The family of a patient receiving specialised neurological rehabilitation abroad has been forced to cover the cost of her continuing treatment after the Health Insurance Organisation (HIO) declined to approve a further extension of funding.
The patient was originally sent overseas with approval from the Health Ministry after suffering a serious accident and undergoing medical and surgical treatment in Cyprus. Her case was raised before the House Health Committee during a discussion on procedures for sending patients abroad for treatment.
Family questions decision to return patient
The development follows an open letter from the patient's family seeking answers over the HIO's decision and plans for her return to Cyprus.
The family said it learned through third parties that an air transfer was being considered without being told where the patient would be taken, who would assume responsibility for her care or what rehabilitation programme had been secured in Cyprus.
AKEL MP Marina Nicolaou questioned how the patient's return could be recommended while her treating doctors abroad were reporting progress and advising that therapy should continue.
Other members of the committee criticised the fact that, according to the family, the HIO had not communicated directly with relatives about arrangements or plans for the patient's return.
HIO says progress was minimal
HIO director Monica Kyriakou presented a different assessment of the case.
She said that after responsibility for the overseas treatment programme transferred to the organisation, two extensions of treatment and additional services were approved.
However, when the latest request was submitted, an expert panel reviewed information provided by the doctors abroad and concluded that the patient's progress was minimal to non-existent.
The request for another extension was consequently rejected.
According to Kyriakou, the family appealed against the decision, but a second expert panel reached the same conclusion.
Family says treatment is not complete
Following the committee meeting, the patient's sister told Politis that the family now has no practical choice but to fund continued treatment privately to avoid any interruption.
"This is not a real choice for the family," she said, describing the decision as a necessary step to ensure continuity of care.
According to the family, the doctors treating the patient abroad and monitoring her clinical condition daily believe that treatment has not been completed and that she continues to require hospital care and specialised neurological rehabilitation.
"The family is not going to risk the patient's health and progress because of the HIO's decision," her sister said.
No official communication, family says
The patient's sister also said the HIO had still not formally contacted the family about what would happen next or what arrangements would be made following the termination of coverage.
As a result, she said the family has been left to make the necessary arrangements itself to ensure treatment continues.
She stressed that paying for the patient's continued care should not be interpreted as accepting the HIO's decision, nor as relinquishing any rights or claims available to the patient and her relatives.
The family also maintains that its decision to pay privately does not relieve the HIO of any responsibility it may have in the case.
Questions raised over compulsory Gesy contributions
The patient's sister also questioned the compulsory nature of contributions to Gesy, arguing that beneficiaries can find themselves required to pay privately for treatment despite contributing to the healthcare system.
She questioned why beneficiaries have no choice over their contributions if they can ultimately be required to fund treatment themselves.
"It cannot be the case that the obligation is absolute when citizens are required to pay contributions, but when they need treatment, the answer is that they can continue as long as they pay for it again themselves," she said.
The case highlights differing assessments between the medical team treating the patient abroad and the HIO's expert panels over whether continued overseas rehabilitation remains medically justified.
