**Title: Gesy Personal Doctor System Faces Scrutiny in Parliament**
The national health scheme of Cyprus, known as Gesy, is currently under scrutiny as members of parliament (MPs) examine its effectiveness, particularly concerning the system of personal doctors. On Thursday, the House health committee convened to discuss various concerns, including the payment structure for personal doctors, the introduction of new quality criteria, and the maximum number of patients each doctor can register.
One of the primary issues raised during the session was the staggering number of patients assigned to individual doctors, with reports indicating that some personal doctors are responsible for patient lists of up to 2,500 individuals. This situation has prompted significant concern among lawmakers regarding the quality of care that can be provided under such circumstances. Disy MP and acting committee chairman Charalambos Pazaros expressed his intention to propose legislation to cap the number of patients a personal doctor can register, stating, “No one can deal with 2,500 patients.”
The Health Insurance Organisation (HIO) representative, Petros Neophytou, acknowledged the challenges within the system, noting that the remuneration model for personal doctors is set to change in 2027. The current payment structure, which allocates 80% of remuneration based on patient registration and 20% based on performance, will shift to a 70-30 model, increasing the emphasis on performance-based pay. Neophytou also mentioned that the HIO is planning to introduce new quality criteria and reassess performance indicators to enhance the quality of primary care.
Concerns were also raised about the qualifications and training of personal doctors within the Gesy framework. Andreas Ioannou, a representative from the Pancyprian Medical Association, highlighted the disparity in training among personal doctors, stating, “Not all doctors have the same knowledge, but they are called upon to do the same job.” Currently, Gesy comprises 640 personal doctors, which includes 150 specialists, 150 general practitioners, and 80 doctors from other specialties. Ioannou pointed out that approximately 170 doctors are managing patient lists of around 2,500 each, raising questions about the adequacy of care provided.
The role of personal doctors as the first point of contact in the healthcare system was emphasized by various stakeholders during the committee meeting. The patients’ association Osak underscored the importance of personal doctors in the success of Gesy, advocating for an upgrade of the institution to foster genuine relationships between doctors and patients, which could enhance preventive care. Similarly, Sotiris Koumas, president of Pasiki, described personal doctors as a cornerstone of the health system but warned that many are being pushed towards private practice, leading to a depletion of staff in public hospitals and emergency departments.
The discussions took place in the context of a recent World Health Organisation (WHO) study on Gesy, commissioned by the HIO. A representative from the health ministry informed MPs that the report did not find evidence of systemic abuse but did offer recommendations for improvements within the scheme. The finance ministry expressed its support for the WHO's suggestion to adopt a mixed remuneration model for personal doctors and to expand the system further.
As the debate continues, the future of the personal doctor system within Gesy remains a focal point for policymakers, healthcare professionals, and patients alike. The proposed changes aim to address the current challenges and enhance the quality of primary care, ensuring that personal doctors can effectively serve their patients while maintaining a manageable workload.