European Trade Union Institute, ETUI.

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29 June 2017

Cyprus: debate about health care reform finalised

Health care workers, NGOs and doctors that had asked the government this spring to take more time for the implementation of a national health system reform, now urge the parliament to speed up. Besides problems related to pay, the recruitment of new staff were on the agenda. The unions complained in the beginning about a lack of dialogue, but started later on an alliance with NGOs to support the planned reform.

The health system consists of a public and a private sector. Low-income workers, public sector workers and patients with chronic illnesses are eligible for public-sector care coverage. The government pays for public-sector health care while individual patients and private health insurers pay for private-sector health care. During a meeting in parliament of the health committee in mid-April 2017 it became apparent that a planned reform of the health system still needed more reflection. Several stakeholders expressed doubts about the proposals. In the following weeks the health ministry held talks with the most relevant actors. Soon after, an alliance of patients’ and consumers’ associations, together with the trade unions, launched an online signature campaign to raise as much support as possible for the implementation of the plans.

By mid-June 2017, the health committee of the parliament signed the Bills related to the national health scheme (Gesy), which passed the plenary meeting on 16 June 2017. One Bill creates the institutional and organisational framework for such a health scheme. A second Bill includes a reform of the healthcare sector, rendering state hospitals administratively and financially autonomous. In future, patients will be able to choose which doctor and which hospital to visit. The idea is to establish a public entity that will oversee hospital autonomy, with strict controls and monitoring for proper utilisation of the resources absorbed by Gesy. During the first phase of the scheme (as of 1 March 2019) workers and pensioners will pay a health levy of 1.7% of their wages, employers 1.85% and the state 1.65%. Self-employed will contribute with 2.55%. In a second phase, these contributions will increase respectively to 2.65%, 2.9%, 4.7% and 4%.

The reform is a consequence of a memorandum of understanding that Cyprus agreed in 2013 with creditors (from the European Commission, the European Central Bank and the International Monetary Fund). The memorandum called initially for the introduction of a national health system by mid-2016 to ‘strengthen the sustainability of the funding structure and the efficiency of public healthcare provision’ and to promote ‘free choice of (health-care) provider, social equality and solidarity, financial sustainability, and universal coverage of a minimum benefit basket’.

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