The fracas surrounding university hospital clinics continues, following last Thursday’s stormy session of the House Health Committee. The discussion was enough to reignite tensions, with the doctors’ unions (PASYDY, PASYKI) issuing a joint statement yesterday claiming there was a “clear and public admission” by the Minister of Health and the OKYPY chief executive that, for months, a university-clinic regime has effectively been implemented without any legal framework in place. They refer to two clinics in public hospitals operating under academic directors, describing this as an autonomous intervention of university structures in OKYPY’s organisational processes.
The two unions describe the situation as an “administrative breach” and call for the immediate reversal of the relevant actions. If this does not happen, they warn of escalating measures - from union action to administrative and judicial challenges. For the unions, the issue is not only legal but institutional: whether a public hospital can operate with parallel lines of authority without explicit provision in the law.
Disagreement over the model
In their detailed memorandum to the Health Committee, public-sector doctors clarify that they support university medicine and the need to strengthen medical education and research. Their disagreement, they stress, concerns not the goal but the way it is being implemented. According to the union, the bill introduces a model that creates parallel administrative structures and two distinct categories of doctors within the same departments. They also note that the bill leaves the boundaries of administrative and legal responsibility “blurred”, particularly regarding who is accountable for patient safety and for ensuring adherence to medical protocols.
As they point out, clinical directors in public hospitals remain fully responsible for every decision made within their clinics, yet they have no supervisory or disciplinary authority over university doctors, who answer to their respective medical schools. They describe this arrangement as “responsibility without authority” - a situation they argue does not exist in any modern health system.
The unions also express concern that having two employment systems - with different working hours, evaluations, on-call duties and remuneration - will create “two tracks of doctors” within the same department. This, they argue, leads to inequality, undermines team cohesion and complicates daily clinical operations. They further warn that the bill’s transitional provisions risk legitimising existing practices that developed without a clear institutional framework.
Alternative model proposed
In its own memorandum, the Cyprus Medical Association states that it shares the main concerns of the public-sector doctors. It emphasises that the bill leaves the distribution of responsibilities unclear and risks creating parallel structures within hospitals. However, it proposes a different approach: it supports the establishment of university clinics but recommends adopting the UK model of “Affiliated Teaching Hospitals”, where university activities are integrated into the hospital’s existing structures and do not form a separate entity.
According to the medical association, this model ensures a clear hierarchy, unified management and avoidance of internal “dual authorities”, while maintaining high standards of education and research.