Implementing a comprehensive National Health Scheme, promoting medical tourism and supporting ground-breaking medical research are top priorities for Cyprus.
What are the key priorities of your ministry for 2016?
Cyprus has great opportunities to utilise and move up in the medical sector. Our priority on health is the improvement of the health care system in order to improve overall health and quality of life of the Cypriot population. Building a National Health System is a key priority and will establish a framework that will be more patient-oriented, reliable, accessible and safe. Restructuring public hospitals and creating a system that provides affordable care by reducing the cost of quality health care to all is a key goal for the Government and the Ministry of Health.
How would you describe the health sector of Cyprus?
The health system in Cyprus consists of two parallel delivery systems, public and private health care. The public system is highly centralised and almost everything regarding planning, organisation, administration and regulation is under the responsibility of the Ministry of Health. It is exclusively financed by the state budget, with services provided through a network of hospitals and health centres directly controlled by the Ministry. Public providers have the status of civil servants and are salaried employees. The private system is financed mostly by out-of-pocket payments and to some degree by voluntary health insurance (VHI). It largely consists of independent providers and facilities are often physician-owned or private companies in which doctors are usually shareholders. Cyprus has one of the highest shares in out-of-pocket expenditure in Europe with 47.2%. The general Government Health care expenditure is 45.7% and the share of private insurance enterprises expenditure is only 4.5%.
It has to be noted that though the total expenditure on health in Cyprus as a percentage of the GDP (6.7%) in 2013 is lower than the OECD average, which was 8.9% in 2013, the health care statistics are performing better than the EU average and can be easily compared with the large and developed EU member-states. This can be attributed to the Cypriot physicians’ qualifications and the efforts of the Ministry of Health, Cyprus Medical Association and Cyprus Medical Council to keep these good results and improve them.
Cyprus has highly trained medical professionals as well as expertise, how many does this sector employ and how does it compare to the rest of the EU?
The capacity of personnel, hospital beds and medical technology compares favourably with other developed countries. Cyprus has very skilled and highly qualified medical and other health care professionals working in both the private and public sector. The majority of the doctors are educated at advanced and reputable universities in the UK, Greece, Western Europe, Russia and the US. There are currently 3,027 practicing physicians that correspond to 3.5 physicians per 1000 population. This is comparable to the OECD average of 3.3 physicians/1000 population (UK has 2.76 and Germany 3.9). There are 4,260 nurses, or 4.9 nurses /1000 population, a number quite low compared to the OECD average of 9.1.
Employment in the sector decreased by 1.6% in 2012 compared to 2011 and reached 16,642 persons, accounting for 3.9% of the total economically active population and 4.5% of the total gainfully employed population. The capacity of Cyprus as far as hospital beds and medical technology (MRIs and CT scanners) is concerned is satisfactory and comparable to the other European countries. There are in total 2,938 hospital beds (1,525 in the public sector and 1,413 in the private sector) corresponding to 3.5/1000 population. In Cyprus there are 19.9 MRIs and 33.6 CT scanners per million population which puts Cyprus in the top three countries.
What opportunities do you see for growth and foreign investment in the health sector?
A key area offering investment opportunities is e-Health, a cornerstone for the introduction of National Health System. Currently public and private hospitals are using ICT applications to an extent but there are plans to expand the use of various e-Health applications to create a unified national health information system. Medical tourism also offers opportunities for further foreign investments. On a global scale, the world medical tourism industry is worth as much as $40 billion and accounts for approximately 2.5% of international tourism revenue with very positive growth perspectives. Our plans and efforts to turn the island into a leading centre for health tourism in the Mediterranean region are paying off and Cyprus is steadily becoming a recognised destination. Our excellent infrastructure of medical facilities, laboratories and other diagnostic centres coupled with the beneficial climate conditions throughout the year, offer the opportunity for patients to combine a treatment with a holiday and recovery. Since 2013, the Government undertook concrete measures for promoting medical tourism. Doctors from Israel, the United States and other third countries (non EU member states) are now allowed to provide services in Cyprus, under certain conditions, regarding medical tourism. This decision not only promotes medical tourism and generates income mainly for the private hospitals, but it also promotes further training for Cypriot doctors with a number of hospitals becoming Centres of Excellence for the eastern Mediterranean region, the Middle East and Europe.
Where do the majority of Cyprus’ medical tourists originate from and what are the most popular procedures?
The majority of medical tourists are from Great Britain, Germany, the Netherlands, Russia and the Middle East. While dental and cosmetic procedures are at the top of many visitors’ lists, an increasing number of tourists now seek out fertility procedures with treatments, such as In Vitro Fertilization (IVF), gaining particular recognition over the past few years. Cyprus is gaining a reputation for other specialist procedures in other fields too, from basic check-ups and diagnostic tests to major surgery, such as kidney haemodialysis, transplants and cardiothoracic surgery procedures, orthopaedic, musculoskeletal surgery and many more. With our skilled medical staff, excellent clinics and wide range of treatments available at reasonable costs, Cyprus has the potential of becoming a very strong player in the field of medical tourism in the wider region.
The successful collaboration between the University of Nicosia and St George’s Hospital (University of London) has heightened the image of Cyprus as providing opportunities for medical students. What other initiatives could Cyprus pursue to strengthen its appeal?
The establishment of Medical Schools in Cyprus is a decisive step in the ongoing process of improving the health of the population and further development of research and innovation. Medical Schools are also a catalyst for boosting Cyprus’ economy. Over the last five years, three Medical Schools, one public and two private, have been established in Cyprus. The private Medical Schools offer classes in English, providing the opportunity for the enrolment of English-speaking foreign students. All Medical Schools are affiliated with hospitals throughout Cyprus and their programs are carefully designed and are focusing on critical thinking skills, lifelong learning and excellence in patient-centred clinical practice. Equally valuable is the establishment of Schools at a University level offering degrees for other health professionals, such as nurses, physiotherapists etc. as well as postgraduate degrees at a Masters or Doctorate level. All the academic entities promote educational tourism, not only in the form of students attending full medical degree programs in Cyprus, but also in the form of exchange programs, seminars and conferences. In addition, their establishment contributes in positive terms to medical research and innovation – enabling the provision of innovative medical services and diagnostic tools to the benefit of the patients. The worldwide health workforce shortage challenge may also emerge as an opportunity for Cyprus, as its geographic position and EU membership provides opportunities for well-trained students, originating from third countries, to acquire EU-recognised qualifications and to become Cyprus ambassadors to the world.
How does Cyprus stand internationally in terms of medical research and innovation?
Over the past 25 years, Cyprus has made highly commendable achievements in the fields of medical research and innovation. Starting in the early 1990s with the creation of the Cyprus Institute of Neurology and Genetics, the establishment of the Research Promotion Foundation in 1996 and the launch of the first Department of Biological Sciences at the University of Cyprus in 2002, research in the biomedical field had seen a tremendous increase.
Ambitious research projects have resulted in data and new knowledge, benefitting both the local population and the international community, especially in the field of genetic diseases, hereditary cancer and biotechnology.
The great quality work of Cypriot academics and other researchers is evidenced by important European funding, including 10 ERC grants, hundreds of high-impact publications in international peer-reviewed journals and invitations to present their work at major medical conferences around the world.
Research and Innovation relies predominantly on public expenditure. In 2011, 70.6 % of total R&D expenditure (GERD) was financed by Government, the highest percentage in the EU and considerably above the EU average of 34.9%. The economic crisis and the fiscal austerity measures have led to a considerable reduction in the relevant budget, but the government is committed to supporting the sector. In 2010-2011, Cyprus was classified as fourth at the EU country level in terms of the percentage increase of publications in biomedical research, with a growth index of 1.47 compared to 1.05 of EU-27 average. Cyprus is also classified as fourth in the percentage increase of publications in clinical medicine with a growth index of 1.81 compared to 1.06 of EU-27 average. In the field of public health Cyprus was first with a growth index of 4.89 when EU-27 average is 1.22.
How do you see Cyprus developing in the next two years and what message would you like to relay to the international community?
Cyprus has matured since the 2013 crisis, and resilience has proved once again to be our strongest virtue. We have learned from our mistakes, rolled up our sleeves and we are back in business. Frankly, Cyprus is as competitive as ever and I am sure that it is only a matter of time before this is acknowledged again. I think the future looks bright.