Where has the ESY succeeded and where has it failed? In the more than 20 years since it was founded, the National Health System has provided the Greek people with a valuable service. Politicians and ESY officials aside, the majority of the Greek people recognize this fact. At the same time, many – the prime minister and the current leadership of the Health and Social Solidarity Ministry above all – have observed a number of fundamental weaknesses that not only affect the well-being of this living organism but above all its viability, the way it functions now. These issues are a major priority for our government, the foundations on which to build a healthy and viable system. Our strategy is based on tackling the three major – and in some cases hidden – problems that we inherited from PASOK, such as hospitals’ debts. Three thorny issues One of these is the staffing of ESY units, particularly nursing staff. We are aware of both the chronic and acute aspects of this problem, so we will immediately adopt faster procedures for recruiting hospital staff, monitored by the civil service recruitment organization (ASEP). Then there is the question of the funding and efficient financial management of the ESY. We place great emphasis on the rational distribution of resources available in the state budget, as well as promoting new ways of self-funding by the ESY, particularly through exploiting the «Olympic infrastructures» created within it. This is the central theme of the bill to be tabled in Parliament governing the operation of the Olympic Village Polyclinic. Naturally, proper management and professional organization of hospitals is another priority. Already, our ministry has undertaken the initiative of renewing the ESY’s senior management staff and of preparing the ground for the implementation, in 2004, of a new management style based on self-sufficiency for hospitals and the principle of managers’ accountability to an independent board that will monitor each hospital’s finances and operation. If we deal with these weaknesses, we will be able to capitalize on the value of the ESY to the benefit of the people. Our goal is to exploit the many, and mostly inactive, health structures, by staffing them from the ESY’s bank of excellent scientific experts, many of them leaders in their fields in terms of know-how and social sensitivity, something that is clear to many people who use the services every day. When will beds disappear from hospital hallways? The Ministry for Health and Social Solidarity has presented its proposal – a proposal, not a decision – to the health services and to the press. I am pleased that its basic philosophy meets with almost total agreement from the majority of ESY staff. A three-month pilot period will begin in November. When the initial results are available, some minor changes might have to be made. Immediately afterward, it will be put into action, with the hope that by spring of 2005, these beds will be a thing of the past. Users of the health services continue to complain about long waiting lists and double lists for surgery. What is to be done about these problems? There isn’t a single hospital in any European country that does not occasionally have waiting lists of some years’ duration. With the new system of duty rosters, above all when hospitals are operating all day, the situation will improve. More doctors and nurses need to be hired, which calls for economic support for the move from the prime minister himself, who has so far given the ministry his absolute support. The double lists are due to a lack of transparency. The new hospital administrators, as well as the ministry, have a duty to intervene. I also ask for the people’s cooperation. Nursing shortages in ESY hospitals are a chronic problem. How far will legislation on faster recruitment procedures resolve this problem? In the initial phase, there will be an improvement. We need to hire about 5,000 people a year in order to fill the gaps existing today in both old and newer hospitals within four years. I am sure that irrespective of who the minister is, the prime minster will support him or her in order to achieve this goal. You have forecast changes to the labor status of ESY doctors. What are they and why are they necessary? As I said earlier, these changes are not scheduled for this year but for 2005. When the time comes, we will announce them subsequent to a dialogue with the interested parties. Olympic model The bill for the Olympic Village Polyclinic provides for a societe anonyme monitored by the Greek state, in which state social security organizations may be shareholders. What positive results do you expect to see with this innovative format? This innovation, as you rightly called it, is aimed at greater flexibility in the management of the Olympic Village Polyclinic and at avoiding the familiar time-consuming procedures, since it will immediately provide a high-tech service that will meet requirements both in primary healthcare and rehabilitation. This is a legal framework which allows for a better management of resources (human and financial), greater flexibility in decision-making and therefore greater effectiveness at meeting people’s healthcare needs. So the positive results we expect, aside from the immediate operation of the polyclinic, is better financial management, less bureaucracy, the potential for developing incentives to increase staff efficiency, guarantees of a generally more effective operation and of course the development of a service that will be more user-friendly. Has this system been used in other countries’ health systems and, if so, what has the experience been? First of all, this law does not mean a new model of operation for the country’s health system. On the contrary, it entails the operation of new structures with ultramodern equipment, functioning without delays, effectively and under the control of the state and society. Similar efforts in a restricted number of health units have been successful in other European countries such as Portugal, Spain, Germany and France. Health units in Europe generally function with more autonomy and flexibility, but under tighter controls with regard to decision-making. They have often used more advanced models for specific units or health services which… function under the authority of non-profit agencies, unions and so on, but are monitored by the state. Could this model be used in other health units? If you mean state hospitals, obviously not. This is a pilot program to provide health services in structures outside hospitals and we are being particularly cautious about the first steps; the entire operation will be carefully evaluated and the results discussed with all organizations concerned. Only then will the potential for expansion to other health units be considered. However, this is not something we are dealing with at this stage. It is not the ministry’s intention to change the state character of the system. On the contrary, we want to boost it by improving efficiency, reducing bureaucracy and increasing people’s satisfaction.