Our View: Delaying the national health scheme may be for the best

ALMOST every week we read newspaper reports about operational problems at state hospitals. Operations cancelled because the hospital ran out of consumables, patients sent away because hospital equipment was in a state of disrepair, specific drugs in short supply, opening of new departments constantly being put off: the list of problems is endless. 
Then there are the investigations into dubious dealings. There was an investigation into the purchase of medicine by the Pharmaceutical Services, a few years ago, while currently an investigation is being conducted into the grossly inflated price agreed for expensive equipment for Limassol General Hospital.
A couple of months ago, it was reported that the health ministry was concerned about the soaring cost of sending patients abroad for treatment, particularly to Israel, and decided to appoint an official to deal directly with hospitals there rather than use local representatives. Amounts being spent on drugs by the state, meanwhile, tripled in the last 10 years from €30 million in 2000 to €100 million currently. It is a steep rise even if we factor in inflation and the increase in people eligible for free healthcare.
The general picture of state healthcare is not very encouraging, marked by poor organisation, extortionate costs, corruption and waste. It could be argued that this is inevitable in an organisation on such a massive scale, which employs thousands of people, deals with hundreds of suppliers, serves thousands of people every week and administers equipment worth tens of millions of euros. Even if its administration was in the hands of professional managers, there would be problems, but given that it is run by civil servants and doctors, with limited managerial expertise, it is a small wonder that it works relatively well – despite the waste and inefficient use of resources.
It is these endemic problems which made the late Tassos Papadopoulos less than enthusiastic about the introduction of the National Health Scheme which has been on the drawing board for close to 20 years. He feared that such a big enterprise would prove extremely costly, even though the public and businesses would make monthly contributions, because its sheer size and broad scope of its operations would make it almost impossible to manage effectively and efficiently.
These were well-placed fears, especially after the construction of the Nicosia General Hospital which went tens of millions over budget. What are the chances of an infinitely more complex and much more costly project not ending up a continuous drain on resources, a bottomless pit absorbing increasing amounts of the taxpayer’s money? Concerned about this risk, the legislator included a peculiar safeguard in the law governing the National Health Scheme – the administrative cost could not exceed five per cent of the annual budget. By arbitrarily limiting the administrative cost, could there not be less control of expenses?
It may be too soon to worry about such considerations as the introduction of the Health Scheme is not imminent. Although it was announced that it would be ready in the second half of 2011, the health ministry permanent secretary recently told the House that it could not be introduced before 2012. This was down to delays in the tenders’ procedure for the computerisation of the Organisation of Health Insurance, which would be administering all the finances of the Health Scheme.
Perversely, the delays are no bad thing. It is better for every detail to be taken care of and all identifiable weaknesses addressed, than to rush the introduction and spend years sorting out problems that are bound to arise because the preparatory work was inadequate. The work of Organisation of Health Insurance is not being help by the Health Ministry’s failure or unwillingness to proceed with the drafting of the legal framework that would make state hospitals independent entities, an essential pre-requisite for the introduction of the scheme. So far, nothing has been done by the ministry, which raises serious questions about its competences and ability to prepare the necessary legislation.
This is the same ministry which has presided over the successive blunders mentioned above, including the Nicosia General Hospital fiasco. Perhaps the less the ministry is given to do the better would be the chances of success of the National Health Scheme, when it is finally introduced.

The Cyprus Mail is the only English-language daily newspaper published in Cyprus. It was established in 1945 and today, with its popular and widely-read website, the Cyprus Mail is among the most trusted news sites in Cyprus. The newspaper is not affiliated with any political parties and has always striven to maintain its independence. Over the past 70-plus years, the Cyprus Mail, with a small dedicated team, has covered momentous events in Cyprus’ modern history, chronicling the last gasps of British colonial rule, Cyprus’ truncated independence, the coup and Turkish invasion, and the decades of negotiations to stitch the divided island back together, plus a myriad of scandals, murders, and human interests stories that capture the island and its -people. Observers describe it as politically conservative.