MEMORANDUM

1. Cyprus Association for Ulcerative Colitis and Crohn’s Disease

Our Association was established with the aim of promoting the well-being of patients suffering from Ulcerative Colitis and Crohn’s Disease, as well as supporting their families.

2. Ulcerative Colitis and Crohn’s Disease

As you may already know, these two diseases are incurable, cause a wide range of problems for patients, and may lead to bowel removal surgery or even death.

3. Consequences of the Diseases

During periods of flare-up, these diseases affect patients’ education, professional, social, and family life, often leading to social exclusion.

4. Problems

Health

a) Specialization of a Pediatrician at King’s College Hospital in Gastroenterology

We were pleased to participate in the signing of the technical agreement between the Ministry of Health and King’s College Hospital for the establishment of the Department of Liver, Gastroenterology and Nutrition at Makarios Hospital / King’s College Hospital.

The key provisions of the agreement included:

• The recruitment of a pediatric gastroenterologist in 2014.
• The specialization of a pediatrician in gastroenterology for three years at King’s College Hospital.
• The continued visits of a pediatric gastroenterologist to Cyprus every 3–4 months until the above arrangements were implemented.

Unfortunately, apart from the visits of the pediatric gastroenterologist, all other provisions have been frozen due to financial reasons.

We call for your intervention to secure the necessary funding so that both the recruitment of a pediatric gastroenterologist and the specialization of a pediatrician at King’s College Hospital can proceed.

b) Surgical Procedures

We would like to be informed about the agreement between the Ministry of Health and the specialist surgeon regarding the framework of cooperation for highly specialized and complex surgeries, and whether this collaboration is expected to continue once the National Health System (GeSY) becomes fully operational.

We would also like to receive information, based on Ministry of Health records, regarding:

• The number of such complex surgeries performed in Cyprus during the past two years.
• The surgeons who carried out these procedures.
• The surgeons who have received specialized training.

Former Minister of Health Dr. Petros Petrides had assured us that both specialist training and the creation of a surgical registry would be implemented.

c) Waiting Times for Colonoscopies and Specialized Nursing Staff

In Nicosia, Famagusta, and Larnaca, patients currently face waiting times of six to seven months just to secure an appointment with a gastroenterologist. In addition, waiting lists for colonoscopies often reach or exceed six months, placing patients’ health and lives at daily risk.

Nursing Services had previously assured us, during a meeting with former Minister of Health Dr. Stavros Malas, that nursing staff would receive specialized training in Inflammatory Bowel Diseases through an internal educational program. Two years later, however, we have received no information regarding any such training initiative.

d) Medications

We are deeply concerned by information suggesting that, for cost-saving reasons, the Pharmaceutical Services intend to cooperate with companies producing biosimilar medicines that have not been tested in patients with Inflammatory Bowel Disease, replacing the biological treatments that have successfully kept many patients in remission over recent years.

We must all remember that health comes before economics. Decisions made by the Pharmaceutical Services should always be guided by the best interests of patients.

e) Establishment of Gastroenterology Clinics

We receive numerous complaints from patients across Cyprus who find themselves in difficult situations. Despite receiving biological therapies and often requiring surgery, they remain the “poor relatives” within the public healthcare system.

Sometimes gastroenterologists do not refer patients to surgeons promptly. In other cases, surgeons discharge patients from surgical wards without consulting gastroenterologists. As a result, many patients are forced to seek surgery in private clinics, often while unemployed because of their illness. Additionally, nursing staff are not always able to provide optimal care due to a lack of specialized training.

We therefore request the establishment of dedicated gastroenterology clinics where gastroenterologists, surgeons, nurses, and other specialists work together as a coordinated multidisciplinary team.

Since the creation of a new organizational structure for public hospitals is currently under consideration as part of hospital autonomy reforms, we believe gastroenterology clinics should be included in this planning.