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Victoria Mindova

The entire healthcare system was turned upside down after the government announced that it will further reduce the income of doctors and healthcare staff in public hospitals. They have been protesting since the beginning of last week against job cuts in hospitals, wage reductions and the changes in their retirement plans. Most of their claims coincide with the general dissatisfaction of employees in the public sector, where trends are for the reduction of a great part of the costs without having taken any real steps in that direction.

Doctors in private clinics also went on strike earlier this week and for the present their offices remain closed to patients on Monday and Tuesday. As a result, if a citizen of the Greek capital needs urgent examination he will have to either wait for hours at the emergency rooms in the public hospitals to be examined by emergency doctors, only a few of whom are working or wait until Wednesday, when the strike of the private doctors will eventually finish. GRReporter contacted the President of the Athens Medical Association George Patoulis in order for him to explain to us why private physicians strike and what their requests are for the Ministry of Healthcare and health insurance.

What are the main problems you encounter in your practice and why did you decide to start active strikes?

The strikes now refer to private occupational physicians, physicians, serving patients of the largest Health Insurance fund in Greece IKA and doctors in the hospitals. The reason for the active protest of our union is that the government undertook the reform of the healthcare system in a mediocre way that lead to chaos and currently nobody knows which patient belongs to which health insurance fund or what doctor to visit in order to take advantage of his health insurance rights.

The merging of the various health insurance funds was not followed by the issue of a reference book saying who are the patients of which private physician and thus real chaos occurred. How can we see patients who are entitled to a free examination, if we do not know whether they are insured within the funds that we work with?

What should be done in this case?

Still citizens do not have an updated reference list of doctors who can provide them with a free examination or send them to a specialist. There must be precise instructions about the operation scheme and the obligations of each party in order for the health insurance system to be able to function properly. Therefore we want the government to freeze for at least two months the establishment of the National Organization for the provision of healthcare services. It should replace the existing system. The currently operating social security funds should be given time to get to an understanding on how they will allocate between each other the insured citizens and then inform them about which private doctors will be at their disposal.

A reform programme should be created that would have a beginning, middle and an end, and through which the desired result will be achieved. Currently we are living and working in a strange situation, in which nobody knows what he’s doing, what he should do, what obligations he has and what he is entitled to.

Does this mean that you have situations when you need to serve patients and make free examinations without knowing whether you will receive your money from the state funds?

This is exactly what happens. There is no list of doctors, as it was before, from which citizens can choose a physician of a particular specialty, working with certain health insurance funds. Currently there is a telephone number in operation where you can get information about which doctor works with which fund in a given area. There is also a website with some data, but can you imagine how an old retired lady can work with new technologies to find the doctor she is searching for.

Do you have any feedback from the Ministry of Healthcare about what it intends to do from now on?

We are in constant contact with the Ministry not only regarding the above issues. The state owes the private doctors about 350 million euro. The amount has been accumulated for about two years for services rendered not covered by the insurance system and this concerns over 15,000 physicians practicing in private clinics. We are currently expecting a date to be scheduled for a meeting with the Deputy Minister of Finance Filipos Sahinidis, with whom we will discuss how we this debt can be covered.

Why has nothing been done for the clearing of this debt?

Because every time we discuss this problem with the government obligations are being partly paid, but then payments are delayed or suspended again and the debt grows.

The government of PASOK introduced also some other reforms, which are assessed as positive. For example, the introduction of an electronic system for issuing prescriptions. Do you think this was a positive step?

Yes, I believe that there should be proper control and management of the resources and making some processes electronic helps to this end. It takes time of course, to be fully implemented and it must be well secured so there are no cases of leakage of personal data.

What other measures do you think can be applied so as to improve the public healthcare system?

There is still much to be done for the better functioning of the healthcare, but the introduction of measures should preserve and improve the level of services in Greece, which should in turn correspond to the average European level. Proper control can send some doctors outside the healthcare system, but those who remain in the system should be able to live and work in dignity. The key measures which we insist on is for the state to pay what it owes the private physicians in the country and provide us with an average income which will allow us to live with dignity.

The German model with the civil card, which contains detailed information for each socially and health insured person is a good example that could be applied in Greece. With this card each patient has a specific number of visits to various specialists and every person has the responsibility for its use. Using the card an immediate control can be performed for both the insured person and the activities of the physician. In order to do that, however the entire process must be electronic, and not just some stages of it. Also insurance funds must be connected to doctor's offices and pharmacies.

How long do you intend to continue the strike actions?

We, at the Athens Medical Association, will meet on Tuesday, 10^th January in the evening to make a decision on whether to continue or discontinue the strike actions.