A provision in the revised bill on university clinics that would let a hospital work with more than one medical school has divided patient groups, universities and doctors, Phileleftheros understands. Each side is trying to build support before parliament’s Health Committee discusses the bill on October 29.
The Federation of Patients’ Associations of Cyprus (OSAK) and the University of Cyprus regard the presence of different medical schools in the same hospital as a ‘red line’ on which they do not intend to give way. Other stakeholders and medical circles want the provision kept, arguing that working with several medical schools is necessary to meet training needs.
The dispute has already reached Health Minister Neophytos Charalambides. According to the same information, he is open to discussion and is studying both options. The ministry and the government want Cyprus to finally have a legal framework for university clinics, after 15 years of discussion, and do not want the new disagreement to delay the bill further.
Under the provision, a hospital may sign agreements with more than one university and a medical school may work with more than one hospital. Training capacity would be shared out on transparent and objective criteria, taking into account infrastructure, staff, the volume and range of cases, and the requirements of the accredited curriculum.
The two positions
OSAK and the University of Cyprus argue that having different medical schools in the same hospital risks general confusion, with problems of functionality, responsibilities and poor communication, and would disrupt patient care. They say a hospital needs clear organisation and a specific framework for cooperation, without overlapping or confused responsibilities.
Those who want the provision kept point to two practical issues. The first is clinical training. Not all hospitals have the same specialties, and Nicosia General Hospital, for example, has specialised departments and services that do not exist in other hospitals. Students from different medical schools need to pass through those clinics at some stage, and they ask how this would be possible if a hospital worked with only one university.
The second concerns doctors who already work in hospitals and also hold academic titles at other universities’ medical schools. There are reportedly such cases at hospitals that work, or are due to work, with a different university from the one where those doctors hold academic posts.
On training in specialties found at only one hospital, those who want the provision removed say the law should include a separate arrangement to cover that need.
What the bill says
The revised bill was tabled in parliament by the Health Minister last week, after a further session on the principle of the original text. It aimed to balance the competing positions and bridge long-standing disagreements.
Article 6 allows a hospital to work with more than one university. Article 32 provides for a ‘Main Medical School’ to be designated for each hospital, depending on the extent of its teaching and academic activity. That does not rule out agreements with other medical schools, or university and affiliated clinics with another university, as long as the conditions are met.
The hospital would keep overall administrative and clinical responsibility, and written agreements would set out responsibilities and how the parties work together. These would go beyond providing space for teaching students and must cover, among other things, the number of trainees, their supervision, the clinical hierarchy, the duties of university doctors, insurance cover and how costs are shared.
Patients would have the right to refuse to have students involved in their care without it affecting their treatment, and students’ access to medical records would be limited according to their role. The framework covers both public and private hospitals, with rules on safety, the quality of clinical training and the resolution of disputes between partners.
The first part of the committee’s October 29 session will be devoted to stakeholders and the second to discussion with the Health Minister. The political parties have said they are willing to legislate but have not yet taken a clear position on the bill.
