Interview with Dr. Chrysanthos Athos Georgiou, Head of the Health Affairs Bureau of the Central Committee of AKEL and Surgeon at the Nicosia General Hospital
December 2020 edition of “Youth” the monthly newspaper of EDON
The health system in the midst of a pandemic
- Since last March, Cyprus has been confronting the coronavirus pandemic. Was the health system ready to deal with the pandemic? How would you assess the handling of the Government and Health Ministry during the first wave of the coronavirus in Cyprus?
CG: We view the issue from the perspective that the pandemic represents an unprecedented situation. I recall the statements made by European leaders and Cypriot politicians during the first wave that they must review their policies and that the public health system and public hospitals should be strengthened.
The Anastasiades Government, through its policy of underfunding and regressions, drove public hospitals to decline, shortages of staff, and instead of promoting modernisation, reorganisation and solving problems, it has accumulated new ones. The consequences of the actions, or rather inaction, of the Ministry of Health and the state health services OKYPY (the organization that undertook the task of promoting the autonomy of public hospitals) in the previous years, but also during the handling of the crisis, led to a chaotic situation and generated huge problems.
The planning that was made was inadequate, the preparation was non-existent and communication was derisory. Elementary items of personal protection didn’t exist and training was fragmented. The reference hospital was chosen according to criteria that only raise questions, while some beds for intensive care units were set up after lockdown ended. The issue of supplying hospitals was resolved one month after the first coronavirus case was confirmed. Paphos Hospital closed down, while the other hospitals were rendered ineffective and a large number of health workers fell ill to the coronavirus.
Despite the government’s celebrations for the successful management of the crisis, a sober analysis of the given situation leads to the safe conclusion that the government, realizing the critical condition of the health system and hospitals, proceeded to the LOCKDOWN, which in itself was an expression of the system’s inability to respond to the possibility of increased cases and an admission that we needed the time to prepare ourselves.
While we would like to view in an understanding manner the government’s approach, given that COVID-19 was something so new for the entire world and many countries pursued similar policies, what was not expected and comprehended was the shear complacency basking in the “laurels of success” of the management of the first wave of the pandemic.
- After the quarantine period, the number of coronavirus cases had fallen dramatically. Despite this, a few months later we are faced with the second wave of coronavirus in our country. What is responsible for this sharp increase in coronavirus cases?
CG: The increase in the number of cases is a logical development when normality was restored (after the first lockdown). By ending the lockdown of the first phase, the country’s exclusion from external factors was terminated as a result of which the number of cases increased. I would say that it was to a large extent to be expected. What was unexpected was the panic and contradictions in the government measures that were taken. This is precisely where the effectiveness of the measures implemented between the first and second wave is judged. Expediencies and considerations affected the management of the pandemic negatively and chaotic situations were created.
- Do you think that the Government and the Ministry of Health had shielded the health system properly during the period from the first to the second wave of the coronavirus?
CG: In a pandemic some mistakes or contradictions are natural. Besides, we do not face pandemics every day.
What is incomprehensible is the sloppiness shown and the failure to make use of the period from the 1st to the 2nd wave in order to prepare and shield society as much as possible. As AKEL in our effort to support society during the first wave, we didn’t proceed to exert criticism, but instead submitted proposals to confront the first wave and prepare for the second wave. Unfortunately, the Government and the Ministry of Health were complacent relying on the policy of issuing decrees.
As AKEL we had pointed out that “the state must get ready for another wave of the pandemic or a new epidemic”. We proposed a package of 18 measures such as the allocation of sufficient resources to the public health system, the speedy elaboration and completion of a comprehensive action plan, the recording of the needs in infrastructure, staffing, equipment, training for each possible scenario, the strengthening of Accident and Emergency Incidents Departments, the creation of Intensive Care Units in all hospitals and maintaining spaces/beds on standby. We proposed the utilisation of the military hospital to the General Hospital of Nicosia. We called for the speedy completion of the buildings in the Athalasa mental health hospital, the creation of an infectious disease ward, the expansion of public hospitals, the utilization of private hospitals and structures, the establishment of operating rooms and negative pressure wards in all hospitals, the creation of a rehabilitation centre where those discharged of the hospitals can be referred on the same fay, the creation of a Public Health and Infectious Diseases Laboratory and the prudent management of the staff.
We are asserting that the reference hospital must have all the available means, resources and staffing at its disposal, both to deal with the pandemic but also to serve all the health issues citizens of the district face. We urged the Ministry of Health to handle the concept of requisition as an instrument for cooperation and correct organization, while we also proposed collectivity in decision-making.
- How has the course of the National Health Scheme (NHS) been affected by this whole situation? What is AKEL’s opinion?
We are concerned if the policy being pursued on COVID and the extremely slow-moving implementation of the autonomy of hospitals will operate as a Trojan horse for the NHS, given that the operational planning – 3 years after the relevant bill was approved – is absent. There is no road map. The NHS has not been fully staffed.
As AKEL, we actively supported the reform of the NHS, with the demand however that this would be accompanied by appropriate actions on the part of the Ministry and the Government so that the public health system and hospitals will be supported effectively so that the success and viability of the NHS is ensured.
Unfortunately, very little was done to substantially upgrade the public health system, despite the fact that we asked the Ministry to submit a roadmap, with strict timetables, costed policies and actions to support it.
As AKEL isn’t characterized by a negative stand, we proposed measures such as he following: the formation of a team for the strategic planning of public hospitals with specific timetables, the improvement in the functionality/efficiency of OKYPY, the proper funding and increased annual state support for public hospitals so that the needs of public hospitals can be met, maintaining a readiness for all that will be demanded in response to a crisis situation, for services that will not join the NHS and remain in the Public Hospitals. Proper staffing, introduction of modern procedures for their operation, attractive employment packages, modernization and strengthening of equipment. Implementation of an overall educational policy, the complete computerization of hospitals and their services, the creation of new clinics – ICU in all hospitals, level I trauma centre, creation of an epidemiological surveillance unit and a laboratory to focus on public health and infectious diseases.
Public hospitals exist to ensure that the multi-injured patients will receive proper treatment, the seriously ill will be treated in organized ICU’s and difficult and rare cases will be subject to the best treatment in organized clinics. Public hospitals provide care to everyone, to the uninsured immigrant, to people from EU states, third country citizens, the disabled and mentally ill. Furthermore, public hospitals exist to deal with mass disasters and epidemics that affect us from time to time.
Public Hospitals exist to constitute the opposite pole to a profit-driven private health system so that the cost of health can be limited and all those health services that the private sector won’t seek to cover are ensured and finally to safeguard the viability and existence of the NHS.
The sole concern of AKEL is to safeguard and ensure the health of the people. The current situation reminds us that our society must be a society based on solidarity and this enhances AKEL’s steadfast position that health cannot and must not be a commodity. Health and the right to life are non-negotiable and we shall continue to struggle for them.
