The principle underlying the Government's health policy is that health, as a social good, is the responsibility of the state. The Government's main objective is the continuous improvement of the standard of health of the population, through the promotion of health, the prevention of disease and the provision of high quality health care to all citizens.

The health strategy is characterized by the emphasis on the prevention of the causes of morbidity and mortality, ensuring equality of opportunities for health care to every individual irrespective of socio-economic situation and place of residence, making the best use of health resources through the co-operation between the public and private health sectors and increased efficiency and effectiveness of health services.

Disease Profile - The main causes of morbidity and mortality are those common in developed countries that is cardiovascular diseases, cancer, diabetes, smoking and traffic and other accidents. The most common causes of death are cardiovascular diseases (40%) and cancer (10%).

Health Indicators - he standard of health of the population of Cyprus compares favourably with the standard of health in European and other developed countries. In 2000-2001 the average life expectancy at birth was 76, 1 years for men and 81, 0 for women. Infant mortality in 2002 was 4.7 per 1000 births and the crude mortality rate was 7.3 per 1000 population.

Cyprus Provision of Health Care - Health care is provided by the Government Medical Services and the private medical sector. The Government Medical Services can be used by any person who chooses to be treated at a Government Medical Institution. Free of charge or at reduced fees care is provided by the Government Medical Services to certain groups of the population as described below. Patients not belonging to these groups pay the fees prescribed from time to time.

The government medical institutions are administered by the Ministry of Health through the Department of Medical and Public Health Services and are financed by general taxation through the budget. Persons making use of the private medical sector pay the fees out-of-pocket. Certain groups are covered by medical funds, operated by trade unions or employers. These funds provide full or partial coverage of medical expenses incurred by their members.

Coverage

The Regulations distinguish the persons, who use the Government Medical Services, into the following categories:
 

Persons not coming under categories (a) and (b) can make use of the Government medical services against payment of the fees prescribed from time to time. Paying patients may have the fees for costly in-patient treatment reduced, taking into account the level of their income.

Private Health Sectors in Cyprus - The share of the private sector in the provision of health care continues to be quite large. Private medicine is dominated by a large number of physicians in individual practice. A number of polyclinics have also been established in urban areas offering a wide range of medical services, at all levels of health care, including highly specialized services like cardio surgery and other treatments. Non-profitable medical institutions have also been established: the 'Paraskevaidion' Transplant Centre, the Bank of Cyprus Oncology Centre and the Institute of Genetics and Neurology, all of which provide high quality services in their field.

Special Schemes

A number of special schemes cover specific sections of the population and include:

• Medical Services provided by the Trade Unions to the members and their dependents. These schemes provide mostly primary health care. The schemes use both the government and private sector wherever secondary or tertiary care services are needed, through a partial reimbursement of medical expenses.

• A number of employer-sponsored arrangements, all of which provide free medical care through the public health facilities or the private medical sector.

Protection of Public Health - Apart from the curative services offered by the public and private sectors, the public services, in cooperation with other Ministries and the Municipal Authorities, provide preventive health services in the form of health education, inoculations, control of epidemics and infectious diseases, the disposal of sewage, the control of the quality of drinking water, food etc.

Primary Health Care in Cyprus - The primary health care needs of the Cyprus population are met through 23 rural health centres, scattered all over the island, four urban health centres located in the Nicosia District and through the outpatient departments of the district hospitals. All centres, both urban and rural, are staffed by doctors, nurses, pharmacists, health visitors, health inspectors and other paramedics. The primary health care team of the centre provides curative as well as preventive and promotive services i.e. maternal and child health care, immunization coverage, health education and school health care. Primary health care is also provided by doctors from the private sector having their own surgeries mainly in the cities. Appropriate services for prenatal care, education and family planning have been developed, together with the introduction of improved pregnancy tests for the early detection of congenital anomalies. The prenatal maternal and child health services aim towards early detection and monitoring of families and children at high risk for early intervention.

Mental Health - The public Mental Health Services are being decentralized. A network of services in all districts is gradually being set up, so that they are directly accessible to the community (primary and preventive services, nursing services at home, psychiatric clinics in hospitals, day centres etc.). Also, specialized services have been established such as for child psychiatry, detoxification and family therapy. As a result of these developments, the number of institutionalized patients has been reduced substantially.

Health Care Reform in Cyprus - The present system of health care has for long been criticized for the fragmentation of services, the lack of coordination between the public and private health sector, the lack of equity in its financing and in general its inability to respond to the expectations of the population. On 20 April 2001, the House of Representatives enacted a law for the introduction of a National Health System, which will provide health care free at the time of delivery. It will be universal as regards population coverage and will be financed by contributions from the state, the employers, the employees, the self-employed, the pensioners and all those who have non-employment incomes. The Scheme is expected to be introduced in 3-4 years from now. Preparatory work has already started.

New Hospitals in Cyprus - The construction of two new hospitals will be completed in 2005: The new Nicosia General Hospital (478 beds) and the first phase of the new Famagusta General Hospital (73 beds). Both hospitals are expected to open in 2006.

Strengthening and Upgrading Primary Health Care Centres in Cyprus - The primary health care centres in the rural areas are being strengthened with additional staff and equipment in order to upgrade and extend the scope of their services. The improvements include coverage of the population on a 24-hour basis and provision of preventive services to the rural communities, including schools.

Cyprus Anti-drugs Strategy - The commitment to the fight against the use and spread of addictive substances was translated into the establishment of the Cyprus Anti-Drugs Council. The state has delegated to this Council the salient role of defining a national drugs policy, thus signalling the political will to start tackling the problem in a global and multidimensional way, reflecting the realities of today regarding the drug phenomenon. The Anti-Drugs Council constitutes the supreme coordinating agency in the field of addictive substances.

The National Anti-Drugs Strategy and Action Plan for the years 2003-2006, which is in line with the EU strategy on drugs has set the following main objectives:

• The reduction in demand

• The reduction in supply

• Treatment and social rehabilitation

• The reduction of the consequences of health problems related to drugs

• The enhancement of cooperation with NGOs and encouragement of their active involvement.

• The reduction of drug related offences.

Further to the above development, the Ministry of Health has proceeded with the establishment of a Detoxification Centre for Drug Addicts in Limassol, and a Therapeutic Community for the Psychological Rehabilitation and Social Re-integration of those in need. A Therapeutic Community in Juvenile Drug Addicts is also expected to open during 2005. It should also be noted that a lot of emphasis is given on prevention, which is considered an important parameter of the problem of drugs. To this end, various Prevention, Information and Counselling Centres are functioning, with the aim of raising awareness to young people, through various activities and programmes.