Policy context and impetus for the reform
Since 2017, Greece has been working to strengthen primary care through expanding the national network of local health units (TOMYs) and health centres. In tandem, and as part of the wider aim to increase access to publicly reimbursed community-level primary, preventative and health promotion services, the role of the “personal doctor” was introduced in May 2022 (Law 4931/2022). The “personal doctor” is designed to be the first point of contact within the health system, to guide their patients through the National Health System and to provide a gateway to health services.
The 2022 law stipulated that the personal physician was to be selected by individuals, and the choice could be made either with doctors who served in public primary health care facilities, or with private doctors contracted with the National Organization for the Provision of Health Services (EOPYY), the purchaser of publicly funded health services. Although the initial law underwent various amendments during the following two years, the new system never became fully operational since the number of doctors in public facilities was not sufficient to cover the needs of the population and private doctors appeared less interested and unwilling to sign contracts with EOPYY.
Consequently, on 15 November 2024, the government passed new legislation (Law 5157/2024) bringing in reforms with the aim of expanding the pool of personal doctors and to generally upgrade this function.
Content of the reform
The new law introduces the following provisions:
- The pool of personal doctors is expanded to include rural doctors and private general practitioners or internists. More specifically, the rural doctor service, commonly known as the “agrotiko,” is abolished, and these positions become mandatory personal doctor roles. New doctors will be required to provide personal doctor services to the local population they cover. In relation to private doctors, until now, personal doctor were chosen from specific categories of doctors, either contracted with EOPYY or designated as personal doctors within the publicly funded health system. Citizens are now allowed to choose a private doctor not contracted with EOPYY as their personal doctor, but they will pay for these services out of pocket. Furthermore, according to the new law, even doctors contracted with EOPYY as personal doctors have the right to offer additional personal doctor services privately, and are compensated directly by patients, serving up to 500 additional citizens.
- The function is extended to minors with the introduction of the “personal pediatrician”. Registration with a pediatric personal doctor for children under the age of 16 is optional.
- The registration system has changed. Registration with a personal physician remains mandatory for all adults. However, the disincentive framework that was previously in place and which imposed penalties on citizens for not registering with a personal doctor has been abolished. This framework had not been implemented due to the insufficient number of doctors available for the entire population. Instead, the new legislation provides for citizens who do not voluntarily register with a personal doctor by 1 June 2025 to be automatically enrolled by the electronic system of the e-Government Center for Social Security (IDIKA).
- Financial incentives are provided for young doctors who decide to undergo training in general/family medicine and internal pathology, up to EUR 40 000 as a one-off grant. These newly qualified physicians will be required to serve as personal doctors within the primary care system.
In addition, as part of a bundle of other measures to strengthen access to primary care, the new law foresees the conversion of 8 health centres into university health centres, offering services like telemedicine, preventive medicine, and public health research, while also serving as training hubs for primary healthcare professionals. These university health centres will be affiliated with the designated university medical schools and staffed by faculty members.