Overview

The health care system in Cyprus has been transformed by the new, comprehensive General Healthcare System (GeSY)

Cyprus introduced a comprehensive General Healthcare System (Geniko Systima Ygeias, GeSY) in June 2019, which now provides coverage for the entire population and free access to all beneficiaries. The new health care system is a mixture of a National Health Service and a Social Health Insurance scheme, funded by beneficiaries’ and employers’ contributions and the state budget. Providers come from both the public sector and the contracted private sector. Under GeSY the benefits package is comprehensive and includes a wide range of health services. Extension of coverage and increased availability of health providers under GeSY has seen household out-of-pocket spending decline substantially from 45% in 2018 (among the highest in the EU), to 18% in 2020 and 10% in 2021.

Cyprus has a physician-centred system but is taking steps to improve human resources for health planning

Cyprus has a relatively high number of doctors, but low number of nurses compared to the EU averages. Shortages are, however, recorded in the number of general practitioners (GPs) and the number of nursing professionals graduating from local universities has decreased substantially in the last 5 years. There are serious workforce imbalances between the public and pri­vate sectors, as doctors primarily work in the private sector and nurses in the public sector. These imbalances in distribution and availability are expected to decline with the ongo­ing development of the Capacity Master Plan (CMP). One pillar of this project is to strengthen Human Resources for Health (HRH) Planning, including the development of an HRH plan and workforce planning models to determine a future workforce that will meet expected demand.

The implementation of the GeSY has led to several changes in the organization and provision of primary care

Cyprus has a well-developed network of health facilities, facilitating good access to health care services. Under the GeSY, personal doctors are now the patient’s first point of contact with health services and have a gatekeeping role, with access to specialists only possible via referral. However, data show a relatively high rate of specialist referrals, posing financial and operational challenges. Patients can choose personal doctors from both the public and private sectors, with doctors receiving per capita remuneration based on the age group of registered beneficiaries. The introduction of personal doctors has contributed to a large reduction in unmet needs for medical care – from 1.4% in 2018 to 0.4% in 2020 and 0.1% in 2022.

Lack of data currently does not allow the assessment of quality and effectiveness of the new health care system in detail

Data on preventable and treatable mortality indicate good results for health outcomes in Cyprus and suggest that Cyprus provides a good level of health care overall. However, smoking, obesity (especially among children), dan­gerous driving and various unhealthy lifestyles remain risk factors that require further attention. Cyprus also lags behind other European countries on certain quality indicators such as health care-associated infections (HAIs) and antimicrobial resistance (AMR). Overall, the performance of the health system cannot yet be evaluated, as data on quality of care are currently not systematically collected.

There are a number of challenges to address to in order to improve quality and efficiency of care and the financial sustainability of GeSY

The GeSY faces some future challenges and areas for development including: the reorganization and reform of public hospitals that will lead to their administrative and financial autonomy; the implementation of university clinics in public hospitals; the introduction and use of e-health, including electronic health records, the regulation of data storage and use of bio information; the establishment and operation of the Capacity Master Plan for Health; the integration of quality and performance indicators in the compensation mechanisms of GeSY providers; and the introduction of medical and ther­apeutic protocols and guidelines to help improve qual­ity of services and the effectiveness of medical procedures.