Paphos People

A BRITISH expat who is terminally ill with lung cancer and a brain tumor is unable to receive treatment in Cyprus because no one seems to know what his entitlements are as an EU citizen.

Long-term resident of Cyprus, Richard, who is 55, was turned away from the Bank of Cyprus Oncology Centre in Nicosia on Thursday when he was unable to pay a bill of €10,000 for previous treatment because he does not have private insurance.

And because he did not have a free cancer treatment, or so-called ‘white’, card from the Health Ministry, administration staff at the oncology centre sent him packing.

The director of the Oncology Centre Alecos Stamatis confirmed that all cancer sufferers who have a white card from the Ministry are treated free, irrespective of income or possession of health insurance. But someone who shows up with no card and no insurance cannot be treated, he said.

Richard cannot get a white card from the Ministry without possessing a general EU medical card, which entitles him to the same treatment as Cypriots.

In fact, according to another expat, Bob Cracknell, who is speaking on behalf of the man’s family, administration staff at Limassol hospital said Richard was not entitled to the white card “because he was a foreigner”, and that free cancer treatment was only for Cypriots.

Richard applied to Britain for the EU medical card that could help him get a white card in Cyprus but was turned down because he had not lived and worked in the UK and so did not qualify.

He has been in Cyprus for around eight years, locally employed by a British tour operator until his recent collapse, when it was established he has tumors on both lungs, and also a brain tumor.

No one seems to know what Richard’s rights are. Neither the oncology centre, the British High Commission nor Health Minister Christos Paschalides were able to answer the questions, ‘If cancer care is free for all Cypriots irrespective, are other EU citizens entitled to the same free cancer care?’

And: “Does Richard need a general EU medical card to obtain the white card necessary, or is he, as an EU citizen resident on the island, allowed to get only the white card to have his specific illness treated?”

To be fair to the Minister, the Sunday Mail was only able to track him down yesterday where he could not give a direct answer. He said there were various categories that Richard might fall into from discount cards to free treatment. Paschalides said he would look into it tomorrow.

“It needs to be established,” Richard said yesterday. “There could be lots of other people in similar circumstances and they need to know.”

When he was first taken ill, Richard’s medical costs were covered by his employer. They also offered to fly him back to the UK for treatment on the NHS but Richard has no family or support in Britain, and Cyprus is his home.

“I was told by my (private) doctor here that treatment for cancer was free full stop,” said Richard. “That’s the reason I decided to go ahead with the treatment here.”

When he first went to the Oncology Centre in Nicosia staff must have assumed he could pay, or was insured because no one really pressed him to pay up front even though he spent 22 days in intensive care. He in turn thought he was receiving free treatment, he said.

That was until Thursday when he was due to be checked in for chemotherapy and was told unless the €10,000 bill was paid, they could not readmit him to the centre.

“I was devastated,” he said. “I didn’t have any money and they said they couldn’t treat me. The woman was unequivocal. She said sorry we can’t treat you until you pay.”

Richard must receive his chemotherapy on Tuesday at the latest. “If I don’t, it could affect my chances of recovery,” he said. ‘There is a time pressure.”

Richard’s doctor at the centre has told him that if he could scrape enough money together for the chemo session, the issue of the outstanding bill could be negotiated so his family is considering borrowing the money to at least keep up the chemo. “But it’s not a matter of penny pinching,” said Richard. “What we need to know is whether cancer treatment for EU citizens costs or it doesn’t.”

Stamatis said the clear criteria for treatment at the centre was whether someone was the holder of a white card from the Ministry of Health, or not.

“If they do then they are entitled to all of our services in the same way as a Cypriot citizen,” said Stamatis. ‘If the Ministry is unable to issue the card a person is obligated to pay out of his pocket. This is the agreement we have with the government.”

Stamatis said he was not sure what the status was vis a vis the EU, only that the law states they must be treated the same way as Cypriots, which brought the subject back to the necessity to have a white card and another round of going in circles.

Cracknell, who has been fighting Richard’s corner since he first took ill in July, said he was sure Richard was entitled to the white card, even if he didn’t have the EU general medical card. “I’ve heard Ministers say cancer patients do not pay in Cyprus,” he said.

“To turn to a dying man and say ‘if you don’t pay, you don’t get treated….’ Where is the Hippocratic Oath?”

A spokesman at the British High Commission was also flummoxed over what the exact entitlements were. “It’s all very complex,” he said. “It appears he (Richard) has fallen through the net really.” The spokesman said Richard, as a British citizen in distress, should contact the consular section of the High Commission to try and establish his rights.

Good news for cancer patient


A BRITISH cancer sufferer who appeared to fall between the cracks when it came to treatment in Cyprus may qualify after all for medical help despite being initially turned away.

Richard, 55, who has lung cancer and a brain tumour was initially turned away as not qualifying for free cancer care at the Bank of Cyprus Oncology Centre because he was told he did not qualify for a medical card.

He had no private insurance and didn’t qualify for an EU medical card from the UK.

However Health Minister Christos Patsalides referred the case to an official at his Ministry who was knowledgeable about the rights of EU nationals in Cyprus. It appears now that Richard may after all qualify for free cancer care.

According to another expat, Bob Cracknell, who had been trying to help Richard establish his rights, Ministry official Andreas Kyriakides took it on himself to check with the Labour Ministry to see if Richard had paid social insurance.

He established that Richard had paid into the system and will probably qualify for a card, Cracknell said. He said Kyriakides could not have been more helpful and had spent two days on the case.

Richard was due to begin a new round of chemotherapy yesterday, and Cracknell said there was more good news for the British expat when his employers, Thomas Cook decided that even though Richard has had to stop working, they would pay his salary until October.

“This might help pay for a carer when Richard’s daughter leaves,” said Cracknell.

When Cracknell initially went to health officials on Richard’s behalf he was told Richard did not qualify for free cancer care because he was a “foreigner”.

In the intervening time when Richard was being treated, it resulted in a bill of €10,000 from the Bank of Cyprus Oncology Centre, money Richard’s family does not have.

The two month saga was a direct result of the fact that no one at lower levels in the health sector were able to clearly state what his rights as an EU citizens were.

On Wednesday Kyriakides urged all EU nationals from other member states to make sure their residency and work status in Cyprus is properly established to avoid mix ups over medical treatment down the line.