Strengthening primary health care and reducing overprovision of low-value specialist care: policy options for Cyprus

Overview

Since the launch of the General Healthcare System (GeSY) in 2019, Cyprus has made significant progress in expanding access to health care and reducing financial barriers. However, misaligned incentives and a weak primary care (PHC) system have led to inefficiencies, particularly the underuse of general practitioners (referred to as personal doctors in Cyprus) and overuse of outpatient specialist (OS) services. While some patients bypass personal doctors due to a lack of trust or a cultural preference for specialist care, these behaviours are also shaped by systemic factors, including unclear care pathways, limited enforcement of gatekeeping, and financial incentives that encourage specialist overuse. At the same time, the national Health Insurance Organization (HIO) relies on historical spending to allocate budgets, perpetuating supplier-induced demand rather than aligning resources with population health needs. These challenges increase costs and weaken the potential of a PHC-led system. To strengthen PHC and curb the overprovision of low-value specialist care, this brief proposes a series of supply- and demand-side policy options.