articles | 19 May 2014

NHS deal clinched with the troika

Health Minister Philippos Patsalis recently announced a final agreement with the troika on the basic principles of the National Health Scheme (NHS).

Speaking at a news conference, a visibly pleased Patsalis said the agreement would be incorporated in the revised memorandum – the troika’s list of structural reforms Cyprus has to meet in exchange for a €10-billion rescue loan.

The announcement came after the last of back-to-back meetings Patsalis has been holding with troika delegates since May 6, when the mission of international lenders commenced its fourth review of the country’s adjustment programme, and marked the “completion of the ministry’s negotiations with the troika.”

“Throughout the negotiations we have held a very assertive stance, with a focus on the viability of the healthcare system and securing the desired quality of healthcare services provided to all Cyprus citizens,” Patsalis said.

The basic principles of the planned healthcare system include comprehensive coverage for all citizens, socially fair cost allocation that supports vulnerable groups, the free choice of doctor and healthcare facility for citizens, and the financial viability of the system.

As agreed with the troika in an earlier review of the adjustment programme, full implementation of the NHS was pushed back to mid-2016 after gradual implementation begins in mid-2015.

“We have managed to convince the troika to implement the NHS in three steps: the first stage, starting on July 1, 2015, will include primary healthcare services – visits to personal doctors and paediatricians; the second stage, starting on January 1, 2016, will cover out-of-hospital healthcare – including all visits to specialty doctors and medication; and the third stage, on July 1, 2016, will see all aspects of the NHS implemented,” Patsalis explained.

The new healthcare system will be funded by contributions based on income, with employees paying around 2.1% of their total income, employers contributing a slightly higher rate of 2.2%, and the government contributing 4.5%.

The new plan envisages a single-insurer arrangement – the governmental Health Insurance Organisation (HIO) – but opens the window for its transformation into a multi-insurer system, which would allow private insurance companies to compete with the HIO in the health insurance market.

“The plan is based on the provision of insurance by a state insurance organisation, but will allow for the consideration of an ‘open’ insurance system, which will allow for the participation of more than one insurance company, provided this is to the benefit of patients and citizens,” Patsalis said.

Further issues agreed during the negotiations were the autonomy and reorganisation of public healthcare facilities, as well as the restructuring of the health ministry’s functions.

“The basic aim of these reforms is the modernisation of healthcare facilities’ operation so that they can compete under the NHS,” Patsalis said. “This includes changes to hospitals’ administration and structures, with a view to self-sustainability.”

According to Patsalis, actions to achieve the self-sustainability of healthcare facilities will begin immediately and are forecast to require additional monitoring and review for two years following full implementation of the NHS.

In conclusion, the health minister said that a detailed action plan – including a roadmap for implementation – will be ready for approval by the Council of Ministers by June, while relevant legislation must be voted by year end.

Source: Cyprus Mail

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