A recent Audit Office report has revealed serious irregularities at the Larnaca General Hospital (LGH), where on-call doctors were found absent from their emergency duties while still receiving on-call allowances ranging from €450 to €850 per shift.

As Brief writes, the findings come from a special audit for the year 2023, which uncovered that in most cases, specialist doctors on call (on-call physicians) did not appear at the Accident and Emergency Department (A&E) — even when patient admissions required their presence.

In these situations, junior doctors handled patient examinations and care, yet the specialists still received their full on-call pay.

From a sample of 23 cases, in 22 instances where patients were admitted, the on-call specialist had not documented the patients’ clinical condition or examination time in the official A&E records.

According to the AO, accurate recordkeeping is crucial to ensure the quality of healthcare services, proper updating of medical files, and verification of specialists’ attendance during on-call duties.

The audit’s conclusions, combined with information from the LGH management and the Health Services Organization’s (OKYPY) Board decisions, indicate that it has become standard practice for on-call specialists not to report physically for their shifts, leaving junior doctors to manage emergencies alone.

This situation raises several concerns:

• Patients may not receive appropriate medical care, as telephone consultations between juniors and absent specialists cannot replace in-person evaluations — leading to potential misdiagnoses, incorrect treatment, or premature discharges.

• Public funds are being misused, as doctors are paid significant on-call allowances (€450–€850 per shift) without providing the corresponding service.

• A lack of clear internal guidelines allows such practices to persist, with no defined cases where supervision can occur without the specialist’s physical presence.

The AO recommends the introduction of explicit instructions and strict penalties for non-compliance to prevent further misconduct that could endanger patients or compromise medical integrity.

The report also uncovered severe documentation gaps—missing signatures, timestamps, and clinical details in patient records.

In 2023 alone, LGH failed to submit 5,116 claims to the Health Insurance Organization (HIO) for outpatient services, resulting in a loss of €67,681.

One physician alone failed to submit 51.22% of patient visits, with no disciplinary action taken.

Overall, the hospital submitted 76,885 claims to the HIO for inpatient and outpatient services and received €28,975,912, covering both 2023 and previous years.

However, the claim submission process remains entirely the responsibility of individual doctors, with no internal monitoring or control mechanism for outpatient claims. By contrast, inpatient services are subject to a tracking and verification system ensuring the proper filing of claims.

The AO warns that unsubmitted claims not only deprive the hospital of revenue but also leave patient medical records incomplete in the HIO’s system — a serious concern that could jeopardize patient safety.

The report also highlights inadequate archiving conditions for A&E documentation, stored in unsuitable spaces without a filing system, exposing data to loss and privacy breaches.

The AO stresses that these findings, while alarming, are not new — many of the identified issues are long-standing despite previous efforts by the Health Services Organization.

It calls on relevant authorities to take decisive corrective measures to restore accountability, ensure patient safety, and safeguard public resources.