. Karaiskakis also raised the issue of regulating the advertising of medical procedures in traditional media and on social media platforms, such as TikTok, as well as in podcasts and online broadcasts.

He called for clear boundaries to be established between responsible reporting and the commercial promotion of medical services, while emphasizing the need to regulate the distribution and use of medical devices to ensure they are installed in appropriate facilities and used by trained personnel.

Shortcomings in equipment oversight

Michalis Potamitis highlighted the absence of an adequate regulatory framework for medical technology equipment, on behalf of the Cyprus Association of Medical and Scientific Equipment Representatives.

As he noted, there is not always a corresponding licensing requirement for importers and suppliers of medical devices, as is the case in the pharmaceutical sector.

It also pointed out that the relevant department is understaffed and lacks the capacity to conduct all the necessary inspections to verify compliance with European regulations.

The Association is calling for the creation of a clear national framework for suppliers, with substantive inspections and the ability to impose sanctions. “At the moment, we are subject to more inspections by our suppliers than by the government itself,” he said.

Legislation on Staffing and Training

Marios Theodorou, on behalf of PASYNO, presented specific recommendations regarding staffing and staff training, noting that current legislation does not adequately specify either the nurse-to-hemodialysis-machine ratio or the qualifications required for the staff who operate them.

As he noted, nursing care includes preparing the patient, monitoring them during treatment, providing post-treatment care, and ensuring the safe use of the equipment.

PASYNO recommends establishing regulations requiring treatments to be administered in organized hospitals, the establishment of a minimum staffing ratio of one nurse per patient, and the presence of a second nurse in the unit, in accordance with relevant scientific guidelines.

It also calls for a recognized program of specialized training and retraining, an assessment of staff competence, uniform medical and nursing protocols, and the involvement of relevant nursing institutions in shaping the framework.

The Ministry should come back with specific proposals, says OSAC

The President of the Federation of Cyprus Patients’ Associations, Miltos Miltiades, has asked the Ministry of Health to come back with specific proposals to address the gaps that have been identified.

As he noted, a clear and comprehensive institutional and regulatory framework is needed so that the Ministry, as the competent authority, can effectively exercise its supervisory powers.

He also raised the issue of strengthening oversight of health service advertising on social media, calling for clarification on which bodies will be responsible for oversight and intervention where necessary.

In remarks following the session, the Chair of the Parliamentary Health Committee, Savia Orfanidou, expressed her deep concern about the issues raised during the discussion regarding bloodletting and other medical procedures.

As she noted, issues arise from the performance of medical procedures in unlicensed facilities, which lack the necessary infrastructure and appropriate support to address potential complications. At the same time, she raised the issue of medical equipment being made available without adequate oversight regarding its use.

Ms. Orfanidou emphasized the need to address the legislative gaps that hinder the immediate intervention of the competent authorities in cases of illegal operation of medical centers, while calling for better coordination among the relevant agencies, stricter penalties, and meaningful sanctions for the illegal distribution of medical equipment.

According to the briefing received by the Committee, the Ministry of Health is preparing legislation for a comprehensive control system, as well as for the creation of a registry of medical devices.

At the same time, the Committee Chair requested data on the mapping of centers that provide such treatments, in order to gain a clear picture of the extent of the problem.

AKEL MP Marina Nikolaou raised serious concerns before the Parliamentary Health Committee regarding the oversight and regulation of medical centers where plasmapheresis was allegedly being performed without the required licensing.

As she noted, the discussion raised questions about the adequacy of the inspections conducted by the Ministry of Health and about potential gaps in the existing legislative framework. Marina Nikolaou requested detailed data on all complaints and inspections conducted from 2022 to the present, as well as an update on the progress of the investigations into the relevant cases.

The AKEL MP stated her party’s readiness to contribute to advancing the necessary legislative measures, should this be deemed necessary, in order to address any gaps in the oversight and regulation of medical centers. At the same time, she emphasized that the protection of public health requires effective controls, a clear institutional framework, and meaningful accountability, so that every medical procedure is performed under safe conditions and by properly trained staff.

DIKO Member of Parliament Andreas Apostolou stated that the promotion of treatments, especially through social media, to patients who are in a vulnerable position and are desperately seeking a solution to their illness. He emphasized that it is unacceptable to raise expectations about treatments that have not been proven to help with this specific illness.

Mr. Apostolou asked the Ministry of Health to clarify whether there are legislative gaps that prevent the effective oversight of these centers and when the necessary legislative measures, while also requesting an update on the inspections being conducted regarding the advertising of such therapies, as well as the process by which it is determined whether the relevant claims and medical practices are lawful.

Furthermore, he called on the Cyprus Medical Association to examine the personal responsibility of doctors who staff such centers and participate in medical procedures that may not be able to be performed safely in specific facilities, even when there are legal loopholes regarding their operation.

ALMA Movement Member of Parliament, Litsa Drousiotou, noted that the discussion highlighted serious issues regarding the licensing, supervision, and inspection of facilities where plasmapheresis is performed.

As she explained, she raised questions regarding the number of complaints, how they were investigated, the cases referred to the police, and whether criminal charges were filed, while also requesting an update on the status of the investigation into a case that arose in September.

She emphasized that patient safety cannot depend on whether a complaint is filed first, but requires an effective system of prevention, oversight, and accountability.

Source: CNA