Govt-Tšepong stand-off leaves patients stranded

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…some medical operations deferred as hospital tells patients to come in 2019

Mohalenyane Phakela

THE stand-off between the government and Queen ‘Mamohato Memorial Hospital over the admission of patients has left hundreds of patients requiring medical attention including operations stranded, the Lesotho Times has established.

The hospital has been turning away patients requiring operations, telling them to come back in 2019 after it exceeded its quota of patients for 2018 in terms of its agreement with the government.

Tšepong, as the hospital is widely known, was opened in 2011 replacing Queen Elizabeth II Hospital as the country’s major referral health facility. It refers cancer patients to Pelonomi, Univesitus and National hospitals in South Africa, with government footing the bill.

The hospital is owned by the government but is run by the Tšepong consortium of five companies, namely Netcare Healthcare Group and Afri’nnai of South Africa, as well as Excel Health, Women Investment and D10 Investments from Lesotho.

In October, the hospital announced that it would only admit patients with life threatening conditions and attend to emergencies until further notice.

This was in response to a government announcement that it would no longer pay the hospital for inpatients beyond the contractual number of 20 000 inpatients per year. Tšepong is mandated by the government to provide health services to a maximum of 310 000 outpatients and 20 000 inpatients annually.

The contractual quota of 20 000 inpatients was reached in September and the government subsequently stated that it would not pay for extra admissions the hospital made to its private wards and other departments.

Tšepong has since responded by turning away hundreds of patients of patients including those requiring operations for various medical ailments.

Despite requiring urgent medical attention, some patients told this publication that they were told to “go home and only report at the hospital next year when Tšepong can take in new patients in terms of the agreement with the government”.

One patient who spoke to this publication on condition of anonymity said he had been scheduled by Tšepong to undergo surgery on 3 December this year. He said when he went to the hospital on the said date, he was turned away and told to return in April 2019 as the hospital had reached its quota of operations for this year.

“I have been going for medical check-ups at Tšepong for a long time and sometime in August a doctor told me to come for an operation on 3 December. But to my surprise on 3 December, I was told to return in April next year as they had reached their quota of operations for this year.

“I tried to reason with them that I had been allocated this date a long time ago but I was told there was nothing the hospital could do about it other than to refer me to a new date next year because the government had ordered them to stick to the agreed annual quotas for admissions.

“I do not know what to do or what to expect of my health while waiting for April 2019. I believe I was given the December 2018 date because the doctor was sure I needed the operation. Postponing for four months is a danger to my health,” the patient said.

The patient however, refused to disclose the nature of the operation he was meant to undergo, saying it was a personal issue.

Another patient told this publication that the hospital deferred her scheduled operation to remove fibroids from her private parts. She said the condition resulted in excruciating pain and discomfort.

Tšepong Spokesperson Mothepane Thahane confirmed that they were turning away patients because of the government’s insistence that they stick to their contractual obligations.

She said the government decision was not only a setback to patients but also to the hospital as they were committed to helping patients.

“This is the first time that we were told not to exceed the quota because before this we have always helped patients whenever they came to us. Our goal is to help the ill to recover as fast as possible but now we are having to refer patients to other dates next year. This is not only a blow to the patients but to our doctors who have to suspend their work,” Ms Thahane said.

“However, the kind of operations we have suspended are those that are not emergencies such as those that require elective procedures which scheduled in advance because they do not involve a medical emergency.

“We were on the other hand told that alternatively, the government would treat patients at their own hospitals but I do not know which those hospitals are and whether they have the right equipment for the procedures. We started turning away patients in October but we will start treating them again in January next year in terms of the quota we were given by the government.”

On his part, the Minister of Health, Nkaku Kabi, referred this publication to the Director of Public Private Partnerships, Ms Ntoetse, saying she was better placed to answer as she was dealing directly with Tšepong issues.

However, Ms Ntoetse said that she was no longer employed by the Ministry of Health and therefore could not answer on their behalf.

“I am no longer with the Health Ministry therefore I cannot be expected to answer anything related to it. I cannot expect you to answer anything on behalf of Lesotho Times when you are no longer with them,” she said.

Mr Kabi recently accused Tšepong of working to tarnish government’s image.

His remarks shortly after the hospital announced that it would only admit patients with life threatening conditions or attend to emergencies until further notice.

Tšepong further stated that it will no longer facilitate non-emergency referrals to Bloemfontein, South Africa and that patients who need treatment in Bloemfontein will be referred directly by the Ministry of Health.

However, Mr Kabi accused Tšepong of being “attention seekers” who only released the statement to divert the negative publicity it had been receiving to the Ministry of Health when in actual fact, the hospital had failed in its mandate of delivering quality services to Basotho.

“Our suspicion is that they are closing these (hospital) wards to cause mayhem and divert the attention to the Ministry of Health,” Mr Kabi said.

“We have a contract with Tšepong which they have been failing to comply with. As per our agreement with Tšepong, we have public wards which are subsidised by the government and the private wards which are supposed to be run by Tšepong who should incur all the risks and finances.

“They (Tšepong) have been avoiding to run the private wards at their own expense and only opened them to the public so that government can pay them. They then kept reminding us that the opening of the private wards to the public would result in costs to the government yet they were never supposed to be opened to the public in the first place.”

Mr Kabi said although there were ongoing talks aimed at finding long-lasting solutions to the challenges at the hospital, it was wrong for Tšepong to announce that they closed the private wards to comply with the original agreement with the government.

He said the hospital authorities erred when they said that the Ministry of Health had called for the closure of the private wards when they knew very well that they should have operated such wards at their own expense.

“We are simply referring to the contract which was supposed to be followed. Tšepong need to be clear about the private wards.

“Tšepong is also expected to perform other special health services or operations but it fails to perform such services and refer patients to Bloemfontein.

“Tšepong is supposed to refer patients at its own expense because the expectation is that if they fail or lack the expertise they are supposed to have, they should not bill us for the costs of such referrals. The contract clearly states that it is their responsibility to source those services.

“Besides this we had a gentleman’s agreement with them to assist us with logistical arrangements for the referrals of cancer renal and plastic surgery patients while we bore the costs. If they are abandoning that arrangement, we are ready to take over as the responsibility has always been ours but only used them for convenience. We will use our ambulance or we will outsource to a private ambulance company and pay them to carry out the work.”

He said the ministry was still waiting to take delivery of the equipment it had ordered so that they can attend to patients at chosen regional hospitals such as the Motebang Hospital and Mafeteng Hospitals. He said when that happens Tšepong would be used only in emergencies.

“Ours is to wait for the medical equipment to arrive, they should close their private wards and we should close Tšepong. We should beef up our system and see how they will survive without any referrals because they have failed to do what they are supposed to do.”

He accused Tšepong of acting the way it did out of the knowledge that it took a long time to resolve disputes in the courts of law.

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