SOME PROGRESS has been made with regard to the introduction of the National Health System. Last week, the Council of Ministers approved two pieces of legislation that gave an indication of how the system would be structured and organised. Whether the state services would be able to implement these changes, which would create a completely new health system, is anyone’s guess.
This is a massive undertaking that would require a type of complex planning and organisation that is unheard of in Cyprus. Unless the government hires teams of foreign consultants to do the job, there is no way it would be completed by civil servants by next year’s deadline for the implementation of the first phase, or the year after that. It is naive to think the state services that completed the Nicosia General Hospital – three years after the original deadline and grossly over-budget – could set up a completely new health system that requires detailed study and meticulous planning, within a year.
But such considerations did not dampen the optimism of health minister Philippos Patsalis when announcing what had to be done. The six main hospitals would become independent and self-sufficient organisations run by a board of directors controlled by the government as well as an assortment of committees, he said. Each hospital organisation would manage its revenue and expenses, submitting the annual budget to the government for approval. Deficits in the first three years would be covered by the state. For this to happen, the health ministry would have to carry out a major costing exercise of all hospitals, establish operating costs, evaluate assets, make investment forecasts and a hundred other things.
And to make matters worse, if the new hospitals hire staff from the old hospitals, they would guarantee them the same wages and benefits they enjoyed as public employees. In short, the autonomous new hospitals would be burdened with crippling labour costs from the first day of their operation, because it is unlikely they would be allowed to hire new staff.
Even worse was the minister’s decision to put the administration of the system under the health ministry. The independent Health Insurance Organisation that would have been administering most aspects of the system, including finances, will lose all its powers which would be transferred to the health ministry. These are the same health ministry employees who did such a great job managing drug prices that people ended up paying much higher prices than they should have.
Patsalis’ faith in the ability of health ministry technocrats to plan and introduce a functioning national health system within is a year is admirable, even though it could only be described as a fantasy.
