Adaptability – durability – immediacy. This is the triptych of the ESY’s transition to the new era, which turns 40 this year. “We are adapting immediately to become more resistant to the challenges of the times”, emphasizes in an interview with APE-MPE the Deputy Minister of Health Marios Themistokleous. He reveals that in the near future there will be a comprehensive plan that will regulate the possibilities of private work for NHS doctors, additional fees and targeted interventions in clinics that are experiencing staff shortages.

He talks about the removal of the three governors, the new selection system, the building upgrade of the hospitals which he even characterizes as “the most coordinated upgrade effort that has been done in the field of health infrastructure for years” and the list of surgeries which is currently being updated . “Since it was created in 2017 it has not been updated, resulting in a falsely inflated list size.”

It highlights the steps taken for it digitization of the NHSmaking special reference to the National Registry of Neoplastic Diseases and the Oncology Information System that will be installed in hospitals and will be completed by the end of 2025. Finally, it gives data on the performance of the measure of the mixed crews of the Ambulance Service, emphasizing with emphasis that 1,500 patient transfers were made which, either would not be done or would be done with a very long delay.

The following is the interview of Deputy Minister of Health Marios Themistokleous to APE-MBE and journalist Efi Fousekis:

Q: What is the problem of the NSS, after all? Constantly, we hear about staff shortages, poor organization, degraded infrastructure. Has a fatigue developed that after 40 years is considered a regime?

A: Let’s put things in a row. This year, the ESY turns 40 years old. In these 40 years, despite any weaknesses it exhibits, it has been a key pillar of Greek society fighting for the assurance of the supreme good, that of Health. The National Health System was and is a key mechanism for ensuring social cohesion, reducing inequalities and ensuring citizens’ accessibility to health structures. During these 40 years, millions of our fellow citizens, perhaps in the most difficult moments of their lives, were visited, examined, diagnosed, treated and perhaps lost someone of their own in hospitals and Health Centers. In difficulties and crises, that’s where “everyone’s buoy is measured”, the ESY, not only endured but also took the lead, at a time when corresponding systems of other European countries collapsed. We do not hide the problems, nor do we as a Government try to beautify the situation. All healthcare systems in Europe are experiencing malfunctions, especially after the pandemic. I believe we will all agree both on the extremely important offer of the National Health Service and on the fact that after 40 years it is imperative to reform, improve, upgrade. So, this transition is governed by the threefold adaptability – resilience – immediacy. We adapt immediately to become more resilient to the challenges of the times.

Q: How will the NHS become attractive to doctors? Positions are advertised and there is no response. Citizens are forced to turn to the private sector as a result of which our country has one of the highest private health costs.

A: This issue does exist, but it is limited to specific specialties and in some areas of the country, mainly in the regions. For example, there is a problem in the specialties of anesthesiology, which is now in demand in all health systems worldwide, in the specialty of pathology, mainly in peripheral areas, and in certain laboratory specialties, such as radiology and pathological anatomy. However, we see that, in general, more applications were submitted to the doctor’s announcements.

The percentage of private health expenditure in Greece is at the same levels since the establishment of the NHS.

It is common ground that the NHS should become more attractive. In the next period of time you will see a comprehensive plan that will regulate the possibilities of private work of the NHS doctors, additional fees and targeted interventions in the clinics that have staff shortages.

Q: In one month we had the removal of three hospital administrators. What exactly is going on? Is there a stricter control by the central administration, is there a stricter evaluation?

Answer: In our country we have 126 hospitals. Hospitals, especially large ones, are complex organizations with high budgets and many needs.

The administration of hospitals is linked to the provision of health services and the management of public money, and as the Minister of Health, Mr. Michalis Chrysochoidis pointed out, the evaluation of the administrations is on a daily basis.

Most of the commanders we have now were on the front lines during the pandemic and helped make our hospitals resilient and double intensive care beds “on the go”. They therefore had the responsibility of administration under very demanding and unprecedented conditions. There is, however, room for improvement, which is why the Government will soon pass a new law on the selection of administrators.

Q: Health is a priority and the restructuring of the NHS is a goal. But when will the patient waiting months on the waiting list for surgery see the results of the reform?

A: As you know, a few days ago a provision was passed in the Parliament for the digitization of the process of joining the List. This will allow us in the first stage to have the exact data. Why do we need to do this? The list of surgeries was created in 2017, but there was no provision for updating the list. In many cases, even if a surgery was performed, the system was not updated and the patient remained on the list for surgery. This created a falsely inflated list size that did not reflect reality and made scheduling and patient management impossible.

Henceforth, the inclusion of the patient in the list will be done by the attending physician, only through the hospital’s digital platform, and the manual system of entering patients into the list will be abolished. In addition, we ensure that the system can be informed immediately if someone has been operated on in another hospital or on an emergency basis. In the same context, a phone call has been planned with all the citizens on the list to confirm their stay on it.

Mrs. Fousekis, after these necessary steps, we will proceed to the big “leap” which is the reduction of the waiting time.

Q: At what stage is the upgrading of the building infrastructure?

Ans: The upgrading of the building infrastructure is the most coordinated upgrade effort that has been done in the field of health infrastructure for years. Our goal is not just to change the face of hospitals and health centers. The form often determines the content as well. We are talking about a fundamental process of modernization and improvement of the quality of health services. To give you concrete numbers: we are starting with 80 hospitals with a budget of around 310,000,000 euros with the process to be completed by December 2025. This really vital project “runs in parallel” with the energy upgrades project for 78 hospitals, with a budget of 178,000 .000 euros, as it has been included in the NSRF 2021-2027. In addition, for the “Sotiria” Hospital, the establishment of a Radiation Therapy Center is planned, amounting to approximately 40 million euros, and for the “Papanikolou” GNTH hospital, the construction of a building focused on cell and gene therapies and hematology clinic laboratories is planned, amounting to approximately 14 million euros.

Upgrading the infrastructure is not just better walls and windows, it is a better working environment, it is the framework for a more “human” provision of services to the citizen.

Q: When will the digitization of the system, one of the strategic priorities, be completed?

A: Digitization is the transition of the NHS to the new catalytic era and is a dynamic process. The first steps have already been taken. The successful project of the vaccination program created a series of digital processes from appointment to certificate issuance. A typical example is the implementation of the new appointments that apply from 2022 for Primary Health Care. Major and important projects, such as HospitalDigitalReadiness and the NationalHealthRecord, are also included in the National Recovery and Resilience Plan.

And one more very important thing. I am referring to the development of the National Registry of Neoplastic Diseases and the Oncology Information System that will be installed in hospitals and will be completed by the end of 2025. It is being implemented with resources from the European Recovery Fund with a budget of 36.4 million euros and the implementing agency IDIKA. As can be seen, the digitization of the system is based on the needs of the modern era and serves society.

Q: You implemented a plan over the summer using the Armed Forces as ambulance drivers instead of ambulance crews. It was a measure that caused many reactions. Will this continue?

A: In the first place, the reactions were limited and if you will allow me this reflects that many times the public health dialogue is done with clichés and prejudices.

Let’s start things from the beginning. In our country, for decades, we have had what we call “mixed crews”. The ambulances were staffed by EKAV crews and in many areas of the country we had the ambulances of the Health Centers staffed by a driver and a paramedic. But in life there is theory and practice. Let’s see what the measure achieved, which was implemented in 57 regions of Greece. The ambulances were reinforced by 159 members of the armed forces. In many of these areas posts had been advertised in the past, either for support staff or even for permanent staff, and had not been filled.

By this measure a 30% increase in shifts was achieved, 2/3 of the transfers were done by mixed crews but more importantly 1,500 patient transfers to some of them were a matter of life and death, or they would not be done or they would be done with a very long delay. I think the last one says it all.