NHS aims to eliminate two-tier care at hospitals

Phased implementation will begin in June 2019 and completed in 2020

The National Health Scheme (NHS) will come in two phases, starting with outpatient services in June 2019 and the autonomy of state hospitals a year later, according to the Health Insurance Organisation (HIO), the independent body supervising the transition and tasked with finding common ground among the public and private health sectors.

HIO chairman Thomas Antoniou said the basic aim of the NHS is to drastically reduce waiting times at state hospitals, while the system will not be able to accept ‘fast track’ services when waiting for a specialist physician or an operation.

“We cannot deny any patient equal access in the new system, which is why the same doctor, whether private or in state hospitals, will see their patients as they register and not by any other priority,” Antoniou said.

“Of course, those with private medical insurance policies may upgrade the services or rooms at hospitals, or even opt to visit the doctor in question privately. Insurance companies will continue to sell private health plans,” he added.

The NHS is expected to have benefits as well as shortcomings when it is fully implemented, as health sector spending, estimated to be valued at EUR 1.2 bln will see some major upheavals.

The biggest stumbling block in i mplementing the system could be the ongoing discussions with the Cyprus Medical Association (CMA), many members of which are hesitant to accept the NHS plan, as they fear they will see a reduction in income.

Workload is another concern as 800 state doctors claim they are overburdened as they care for 75% of the population, while the private sector employs 2,270 physicians.

“The (private sector) doctors will be earning about EUR 100,000 to EUR 150,000 a year, depending on the maximum 3,000 patients each will register, with visits to the designated general practitioner (GP) being free of charge,” Antoniou explained.

Discussions are yet to determine the NHS fee each doctor will receive from the state per visit, but admittedly it will fall below the current tariff that ranges from EUR 40 to EUR 80.

Patients will be able to choose their own GP and must do so once the NHS register goes online, which should be some time in November this year. Once registered, a GP can refer their patient to a specialist if needed, the only exceptions being paediatricians for infants and gynaecologists for women aged over 15. In these cases, patients will be able to visit their specialist directly.

Antoniou added that “all citizens and permanent residents of the Republic are entitled to free care under the NHS, regardless if they have a declared income.” In the case of Turkish Cypriots who are not resident in the Republic, they will have to pay the going rate for visits, referrals and interventions. Contributions will start from 1.70% on salaried income, starting March 2019, rising to 2.65% in March 2020, with employers contributing a further 1.85% and 2.90%, respectively. The state will also contribute 1.65% and 4.00% in the name of all beneficiaries, including civil servants for whom the state is also the employer.