Greece Has Won the COVID-19 Battle – For Now
by Theoklis Zaoutis*
But to win the war against infectious disease – and to be ready for the next health crisis – we need a stronger, more accountable health system.
We should all be proud of our country’s successful response to the coronavirus crisis. It shows that with a concerted group effort from everyone in our society, we can achieve better health outcomes – better even than other countries with far more resources.
Having won this early battle, it’s tempting to pat ourselves on the back for a job well done and return to our normally scheduled programming. But now is not the time to pause our infection control efforts; it’s time to double down on them, and to use the momentum from our fight against COVID-19 to tackle the long-standing challenges of a health system weakened by years of austerity measures.
While the creation of the National Organization for the Provision of Health Services has streamlined a fragmented system devastated by the 2008 financial crisis, and in recent years healthcare resourcing has slowly increased towards pre-crisis levels, Greece still faces a variety of obstructions to the delivery of high-quality care to all of its citizens.
The most pressing challenge of them all is the overarching lack quality assurance and accountability for care provided across the country. Right now, there is no centralized authority overseeing the quality of health services, particularly those provided within public hospitals – and as a consequence, we’re not ensuring that citizens receive the care they deserve.
At best, health services provided without strong quality oversight disappoint patients; we see this manifested in the dismal Eurobarometer survey results that show nearly three out of every four Greeks think hospital care is worse here than in other EU member states. At worst, this lack of quality assurance leads to poorer health outcomes – and ultimately more deaths. The health system regularly encounters staff and equipment shortages, inadequate GP and paramedic training, and other indicators of low-quality service delivery.
These barriers to quality care end up creating an environment that allows infectious disease to spread. Greece tops EU rankings for rates of hospital-acquired infections (HAIs), some of the hardest to treat and therefore deadliest infections. For every COVID-19 case reported so far in 2020, there are at least ten HAIs reported worldwide. Unlike COVID-19 cases, however, we know how to prevent these infections: by providing better, safer care in the hospitals where they happen.
A critical step towards improving hospital care and reducing HAIs is to establish mechanisms for quality assurance and accountability across the entire network of care providers. A new bill proposed by the Ministry of Health in the Greek Parliament would establish a new Agency for Quality Assurance in Healthcare (AQAH) to do just that.
But recent political squabbling may be undermining the bill’s chances, putting again the issues of public health being public and the role of private sector supporting this effort – things that are not negotiable. These criticisms are well-intentioned – indeed the free exchange of opposing ideas is critical to sustaining our democracy – but without the establishment of strong quality assurance mechanisms, the health of the Greek population continues to be at risk.
Parliament must pass legislation establishing the new Agency for Quality Assurance in Healthcare. Without this new quality assurance mechanism, we will miss our chance to leverage our victories against COVID-19 to strengthen the Greek health system and ensure we are prepared for the next health crisis.
As part of its mission, the AQAH would also focus resources on promoting equal access and universal health coverage to the entirety of the Greek population. Universal health coverage for all humans on earth is a core tenant of the United Nations’ Sustainable Development Goals, and a global effort is underway to support this coverage worldwide by 2030.
*Written by Theoklis Zaoutis, MD, MSCE
Director of CLEO,
Professor of Pediatrics and Epidemiology
University of Pennsylvania School of Medicine
Division of Infectious Diseases
The Children's Hospital of Philadelphia