Adonis Georgiadis: I will ask permission to allow private doctors to enter into a relationship with public hospitals

‘ Practical solutions to real problems” according to the minister, introduces the draft law “Public Health Actions – Arrangements to strengthen the National Health System”, discussed earlier today (01.04.2024) to the Committee on Social Affairs. During the analysis of the provisions laid down, the Minister of Health informed members of the parliamentary committee that before the completion of a legislative procedure, he would ask the House to take a mandate to enable, by ministerial decision, private doctors to establish a relationship with public hospitals. The specific report by Mr Georgiadis was made on the assumption that provisions on the terms and conditions for the private work of the physicians have already been included in the bill. The same bill has included an article on how doctors will be rewarded for afternoon surgeries conducted in public hospitals. “For afternoon surgeries the only criticism that could be based are the two speeds. Article 8 says that surgical specialists can earn extra income from afternoon surgery. Having all other specialties, which cannot do afternoon surgery, can do private work. ‘So we solve the imbalance in this way’ said the Minister of Health and informed the Committee on Social Affairs: “I will ask the House to take a mandate so that by ministerial decision I can also allow private doctors to enter into a relationship with public hospitals, provided they undertake service in the public hospital, mainly on call, and relieve those who have a permanent relationship with the NIS. It should be the other way around. To have full balance and justice throughout the medical area and to have a full and balanced relationship between the NIS and the rest of the medical world. That is what we will do and I believe that the House will give me the authorization to complete the reform and it will proceed properly and we will have more doctors in hospitals, more health services, more flexibility, better health services.” ‘Doctors in the ESA and in the private sector’ Adonis Georgiades, referring to the provision of private work by the doctors of the NSS and the corresponding provision introduced by the draft law of the Ministry of Health, urged opposition parties who react to it to study what is happening in the other European countries. As he pointed out in particular: European doctors employed in public hospitals are also allowed to work in the private sector, both in clinics and hospitals.” Mr Georgiades indicated that “Austria and Ireland are allowed public doctors to provide private work. 60% of public doctors in the United Kingdom also carry out private work with a limit on income. Higher limits on income may have public doctors performing private work in France. In Finland doctors in the public sector provide most private sector services to private clinics, and simultaneous work between private and public sectors is quite frequent. In Sweden and Norway the work of the doctors of the NIS in the private sector is absolutely permitted. In southern countries such as Portugal parallel employment has been allowed for 10 to 15 years and over 70% of doctors have at the same time private work with public work.” For afternoon surgery But also for afternoon surgeries, which also receive great criticism from the opposition, the Minister of Health said that since the publication of the Joint Ministerial Decision, about 20 days ago, those who said that there was no staff to become afternoon surgeries, and while some moved “rebellion trumpets”, hospitals in which afternoon surgery was done amounted to 100 in a total of 125 hospitals. “Do you think I do surgery? Do I do surgery or do doctors do surgery? Do I participate in surgery or do the nurses participate in the surgical teams that do surgery? Me or the anesthesiologists are in these surgeries?” said Adonis Georgiades and added: “Are all doctors doing afternoon surgeries traditional? Come out and tell them! To be recorded knowing what everyone thinks.” In this spirit, the Health Minister stressed that reform succeeds, as did reform for afternoon clinics. “You people committed. I want them free. Since earlier, I would point out that, because these are mandated provisions for the exercise of private work, very strict terms and conditions will be respected, as is the case for afternoon surgery,” said Mr Georgiadis and added: “PASOK had introduced the private work in the NSO with afternoon clinics. Operation of afternoon hospitals with payment. In the total of the year 2023, 687,000 appointments were held in the NSS hospitals in afternoon hospitals. For these 687,000 appointments, doctors were paid and some fellow citizens paid us. If your problem is supposed to be the infection of the NSS, from the payment of private money, you are PASOK. You made the law. Evening clinics greatly reduced waiting in morning hospitals, a lot of people were helped to find a date. The average waiting time, before the reform of Alekos Papadopoulos for a date at the NIS for a clinic was 4 months. Today is a month’s average wait, for a doctor’s appointment in a NSH hospital.” ‘Pastaria in prevention’ The Deputy Minister of Health Irene Pavlidakis, referring to her provisions of competence, clarified that there is no cost of prescription to the “Spiros Doxiadis” programmes, the pre-symptomatic check, neither for insured persons nor for uninsured persons. Mrs.Agamidaki said that the program “Fofi Gennimata” has already given “fruits” and over 300,000 women have donated mammography and have been identified in time with symptoms of thousands of women. He also pointed out that the CYA has already been issued which stipulates that the pre-symptomatic screening to prevent cervical cancer will be carried out. “Our goal is to make a pandemic for prevention. Cancer, cardiovasculars, deaths that could have been avoided, are not about parties and it is something that we could have had a broad alliance,” Irini Pavlidakis said. The parties At the committee meeting, last week which was interrupted by the submission of the motion of censure, the ND rapporteur George Brittakos said the bill solves important issues. “The afternoon surgery which is a very important reform has already begun and which will improve the pace of surgery in the public health system,” said the ND rapporteur and referred to the expansion of the possibility for NIS doctors to carry out private work, using their clinical experience and the establishment of necessary conditions and conditions so as not to burden the public health system with this possibility. He also referred to the provision to determine the nature of the income of the physicians of the NRA from the conduct of afternoon surgeries, as income from a private project exercise. “There are issues of adapting Greek legislation to the good practices of European countries, through the opening of the access of doctors of the NSO to the private sector and respectively to attracting private doctors to the National Health System,” said Mr.Brittakos, and added: “this is a reform, combined with afternoon surgeries, but also the increases we make in the income of doctors of the NSO, slowly but firmly, will make the Public Health System even more attractive, because we currently have notices made, but doctors do not come to apply.” In three main articles of the Health Ministry’s bill focuses much of the opposition’s criticism: -Article 7, which refers to the terms and conditions of the private work of the physicians of the NSOs -Article 12, which refers to the fees of the physicians of the NSOs and university doctors from the conduct of surgical interventions or other interventions requiring the stay in hospitals, in addition to the day-to-day operation of hospitals -Article 25 on the execution of diagnostic examinations in contracted diagnostic centres and clinicians. “We see the fourth health bill coming, but no major reform is seen for the benefit of the people,” said SYRIZA’s rapporteur Andreas Panagopoulos and reported that “there are no arrangements to strengthen the National Health System. On the contrary, regulations are introduced that weaken the National Health System and burden the Greek people further.” In this spirit, the SYRIZA rapporteur warned: “As in all other policy areas, so in health the ‘newright’ New Republic of K. Mitsotakis imposes a direct payment culture. You want to be healthy? You will also pay this despite excessive taxation, but also the highest insurance contributions paid every month by the citizens of the country. The Government shall legislate on the basis of the service of its own health, to the detriment of households and their financial situation. It consolidates, a direct payment culture in the highly sensitive area of health, which is addressed to the owners and holders.” “Do you consider it a normality for the patients of the NSS to pay from both pockets of their pants and through insurance contributions, but also from direct to the doctor in surgery or pharmaceutical expenditure, as a dominant measure to deal with health?” said PASOK’s special speaker John Chimaris and added, addressing the government: “You propose a hybrid system, with the involvement of the private sector in a dominant role. So you have a duty to the citizens of the country, to inform them, on the basis of which study the National Health System will be transformed and what will change in citizens’ accessibility.” At today’s meeting, a special speaker of KKE George Lambroulis said that the content and direction of the bill are in full dimension with its title, namely, in dimension with the “enforcement of the NIS”, in light of the needs of both patients and doctors and nurses. They are introduced as anti-laika measures and concern further strengthening business activity, with a decisive measure of all kinds of private business work by doctors of public health units. “These are measures that complement the image of a prominent public health system,” said the KKE’s special speaker and warned that an increasing NSO’s work would depend on the immediate payment of patients. The special speaker of the Greek Solution Maria Athanasiou said that the government is proving, in every way, that it is not interested in providing public health services, but only seeks, by methodical actions, the systematic degradation of the public health sector, replacing it with the private sector and pushing citizens to private individuals. New Left special speaker Ozkiur Ferhat accused the government of an idealist obsession for less state and more health market. He spoke of a solvent situation in the NSS and pointed out that instead of the government investing in its support and staffing, he legislates on the terms and conditions of private work of the NSO physicians, “that is to say, he strikes directly at the heart of the NRA, after abolishing the structural element of the NSO, which is the full and exclusive employment of the NSO doctors”. The special speaker of the “Spartians ” Michalis Gavgiotakis said that with the bill all the philosophy of the NSY changes and inequalities are created with final recipients of the patients themselves. It leads, as he said, to full degradation of the health services provided and further strengthening the commercialisation of public health. The special speaker of “Niki” Nikos Papadopoulos accused the government that while in one night, he increased the salaries of ministers and deputy ministers and administrators of the organizations, he gave the doctor who makes 24 hours 20 euros. The special speaker of “Victory” described the bill as “stretched” and said his party would vote against it. The Special Speaker of the Freedom Freedom Georgia Kefa accused the government of refusing to support the NIS effectively, that it does not give a solution to the underscoring of public hospitals, does not provide solutions to the shortages of specialties. “The bill will hardly give the same incentives to first-line doctors, with the countless on-calls, to large hospitals,” said Mrs.Kefala and stressed that the obligations and rights of doctors should be more specifically recorded, and their maximum and minimum number of overtime. Mainly the bill imposes other expenses by which the patients will be burdened, said the special speaker of the Freedom Sea. According to the Ministry of Health bill, provisions have been included that: – The age group of the beneficiaries is expanded, by the public health action “Preventive diagnostic tests against cancer” including beneficiaries from forty-five (45) to seventy-four (74) years old, instead of 50 to 69 years old today. – It is planned, within the framework of the National Prevention Programme “SYROS DOXIADIS”, to implement the following new actions: Provision is made for the participation of Mobile Units of Primary Health Care for the effective implementation of public health programmes in prevention actions under the aforementioned programme. – the terms and conditions of private work of the NSO physicians serving in NSO hospitals are re-established. Among other things, it is stipulated that such doctors may, at a time other than their regular working hours and on-calls, upon authorisation, carry out private work, provided that they undertake their insurance and tax obligations. The current time limit for the exercise of this project (up to twice a week) is also abolished. – They are included in the income deemed to come from a private project exercise and are taxed in accordance with the prescribed legislation, the fees of doctors of the N.S.A. and university doctors from the conduct of surgical interventions or other interventions requiring a stay at the hospital beyond daily hospital. – It is possible to prescribe medicines, therapeutic acts and diagnostic tests to uninsured and vulnerable social groups by the personal physicians. – The beneficiaries of E.O.P. care I.A. pay from 1.4.2024 to the contracted private diagnostic centres and clinical laboratory physicians EUR 1 per referral for the execution of diagnostic examinations of biological materials and EUR 3 per referral for the execution of imaging checks.