In 2024, Cyprus’s General Health System (GHS), Γενικό Σύστημα Υγείας (ΓεΣΥ), marked its fifth year of operation, providing universal healthcare coverage to all citizens based on residency. The system has achieved significant milestones, including expanding services, improving quality, and maintaining financial sustainability. An actuarial study by the International Labour Organization (ILO) projects that the GHS will remain financially viable until 2031, with reserves totalling approximately EUR 590 million as of 2023.
The GHS has made substantial strides in healthcare service accessibility, with over 90% of the population registered as beneficiaries. The system has expanded its service offerings, improved care quality through performance-based remuneration, and implemented advanced IT solutions for better patient care. However, challenges remain, notably in areas such as waiting times, coverage of certain treatments, and the need for more specialized care. Below, we outline key achievements, ongoing improvements, and strategic recommendations to further enhance the system’s effectiveness.
Achievements and key statistics (June 2023–June 2024)
- Registered beneficiaries: 969 722 (over 90% of the population)
- Utilization of services:
- 807 331 visits to Personal Doctors
- 637 536 visits to Special Doctors
- 319 259 visits to Radiology/Diagnostic Centers
- 501 035 laboratory examinations
- 318 990 dental visits
- 698 650 prescriptions filled
- 83 166 surgeries performed
- New services and providers added: Four new hospitals, two accident and emergency departments, two daycare centres, homecare, and palliative care providers.
- Expansion of coverage: New treatments, speech therapy, clinical dietetics, podiatry, and dialysis centres are being incorporated into the system.
Key actions for quality improvement
The Health Insurance Organisation (HIO), the body responsible for managing the GHS Fund, has undertaken a series of actions to enhance service quality and sustainability, including:
- Performance-based remuneration: Health service providers are now remunerated based on quality criteria and performance indicators.
- Clinical guidelines implementation: Collaboration with the Pancyprian Medical Association and NICE to ensure the adoption of evidence-based practices.
- Chronic patient registries: Specific patient categories, such as those with cancer, diabetes, and thalassemia, have direct access to GHS services.
- Referral categorization: The introduction of routine and emergency referral systems aims to reduce waiting times for specialist consultations.
- IT system upgrades: Beneficiaries now receive notifications about preventive care and follow-up visits via SMS, improving health management and patient engagement.
Research conducted in April 2024 found a high satisfaction rate among beneficiaries, with 92% of participants indicating an improvement in the quality of services since the GHS’s implementation. Key benefits highlighted by beneficiaries included reduced access costs (62%), increased choice of providers (32%), improved service quality (21%), and reduced waiting times (19%).
Challenges and areas for improvement
Despite its successes, GHS faces challenges that need to be addressed to enhance its sustainability and quality further:
- Waiting times: 32% of beneficiaries reported waiting times for doctor visits or surgery as the most significant weakness of the system.
- Coverage gaps: 24% highlighted the lack of coverage for specific tests and treatments, and 23% pointed to the need for referrals from personal doctors to special doctors.
- Specialist shortages: 11% of beneficiaries expressed dissatisfaction with the availability of specialists in certain medical fields.
Recommendations for the future
To build on the GHS’s successes and address its challenges, the following strategic actions are recommended:
- Enhance provider accountability and performance monitoring:
- Extend qualitative criteria and performance indicators (KPIs) linked to provider compensation.
- Reinforce on-the-spot checks to monitor and ensure adherence to quality standards.
- Invest in advanced data analytics and AI:
- Upgrade systems for data analytics and implement artificial intelligence tools to inform decision-making and policy development, ensuring the efficient allocation of resources and service optimization.
- Implement clinical decision support systems:
- Integrate clinical decision support software to improve referral processes, particularly for radiological examinations, following European Radiological Society guidelines.
- Expand rehabilitation and specialized services:
- Expand access to rehabilitation services, particularly for respiratory diseases, and ensure the continued development of specialized care in underserved areas.
- Address gaps in coverage:
- Work toward filling existing gaps in coverage for specific tests, treatments, and pharmaceutical needs, ensuring comprehensive care for all beneficiaries.
- Reduce waiting times:
- Continue the categorization of referrals into routine and emergency categories and implement measures to improve efficiency in specialist consultations and surgeries.
- Public awareness and education:
- Launch large-scale informational campaigns to educate beneficiaries and providers on responsible use of the GHS services, their rights and obligations, and preventive healthcare measures.