- as hospital turns away patients over unpaid dues by the state,
- even those with terminal conditions like diabetes and hypertension not spared.
Limpho Sello
THE stand-off between the government and the Tšepong Consortium over the state’s termination of the latter’s contract to run the Queen ‘Mamohato Memorial Hospital (QMMH) has left hundreds of patients, including those with terminal conditions, stranded.
The Lesotho Times has established that the hospital and its three filter clinics are turning away patients including those with life-threatening conditions like diabetes and hypertension.
Even patients who had already been booked for check-ups are not being allowed past the hospital gates. The hospital staff and security are telling them that they will not be offered any services because the Consortium has downsized its operations ahead of handing over the hospital and related facilities to the government. This after the government’s March 2021 decision to cut ties with the Consortium which has run QMMH since it opened its doors in 2011.
Announcing the decision, Mr Sekatle said the government felt it could no longer continue its 18-year PPP entered into in 2008 with the Consortium for the construction, running and transfer of the hospital due to serious differences which had plagued the agreement from the very beginning.
South African healthcare group, Netcare, has a 40 percent stake in the Tšepong Consortium. Four other companies, namely, Afri’nnai of South Africa; Excel Health, Women Investment and D10 Investments (all from Lesotho) hold the balance of the shares.
Mr Sekatle had said although the government and the Consortium had differed over many issues, the final straw was the latter’s March 2021 decision to fire 200 striking nurses and nursing assistants at the institution.
The nurses went on strike on 1 February 2021 to press the government and QMMH to award them salary increments to match their counterparts in other government and private institutions.
QMMH nurses said they had not been awarded any increments since 2012 when the government and the Christian Health Association of Lesotho (CHAL) increased the salaries of nurses at other institutions.
According to the Lesotho Nurses Association (LNA), nurses at QMMH earn about M9000 each per month. The figure is way less than the M13 000 earned by their colleagues in CHAL facilities and other government hospitals.
After the firing of the nurses, Health ministry Principal Secretary (PS) Khothatso Tšooana had written to the Consortium informing it of the government’s decision to terminate the contract.
In his 12 April 2021 reply to PS Tšooana, Tšepong general manager Zondy Mohapi indicated that the Consortium would not challenge the termination of its contract but would demand the requisite compensation.
However, the Consortium vehemently denied any wrongdoing, including claims that it had fleeced the government and repeatedly failed to offer specialised care to patients over the years.
The Consortium agreed to vacate the hospital but said the government would have to compensate it for the premature termination of the 18-year PPP deal.
Although the Consortium had been given up to the end of next month to leave, it announced last week that it would be departing earlier than that date.
It did not give a specific date for its premature departure but said it had already started scaling down operations at QMMH and its three filter clinics “as part of processes to hand over the hospital to the government”.
In a statement last Wednesday, Netcare, the biggest company in the Consortium, said, “the decision to commence the handover of the facilities and operations follows the repeated failure by the government of Lesotho (GoL) to settle the arrear payments for services rendered by Tšepong”.
“The GoL has been persistent in demanding that Netcare, as the sub-contractor, continue to provide full services until 31 August 2021, notwithstanding that it is currently four months in arrears and is now into the fifth month of unpaid contractual monthly fees.
“In its capacity as a shareholder of Tšepong, and as the major provider of services to Tšepong, Netcare has continued to act in good faith and provided ample written notice to Tšepong and the GoL, as well as follow-up reminders that GoL is substantially in default of its payment obligations under the PPP agreement. The GoL has repeatedly reiterated that it has no intention of making these scheduled, contractual payments at this stage, and will only consider making payment after the PPP termination date of 31 August 2021.
“In light of these circumstances, Netcare is no longer prepared to fund ongoing operations on behalf of the PPP. Netcare has provided financial support on numerous occasions over recent years to enable continued operations at the hospital and primary care clinics when the GoL failed to make timely payment for services. The refusal by the GoL to pay the outstanding fees clearly places an unreasonable expectation on suppliers to continue providing full services at a substantial level of commercial risk to their businesses,” Netcare added.
It said it will downsize its operations and only attend to emergency cases.
“The hospital will accept all urgent cases and emergencies, including obstetric emergencies, and outpatient services will remain available for any unstable patients. All other patients will be referred to government clinics and facilities,” Netcare said.
The Lesotho Times crew visited QMMH and the Qoaling, Likotsi and Mabote Filter clinics from Monday up to yesterday and observed patients being turned away by staff and security at the health facilities.
At QMMH and all three clinics, there were notice boards boldly inscribed, “Urgent Notice: from Monday 19 July 2021, only emergency services that include delivery and injury casualties among others (sic)”.
It was apparent that life-threatening conditions like diabetes and hypertension were not considered emergencies as patients with these conditions were also turned away.
It did not matter that the patients had prior bookings and some of them were in urgent need of medication and insulin, administered to those with diabetes.
Instead of getting some help, they were told that they could not be attended to because theirs were not considered emergencies.
There was no compassion even for the elderly as they were told to go elsewhere for services.
Some of the stranded female patients milled outside the hospital in the vain hope that they would eventually be allowed in.
One of the patients, an elderly woman with hypertension, begged the security details to let her in as she was due for a check-up yesterday.
After being denied entry, she wondered aloud how she was going to cope as she had run out of medication.
“I do not know what to do because no one has bothered to give us a clear way forward,” said the woman who refused to be identified.
“This hospital saved my life. Before coming here, I used to go to various clinics but my health kept deteriorating. I came here and things changed for the better. The medication they have been giving me is very good for my health.
“Now that they are turning me away, where will I get help?” the woman asked.
Another woman who said she was 70 years old but refused to give her name said she was diabetic and had run out of insulin.
“I have run out of insulin and other medication. I do not know what I am going to do. My medication is every expensive I can’t afford it on my own. I can’t go anywhere else in Maseru to access such services.
“The government must urgently do something to help otherwise we will all die,” the woman said.
QMMH Public Relations Manager, Thakane Mapeshoane-Sepipi, refused to comment saying she had been “strictly ordered not to say anything” on the QMMH and Consortium’s issues until further notice.
“I will not say anything concerning the issues you have asked about. I hope you understand,” Ms Mapeshoane-Sepipi said.
Health Minister Semano Sekatle’s mobile phone rang unanswered yesterday.
