Pascalinah Kabi
THE Ministry of Health has resolved to engage private medical practitioners to avail their facilities and services to the public in a move sources say is part of government efforts to cut itself loose from its costly contract with Queen ‘Mamohato Memorial Hospital (QMMH).
The ministry has also resolved to engage Basotho specialists in the diaspora to offer health services at some of the government facilities.
The Minister of Health, Nkaku Kabi, recently told the media that the measures were part of government efforts to reduce the burden on QMMH after the hospital recently announced that it was filled to capacity and could no longer admit any more patients.
Mr Kabi further revealed that the government had set aside M34 million for the procurement of essential equipment for the health facilities where the foreign-based specialists will work. These include the Mafeteng and Motebang Government Hospitals.
Mr Kabi said the measures would help cut the huge payments the government made to QMMH for extra patients over and above the annual subvention of M549 444 million which was also paid to the institution.
“Local doctors based in South Africa have agreed to come and offer their services at an agreed rate,” Mr Kabi said, adding, “they were supposed to have started work on 1 September but due to stringent government procurement procedures, they could not start because of lack of equipment”.
“The Ministry of Finance has already released M34 million funding but there are red tapes that we must go through before purchasing the necessary equipment.”
He said Mafeteng and Motebang Government Hospitals would be used as referral centres once the necessary equipment is delivered.
“Our measures include availing equipment to the other 19 health facilities and we also want private hospitals to assist us as well. I know we will save a lot of money by engaging them because they are going to charge us way less than what Tšepong is charging us,” Mr Kabi added.
However, some Health ministry sources told the Lesotho Times that the moves to use private health facilities and engage foreign-based specialists were an attempt by government to wriggle out of its costly deal with QMMH also known as Tšepong.
“You will recall that the former Health minister (Nyapane Kaya) said the cabinet had come up with a solution to address problems at the hospital and the measures announced by Mr Kabi are what he was talking about,” said one source.
“Ntate Kabi is trying to be diplomatic on this matter but the fact is that government feels trapped by this contract and wants out.
“So, part of the plan is to leave Tšepong alone by bringing in Basotho doctors from the diaspora and resorting to privately owned local facilities. The ministry is hoping that these measures will only ensure that government saves millions of maloti which would have been given to Tšepong. The ministry also hopes that the measures will stop the management of Tšepong from doing as they please in this country.”
Early this year, Mr Kaya told this publication that the cabinet had come up with a resolution to address problems such as the go-slow by nurses that has crippled operations at QMMH.
However, Mr Kaya would not be drawn to elaborate on the measures the government would take, saying they would be announced in “due course”.
QMMH was opened in October 2011 to replace Queen Elizabeth II Hospital as the country’s major referral healthcare facility.
South African healthcare group, Netcare, formed a consortium with local companies, and in October 2008 an 18-year PPP agreement was signed between the government of Lesotho and the new company, Tšepong.
However, the hospital has been under fire for allegedly fleecing the government and flouting the tenets of the agreement. Its operations have also been hamstrung by a long-drawn go-slow by nurses who are miffed for being overlooked in salary increments given to pharmacists and other staff.
Mr Kaya stated early this year that the government wanted out of what he described as a “lopsided contract”. The then Health minister said the hospital could not justify being allocated M549 444 million from the M2, 5 billion budget meant for the health sector while failing to treat cancer patients or providing dialysis services.
The hospital refers cancer patients to Free State hospitals in South Africa at the government’s expense.
For their part, Tšepong management have said the PPP with the government was costing more than initially envisaged because the hospital is serving more patients than the agreed number.
They have also denied allegations of fleecing the government, saying there is an agreed expenditure formula in the partnership which is directly linked to the number of patients.
Members of the public submitted a petition to Mr Kaya demanding a cancellation of the PPP agreement which they said favoured the consortium.
They also called for an investigation into the hospital’s operations saying many people had died due to negligence.
According to the 18-year Private Public Partnership (PPP) contract the government signed with QMMH in 2008, the hospital can only treat a maximum of 20 000 in-patients and 310 000 out-patients per year.
The government is charged extra costs for the treatment of each patient beyond the agreed numbers of in and out-patients.
In March this year, the Lesotho Times reported that the government owed Tšepong M399, 634, 963, 54 for treating extra patients from 2014 to 2017.
The amount is almost as much the M400 million that the government committed towards the the construction of QMMH in 2008.
Mr Kabi said it was unfortunate that some senior government officials had aggravated the crisis at QMMH by instructing the hospital to admit patients without referrals. He also said the crisis had been worsened by the high numbers of terminally ill patients, expectant mothers and others who suffered complications resulting from illegal abortions.
He said QMMH was only mandated to admit expectant mothers who were likely to suffer complications and it was worrying that 19 other health facilities that delivered babies were shunned by the public.
“(As government officials) we should shoulder the blame because we have misused our powers by instructing the hospital to admit our patients. We must stick to the principles that Tšepong should only admit referrals because we cannot expect the hospital to admit ‘our patients’ and turn others away.”
He also said that Tšepong was also in the wrong because it seemed that making money was more important to them than sticking to the regulations that govern the PPP agreement.
On her part, QMMH General Manager Mathuntsane Zondy Mohapi said the hospital was doing its best to provide health services in line with its agreement with the government.
“We are in an agreement with the government to provide services that the rest of the health facilities are not able to provide and we are providing those services to the level of our capacity.
“We acknowledge that there are some specialists that we don’t have in country simply because when you look at the number of patients that they have to see, it is not economically feasible to keep them in the country. But where there is a need, we refer the patients to South Africa and Tšepong bears the costs,” Ms Mohapi said.
