After decades of deliberations and animosity Cyprus has its NHS.
In the first week, the General Healthcare System stumbled on logistics. The GHS however constitutes a daring political reform that re-draws the map of healthcare provision in Cyprus and exemplifies a process of policy making not seen before on the island.
While the jury is still out on the determination of stakeholders to do the right thing for the country, it should be voiced clearly that the implementation of the GHS connects the dots between political vision and policy making.
For many observers it is distinctly memorable that in 2012 the Christofias government was announcing that by the end of the year the GHS will be implemented. The project eventually did not move forward because of ‘’resistance by organized groups’’. Stranger things have happened on this island but what we are witnessing is a conservative government focused on fiscal consolidation bringing to life a universal healthcare system.
When it comes to policy making, politicians should be judged based on the results of their actions not their intentions. Righteousness in politics is not a measure of success.
Any system that involves redistribution of resources to meet demand for fundamental public services is bound to face resistance by those clinging to comfortable past practices.
The GHS as it was envisioned has the potential to decentralise medical care thereby making the system more efficient. It has in-built effectiveness mechanisms as patients can choose their general practitioner, whereby deficiencies in their capacity to perform their duties will be statistically revealed. Importantly the new institutions set up to run the GHS are more nimble and responsive than the old guard that used to run the Ministry of Health.
The reality is that public healthcare expenditure in Cyprus rose to 7% of the island’s economic output, even though at the same time the private sector grew exponentially, pointing to the ineffectiveness of public healthcare provision as it was administered by public hospitals.
While it is necessary to intensify reforms such as granting public hospitals further autonomy, this relies in the belief that hospitals are perceived as common pool resource institutions, a sector that needs active management.
Service provision in hospitals should be tied to incentives and safeguards not the conscientious nature of the medical staff.
In terms of accountability, the budgetary decisions taken by the board of the Health Insurance Organization should be closely monitored to ensure that investments are made to meet demand and guarantee the financial viability of the system.