- seeks World Bank help in reviewing unfavourable contract
Pascalinah Kabi
HEALTH Minister Nkaku Kabi has accused the Tšepong Consortium of prioritising profits over its contractual obligations to hire doctors to provide specialist services to the public at Queen ‘Mamohato Memorial Hospital.
Mr Kabi said as a result, his ministry was in talks to bring in specialists from Kuwait, Iran and India to ensure Basotho patients had timely access to health services within the country.
He said he had also approached the World Bank to mediate between the government and the Tšepong Consortium in their dispute over the implementation of their 18-year Private-Public Partnership (PPP) agreement for the construction and operation of the Queen ‘Mamohato Memorial Hospital.
Mr Kabi said this at a recent press conference in Maseru.
Widely known as Tšepong, Queen ‘Mamohato, is Lesotho’s main referral hospital.
It 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.
Last 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 2018 and the government subsequently stated that it would not pay for extra admissions the hospital made to its private wards and other departments.
In addition to the stand-off over patients, the two parties are at loggerheads over the latter’s apparent failure to recruit specialists and perform some specialist health procedures locally instead of referring patients to South Africa.
Mr Kabi said the consortium had failed to hire specialists because they were prioritised making profit at Tšepong.
“There are questionable things that Tšepong is doing and this makes the nation angry with us,” Mr Kabi said.
“There are many issues being misinterpreted by Tšepong, probably to make the nation angry and quick to attack us. We know that in the contract we signed with Tšepong, they were mandated to hire specialists and provide specialised care but they are not providing those services because they have not hired specialists.
“This is probably because those specialists are expensive and Tšepong is being cost effective; trying to make high returns instead of paying for services (hiring specialists) that they are supposed to offer. To cover this shortcoming, they are referring patients to South Africa. South Africa is not attending to these patients on time as they only admit Basotho patients where there is space.”
He said his ministry was in talks to bring in specialists from Kuwait, Iran and India to ensure Basotho patients had timely access to health services within the country.
He said Indian specialists, who had recently attended to 49 patients in Leribe during their induction, were expected to start work today. Cuban specialists, who were already in the country, would immediately start work upon completing their orientation.
“We didn’t want to make this announcement before everything is concluded because we have a backlog of 18 000 patients waiting to see specialists outside the country. The number is increasing and other patients are dying due to delays in accessing specialist care.”
He also said the ministry engaged South African-based Basotho specialists but they could not start work as initially planned in September 2018 due to delays in procuring medical equipment for the country’s district hospitals.
“The medical equipment was only delivered in May 2019 and it has been successfully mounted in all district hospitals. We are on the verge of offering specialised care. We are going to have our own referrals in the northern (Motebang Hospital in Leribe) and southern (Mafeteng Government Hospital) regions (sic). We also received donations of intensive care unit equipment for Mafeteng hospital.
“The Basotho specialists (who have been engaged to work part time in Lesotho) are the same people who are assisting our patients in Bloemfontein. The only difference is that at Pelonomi, Univesitus and Mediclinic (hospitals) their bills are too expensive. For example, a cancer patient is charged M800 000 while other operations cost government about M180 000 for each patient. Having specialists here means that there is a going to a huge relief on finances,” he said, adding the government would only pay M60 million per year to have the specialists work part time in Lesotho.
He however, said despite all this, the government would continue paying M540 million annually to Tšepong because of the unfavourable contract government had signed with the health services provider.
“I had thought that the Leribe and Mafeteng arrangements – for patients to see specialists – will drastically cut our spending on Tšepong. I believed that the M540 million paid to Tšepong would go down and the surplus would be directed to other commitments but I am told the M540 million is fixed in the contract.
“In my own opinion, that is the cruelest contract I have ever seen. One would think that Basotho who were negotiating on behalf of this country should have protected this country,” Mr Kabi said.
He however said, all was not lost as the World Bank had agreed to support the government’s quest to renegotiate its contract with Tšepong. He said Finance Minister Moeketsi Majoro, Ministry of Health officials and World Bank experts had met to discuss the issue and it was agreed that the World Bank would look into the issue and advise how best the contract could be renegotiated.
“We complained to World Bank. We tried reviewing this contract with Tšepong but it became clear that we don’t respect each other enough and this could end up in the courts of law.
“This would have been a setback for us and we therefore decided to engage the World Bank and it appears things will go as we had hoped and we might renegotiate the contract. They don’t want this matter to be handled by Tšepong and the government on their own and have therefore asked that they deal with this matter. It will help them determine how best the contract should be renegotiated. I will not go into details until they have completed their process and have submitted the report to us.”
