In the plenary, the bill “Public health actions – Arrangements to strengthen the National Health System” is introduced for discussion and voting. The bill introduces regulations for the implementation of the national action plan for public health, the conditions for private practice by doctors of the National Health System (NHS), the prescription of drugs, the automatic return mechanism (clawback), the National Public Health Organization, the National Health Service Provision Organization, the National Central Health Procurement Authority and the Panhellenic Medical Association, the hospitals of the E.S.Y., the Health Regions and Health Centers, and medically assisted reproduction.

During the drafting phase of the bill in the competent parliamentary committee, the ND declared in favor of the principle. SYRIZA, KKE, New Left and Niki voted against. PASOK, the Hellenic Solution, the Spartans and Freedom Sailing have expressed reservations about their final position in the plenary session.

Working status for the doctors and nurses of the National Health Service

The bill introduces a series of regulations for NHS doctors and nurses. At the center of interest have been the regulations by which the terms and conditions of private practice of doctors of the National Health System (NHS) branch are modified. In particular, with the bill:

  • It is enacted exceptional possibility for doctors of the National Health System (ESH) to practice private work in the field of medicine, as long as they participate in the all-day, beyond regular hours, operation and on-call of the hospital. According to the introductory report, this exceptional opportunity for doctors, through their employment in the private medical sector, is provided on the one hand to make use of their clinical experience and on the other hand to increase their income, while at the same time it is expected to attract more doctors in the public health system, since they will be able to combine employment in the private health sector. The exercise of a private project is permitted after the submission of a relevant application and a reasoned decision approving it by the competent body, as long as it does not disrupt, differentiate or violate in any way the orderly operation (regular hours, on-call, all-day operation) of the hospitals. Furthermore, through limitations, clauses and procedural terms, which are foreseen (e.g. productivity indicators, number of surgeries per clinic, number of medical visits, diagnostic and interventional procedures, paraclinical examinations), which are specified by decision of the Minister of Health, the proper functioning of public hospitals.
  • provided for possibility to extend until 31.12.2025 the length of stay of those doctors in the NHS sector, whose stay had been extended until 31.3.2024, in order to continue to offer their valuable experience and not to disrupt the orderly operation of health facilities. In addition, for reasons of equal treatment, the possibility of staying until 31.12.2025 is also provided for those doctors whose employment relationship ended on 31.12.2023 and whose employment was extended until 31.12.2024.
  • expands the legal exemption from the obligation of field service also for those doctors who had been admitted to the Medical School until the academic year 2012-2013. Given that most of them have already fulfilled the obligation of rural service, the proposed provision facilitates the latter in their access to the practice of specialization and appointment to the National Health Service, without, however, jeopardizing the orderly operation of the health structures staffed by medical officers field service.
  • is also added specialty of dentists in the uniform placement process of doctorsdentists and other health scientists to acquire a specialty and the way of predicting specialist positions in the expenditure budget of the Ministry of Health is clarified technically.
  • the inclusion in Article 29 of Law 4958/2022 is also regulated for those doctors who, when it entered into force, were practicing in the specialty of anesthesiology, while they had stopped practicing in another specialty. In particular, it is foreseen that the aforementioned anesthesiology specialists will be compensated for the entire period of time required to practice in anesthesiology, not including the time period during which they had practiced in the other medical specialty.
  • are added to the incomes of the doctors of the National Health System (ESH) and university doctors from their evening work and those that arise, during the full-day operation of the hospitals, from the performance of surgeries or other invasive procedures that require a stay in the hospital in addition to daily hospitalization, and are taxed according to paragraph b) of paragraph 2 of article 7 of the Income Tax Code (law 4172/2013).

Public health

The bill introduces regulations related to the implementation of the national action plan for public health.

Particularly:

Single frame is introduced breast cancer screening in women aged 45 to 74 years. The proposed provision amends article 24 of Law 4917/2022, under which the “Preventive diagnostic mammography tests against cancer” project, funded by the resources of the National Recovery and Resilience Plan, was implemented. Breast cancer is the most frequently diagnosed cancer in the 27 EU countries. and first cause of cancer death in women. With the establishment of a single framework of universal population coverage screening, in women aged between 45-74 years, it is expected to increase the rates of breast cancer detection at an early stage and its timely treatment, resulting in the improvement of treatable mortality rates and an increase in life expectancy of the population.

The project funded by the National Recovery and Resilience Plan is implemented by legislation “Child – family health promotion”. According to the definitions of the World Health Organization, physical and mental health are interrelated concepts, which can be effectively enhanced by public health interventions, at multiple levels and areas of human activity. The introduced regulation intervenes at various stages of the child’s development, from infancy (with actions to strengthen parenting skills and the early detection of child developmental disorders), adolescence (with actions to promote the health of adolescent girls in relation to with menstruation) and adulthood (with actions to create and operate a model community center for the education, awareness and treatment of the phenomenon of non-suicidal injuries in young people aged 18-24).

It is foreseen participation of mobile primary health care units of Law 2071/1992 in the effective implementation of the public health programs of the “SPYROS DOXIADIS” National Program, which includes, among others, the “Preventive Diagnostic Mammography Tests against Cancer/Mobile Units” project. In this case, and with regard to the last project, the access of women living in remote and inaccessible areas to health facilities will be facilitated and it is expected that the rates of breast cancer detection at an early stage will increase, in order to treat it early.