Directory of European Resources > Eurocleft Clinical Network > Registered Clinical Teams > Greece

Clinical Teams in GREECE

• Athènai
• Athénai (Hellenic Craniofacial Centre)
• Thessalonki

Population
Approximately 10.7 million.

Health Service
At present the provision of hospital services is considered a function of the state. The private hospital as a business enterprise does not occupy a significant position in the delivery of patient care. 30% of beds are in private hospitals, the remainder in NHS hospitals. A recent act passed by parliament aims to shift resources towards primary health care and to give more incentives and autonomy to hospital administration in an effort to increase the efficiency of public hospitals. Also the patient’s charter has been set up by law and a regional network for public health has been established. Approximately 40% of total hospital expenditure is reimbursed by the state, 30% by insurance companies and the rest from private sources. Care is free of charge since almost all Greek citizens are covered by governmental or semi-governmental health insurance.

The largest contributory health insurance scheme for labour and clerical workers under governmental sponsorship (50% of the population) is known as IKA. From 1998 the provision of health insurance for farmers will also be organised under an autonomous semi-governmental insurance fund (23%). Traders, the self employed (13%) and public servants (7%) have their own funds. There are plans underway to create a law for the accreditation of hospitals and other health care organisations.

Cleft Care Organisation
Greece has around 170* new born babies with clefts each year, but many of these are never registered. Three teams, two in Athens and one in Thessaloniki offer cleft care and may be considered as centres, however, care is primarily given by individual clinicians. Officially, there are two centres functioning now in Athens. One in the private sector in a large maternity hospital and one, rather recently established public Centre, in one of the Children's Hospitals of Athens. However, the teams working in the Graduate Orthodontic Clinics, in the Dental Schools of Athens and Thessaloniki, provide co operation between specialists. The "Public Centre for Congenital Malformations" was officially initiated by the Government, in 1999, at the Children's Hospital Aghia Sophia of Athens. Collaboration with the Orthodontic Department of the University of Athens is active as usual, but some of the official positions of the various members of the team are still vacant, as they have not been opened up by the Ministry of Health. Also, official registration of all new borns with malformations, has been initiated, but the response is not satisfactory.

Treatment can be free in the public hospitals or at the discretion of private clinicians. The Greek Society for the Study of Clefts and Craniofacial Anomalies was established in 1989. It brings together different disciplines at an annual conference and has made efforts to encourage a team approach to the treatment of clefts. Also, a parents' organization by the name "ORTHOMORPHIA" has been founded in 1999.

Challenges to Attaining the Eurocleft Consensus Recommendations
The Ministry of Health has not yet prioritised the problem of fragmentation of care and there is no strong medical/dental body to press for change, or consensus on responsibility for primary surgery. There are no special training programmes for clinicians, except in the curriculum of the graduate orthodontic programmes, and no official government policy. As yet there has been no Greek participation in intercentre comparisons or clinical trials.

Future Plans
There is hope that the specialised centre founded in one of the children’s hospitals in Athens will have all its specialist positions filled. There have been some changes in attitude of the authorities, although this process is very slow.

* Estimated number of clefts per annum using World Fact Book figures of 10.7 million population, birth rate of 9.54 per 1,000 population and assuming incidence of clefting at 1:600.