An open letter regarding GESS was sent by the president of the European Academy of Pediatrics, Dr. Adamos Hatzipanagis
As he notes, it is a mistake to allow children under the age of 15 to be able to enroll in a personal adult doctor.
"The aim of the European Academy of Pediatrics is to ensure the best health care for children through existing systems," he notes, among other things.
The letter is as follows:
The General Health Plan (GESY) has completed one year of life. Primary care was the first phase of GESY.
In Cyprus, children have been monitored by pediatricians for many decades. In fact, Cyprus ranks first in terms of the number of pediatricians per 100 children throughout Europe. In other words, we have a large number of pediatricians in relation to the number of children and the number of pediatricians working in Cyprus is the largest in all of Europe.
What is happening with GESY today?
Children up to the age of 15 are enrolled in pediatricians while children aged 15-18 have the option of having their parents enroll them in either pediatricians or personal adult doctors. In addition, the system leaves open "windows" that allow even children under the age of 15 to be able to enroll in a personal adult doctor.
This is a fundamental error and the parties involved must correct it immediately. One can understand the reason why this decision was taken by the authorities at the given time, ie the first months of implementation of GESY and it was clear that the majority of pediatricians refused to be included in the general health plan.
The purpose of the European Academy of Pediatrics is to promote the health of children throughout Europe and we have been invited by many countries to give our expertise on issues related to health systems or anything related to children's health. As an organization we understand the differences between countries, especially in relation to the health systems that follow. In some countries, such as Cyprus, children are monitored (or at least this was the case until the start of GESY) exclusively by pediatricians, in others by general practitioners and some others have mixed health systems. The aim of the European Academy of Pediatrics is to ensure the best child health care through existing systems. If a country such as England or the Nordic countries does not have a sufficient number of pediatricians or their system has been supporting pediatricians for decades, then our aim is to ensure that these health professionals have the minimum pediatric education for be able to deal with the basic issues of development, nutrition and general health of children. The required minimum training time for health professionals related in any way to children is published in the European Journal of Paediatrics.
I do not think that even one of you who reads this letter can disagree that the best of health professionals to "raise" a child is the pediatrician. There is a lot of bibliographic data that supports it but also a lot of examples from our daily life and I will be tempted to share with you a recent experience. A few days ago a parent came with his ten year old child to meet and see the child's health booklet in relation to vaccines. So after advising the parent on what this child should do I asked if he has other children. He replied that he still has a 16-year-old child. He wrote it to a personal adult doctor and told me that he had already visited that colleague and assured him that that child was fully vaccinated and asked me if I wanted to see this particular health booklet as well. I was surprised to find that the child had already had three major vaccinations. I explained to the parent who immediately understood the problem and planned that child's vaccinations.
Vaccinations are the cornerstone of public health and one of the major prevention programs adopted worldwide for children. Pediatricians are the best experts on the subject and unfortunately all the other colleagues know little about this subject, because they have simply never been trained in this subject and in addition they have never had to vaccinate children in the past. The above example is just a small one of the many I could give you in relation to the skills that a health professional should have in order to be able to monitor children but I do not think I need to bother the reader with unnecessary references.
At what age is a child considered to be biologically adult?
The vast majority of national and international organizations (World Health Organization, European Academy of Pediatrics, American Academy of Pediatrics, United Nations Charter on the Rights of the Child, etc.) believe that anyone under the age of 18 is a child and has all the rights of a child . So children are considered all people from birth until they complete the 18th year of life.
Do we have a sufficient number of pediatricians to monitor all children up to the age of 18?
As I mentioned at the beginning, Cyprus has a plethora of pediatricians (first in all of Europe). We have about 250 active pediatricians. They have already registered in GESY 191 and it is predicted that this number will increase.
Are they enough to serve our children from birth to the age of 18?
About 142 children are currently enrolled in pediatricians.
Across Cyprus, about ten pediatricians have registered in their lists from 2000 - 2500 children each. So the 181 remaining pediatricians who are already registered in the system will have to share the remaining 119 children (900 minus 142 400 10). So on average each of the 2250 pediatricians will be able to enroll about 181 children !!
So not only do the pediatricians who are so far registered in the system arrive, but they also arrive and there are more.
The implementation of this proposal is not only in the interest of the children of Cyprus but also for all the beneficiaries who are registered in GESY.
What will happen to the implementation of such a blatantly fair proposal for our children?
Apart from the fact that the children will be monitored by the most appropriately trained health professional who is the pediatrician, we will also have significant benefits in the care of the adults since the clinics of the personal adult doctors will be decongested. As you all know people complain because it just often is not served immediately since many adult personal physicians due to the large number of patients who have been unable to meet the needs of their patients. The numbers are the indisputable witnesses. There are 494 personal adult doctors at GESY and they should serve about 685 000 people. That is, there are about 1386 patients for each doctor. Twice as much as a pediatrician. This distortion MUST be corrected IMMEDIATELY for the good of every citizen of Cyprus but mainly for the good of our children which is the future of this place.
What should be done?
The competent bodies (OAY, Cyprus Pediatric Society, Ministry of Health, organized parents, etc.) should demand and at the same time take the necessary actions so that the monitoring of children 0-18 years old is given exclusively to pediatricians.
There should be an opportunity for a transitional period from 18-22 years, so that the adult can now choose for himself if he wants to continue with his pediatrician for this period of four years or to switch to a personal adult doctor. This is the practice followed by countries where primary child care is offered by pediatricians.
It is the duty of the state to do it immediately if it is really interested in our children, if it is really interested in the future of this place and if it is really interested in each citizen individually.
Source: Sigmalive