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Anastasia Balezdrova

The health reform in Greece is something that is talked much about but little is done for. This was the general conclusion of the discussion, organised by the Hellenic Foundation for European and Foreign Policy ELIAMEP, entitled "The National Health Service needs to change, not to be abolished."

According to Stefanos Geroulanos, Professor of Surgery and History of Medicine, "the health care system suffers from a lack of political will and financial resources, as well as a lack of perspective, coordination, good specialists, hydrocephalus and excessive aging."

Non-partisan management

The fact that hospitals and health services are managed by people who have nothing to do with health care is one of the most serious problems of the health system, according to all participants in the discussion. The result of this is a system of corruption, which has gradually increased health care costs on a great scale "without, however, affecting the quality of services or the improvement of public access to them," said Kyriakos Souliotis, Professor of Health Policy at the University of Peloponnese.

"Various interests are an obstacle for any attempt to implement a reform. Largely, decisions are based on party interests and in favour of the political dispute. It is necessary to establish objective criteria at all levels of the system," said Elias Mossialos, Professor of Health Policy at the London School of Economics.

He focused on key issues, which include:

An excessively large number of doctors

According to the expert, the health system employs too many doctors. He suggested that this number be reduced proportionally with the reduction in the number of students in medical faculties. "We will also have to gradually eliminate hospital staff's clerical way of working, provide incentives for doctors specialising in specific areas and reduce the number of post-graduate students in traditional medical fields."

Merging of hospitals

A lot of the recently held doctors' protests were related to the closure of polyclinics, which was largely imposed by the limitation of government subsidies for healthcare. This also necessitated the merger of hospitals, which was not well received by doctors and hospital staff, either. "We have to realise that the maintenance of such polyclinics, which do not service enough patients, are heavy burden on the health budget. The system's overhaul is imperative even without the difficulties resulting from the crisis," said Kyriakos Souliotis. "Instead of creating new polyclinics, isn't it more rational to cooperate with private medical centres that already exist?," he added and emphasised on the need for cooperation between the public and private sectors.

Souliotis warned that, in the first half of 2012, the National Health Insurance Fund EOPII's revenue deficit exceeded the amount of 700 million euro. "The trouble is primarily in the reduction of health care contributions because of the recession. As a result, the provision of primary health services also decreased, and this is something that should worry us. At the same time, government spending on health care amounts to 1,100 euro per person. We need to remove the obstacles. Otherwise the system cannot survive."

The professor presented the results of a recent study, according to which the Greeks realise that private medical services are more advanced, but nevertheless trust the national health system, especially when it comes to serious and chronic diseases.

"Because of the delay in appointments of a day for examination, 42.5% of people prefer to go to a private doctor. Only 13.8% said that they seek medical care from public clinics and hospitals. The most disturbing thing is, however, that 50% have stopped their visits to the doctor at all," he noted. According to him, currently, entire categories of patients with severe chronic diseases, such as cancer patients, remain without any help in the intervals between their therapy.

The demographic problem requires urgent measures

The participants in the discussion stressed that an overhaul of the health care system is essential, bearing in mind the negative population growth rate. "The extension of life expectancy raises the need for professionals who can respond to chronic diseases.

Medicines

According to Constantinos Evripides, CEO of GENESIS Pharma S.A., the measures implemented over the last two years for the reduction of costs, via transferring drug prices to producers, pharmacists and patients, were only piecemeal and have not solved the problem. His suggested that prices be calculated on the basis of the three lowest prices in the European Union, as well as the introduction of a modern and transparent health system that will operate on the principle of return and in benefit of citizens.