The mechanisms for dealing with abuses and the control of procedures in the context of the NHS, as well as the planning for the promotion and completion of the necessary upgrading projects in the public hospitals of Cyprus, were at the center of today's discussion of the budgets of the Health Insurance Organization (OHI ) and the State Health Services Organization (OKYPY), during the meeting of the Parliamentary Finance Committee.
In addition to the OAU and OKYPY budgets, the Committee also examined the budgets of the Cyprus Addiction Treatment Authority, as well as the Council of Medically Assisted Reproduction, in order for the texts of all four budgets to be put to a vote by the Plenary of the Parliament on December 2, before the dissolution of the body in view of the presidential elections.
Triptych to deal with abuses in the OAU and cuts from the Ministry of Finance
During the meeting, the President of the OAU, Stavros Michael, presented the main axes of the Organization's budget for 2023, which amounts to €1.5 billion. Answering questions from the Members of Parliament, Mr. Michael emphasized that the Organization's first concern is its sustainability and added that this is why “we must not let the budget slip”. He noted that due to uncertainty about the Agency's finances, the Ministry of Finance requested some cuts from the budget, which he assured would not prevent the OAU from developing its programming. “If the planning goes ahead, we will go back (to the Ministry of Finance) for an increased budget,” he added.
Regarding the abuses detected in the operation of the NHS in previous years, Mr. Michael noted that they are not committed by the majority, “but by a small minority of health providers, who take advantage of weaknesses in the system”. The first check to identify them, as he said, is done through the accounting system, and he added that a system upgrade is also being done for analytical data that will allow the identification of abusers. The second way of control has to do with on-site visits, while he said that medical records should be checked. “Of course, it is difficult to find doctors in Cyprus who will leave medicine to start researching their colleagues,” explained Mr. Michael.
Regarding the status of personal physicians, the President of the OAU said that there will be meetings with their representatives in the coming days, in order to discuss their training, but also how the System is protected. Responding to questions regarding the long waiting lists in certain specialties, he said that the Agency is focusing on this, stating that “if there are waiting lists in the NHS, we have failed”.
He reminded that the OAU is waiting for this period and the court's decision to settle the cases of doctors who are not contracted with the NHS, but are based in hospitals that are contracted. He also said that the Organization is ready to implement quality criteria for the regulations of cooperation with hospitals. Referring to the effort to provide rehabilitation services by the NHS, he said that at the present stage there is no legislation that covers such a thing and that is why the OAU addressed the organization to hospitals that already offer rehabilitation services, in order to secure collaborations in Nicosia, Limassol, Larnaca and Paphos. At the moment, consultations are underway, he added, with the aim of joining the National Health Service on 1/1/23.
He also referred to the need for an increased number of physical therapy sessions for specific categories of patients and said that for this purpose a patient registry is being drawn up, after evaluation by a committee. Accordingly, he said that the committees that prepare protocols for drugs have received instructions to intensify the procedures, so that innovative drugs can also be included in the System.
Finally, answering a question about the OAU's attitude towards the possibility of hospitals being acquired by monopoly groups from abroad, he said that the Organization expects assistance from the Competition Committee, as well as from the Parliament on the matter.
< p>Hospital upgrades a priority for OKYpY
With OKypY budget priority, the upgrades of public hospitals, the Organization submitted to the Health Committee in the form of the urgent bill for amendment of the law, so that the Executive Director is not limited to the responsibility for setting up committees that undertake the examination of contracts.
The Executive Director, Kypros Stavridis, explained to the Committee that with the existing law the Board can only delegate powers to the executive director of OKYPY, which, as he said, makes him a single-member body, with too many powers, which is not what what is best for the transparency and good administration of the Organization. He stated that the text of the bill has received the consent of the Legal Service as well as the Ministry. of Health and aspire to have this voted on on December 2nd.
In his statements after the meeting, the Chairman of the Board of OKYPY, Marios Panagidis, said that the budget has been prepared taking the actual data of the last two years of operation within the GeSY, as well as the Organization's Business Plan, and through this the actions are determined that must be done at all levels, with the aim of improving its results and achieving the Organization's goals.
He stated that for 2023 a fund of €123.3 million has been calculated for equipment purchases and development projects to upgrade and expand infrastructure in public hospitals, while for the three-year period 2023-2025 the amount amounts to €311.2 million and he added that most projects will be announced during the first quarter of 2023.
He explained that the total revenue for 2023, excluding the state sponsorship, is estimated at €612.4 million compared to €501.7 million in 2022, as the revenue from the distribution of medicines at OKYPY pharmacies, amounting to €126 million, is included The Organization's expenses, as he said, amount to €610.9 million compared to €505.5 million in 2022, due to expenses for the purchase of medicines, while a reduction has been calculated for operating expenses.
“Taking into account the above, for 2023 the Organization is expected to present an operating cash surplus of €10 million and after deducting depreciation, which are cash outflows, the accounting operating surplus will amount to €1.7 million.” , added Mr. Panagidis, while noting that operating surpluses are expected to increase to €18.6 million in 2024 and to €33.6 million in 2025.
Mr. Panagidis concluded that with this budget, the Management of OKYpY “confirms its commitment to the achievement of an important goal of the Financial Autonomy of the Organization”.
Declarations of Members of Parliament
In his statements after the meeting, the President of the Committee and MP of DISY, Efthymios Diplaros, said that a positive sign was recorded in the fact that both organizations have development budgets. “There is a strategy and a plan from OKYpY, to upgrade hospitals, but also from OAU, to include innovative medicines,” he said.
“We must all realize that public hospitals are today the backbone of the NHS”, he added, stressing that the Parliament's support for OKYPY is a given. “As DISY we support all four organizations, recognizing that there are problems and distortions that need to be corrected”, he said and noted his satisfaction with the fact that OAU and OKYPY recognize that improvements must be made, on the one hand in abuses and process controls and on the other in the upgrading of the hospitals, so that they are competitive.
Disy Member of Parliament, Savia Orfanidou, referred to the budget of the Medically Assisted Reproduction Council, welcoming the announcement of the Minister. of Health that the amending bill on extracorporeal therapies will be immediately submitted to the Parliament and will be discussed next March.
AKEL Member of Parliament, Marina Nikolaou, said that with satisfaction the Committee heard the OAU say that by 2023 the work on the protocols for innovative drugs will be completed, as well as that the integration of palliative health units and rehabilitation units is underway.< /p>
“We once again requested that the Commission be given the business plan of OKYpY and we emphasized the need to upgrade the public hospitals, as well as the re-operation of the THEMEA structure, the only structure in Cyprus that deals with alcohol addiction and has been put out of operation last time”, he concluded.
DIKO Member of Parliament, Chrysanthos Savvidis noted that with €1.5 billion, OAU has one of the largest budgets, therefore the responsibilities of the Board are very large. He said that the problem with abuses was highlighted and a specific plan was requested to deal with them. He added that the problem of sending patients abroad was highlighted, while with regard to innovative medicines he noted that the €40 million fund, but it was not clarified what percentage of the medicines it covers.
Regarding OKYPY, he said that the Organization with €659 million, receives €27.8 million from the state, but shows a deficit of €65 million, so OKYPY wants to extend the state sponsorship, beyond 2024, due to conditions such as pandemic. “As DIKO, we requested that it be recorded when the funding from the state can end”, he noted, in the context of the Organization's attempt to become autonomous. “We have also raised the issue of schedules for the development budget,” he concluded, regarding the completion of the projects.
The MP of DIPA, Michalis Giakoumis, in his statements after the meeting, noted that during the discussion of the Committee on the OAU Budget, particular importance was given to the sustainability of the National Health Service, as well as to the abuses identified following requests. “We expect the methods of dealing with abuses to be implemented, which the OAU mentioned today and mainly concern checks, even on-site, as well as conducting checks of transactions, which is expected to immediately eliminate the abuses”, he noted.
He also referred to the budget of the Cyprus Addiction Treatment Authority, declaring his faction's support for the Authority's efforts. Accordingly, he said that he also supports “all couples and all women undergoing IVF”, assuring support for the Medically Assisted Reproduction Council's Budget as well. He concluded by saying that DIPA “unreservedly supports the budgets, so that we can strengthen all efforts to modernize the system and enrich health services”.
EDEK Member of Parliament, Marinos Sizopoulos, noted in his statements that €1.5 billion was calculated in the OAU budget and explained that it implies a 60% increase in relation to the study that was initially done on the offer of services by the OAU. “All this needs a full investigation, in order to make a rational assessment of whether these costs correspond to the quality of the services offered to citizens,” he added.
He also mentioned two issues that need attention. He emphasized that “it is not possible for private hospitals to continue to be within the NHS, while their TAEPs are outside, and at the same time for the System to cover additional money for on-call clinics”. On the other hand, he noted that so far there is no action to limit the waiting time of patients in specific specialties.
Regarding OKYpY, he said that the public sector should be upgraded, to become competitive with the private sector. sector, but concluded that it has also been confirmed with the pandemic that the public sector is the backbone and concluded that he submitted proposals, in the hope that they will be evaluated correctly, in the direction of achieving financial and administrative independence of OKYPY.