HUNDREDS of patients in desperate need of medical attention for various conditions including cancer, fibroids, complications arising from illegal abortions and stab wounds are stranded after Queen ‘Mamohato Memorial Hospital in Maseru recently began turning them away after reaching its quota of in-patients in terms of its agreement with the government.
So dire is the situation that at least 100 patients had to be given new dates for biopsy tests after the hospital said it was full and could not take in more patients.
A biopsy is a medical procedure to remove a piece of tissue or a sample of cells from the patient’s body so that it can be analysed in a laboratory to test for certain conditions including cancer.
Some stakeholders in the health sector who spoke to the Lesotho Times on condition of anonymity, urged the government to reconsider its stance and allow the hospital to admit more patients into its private and other wards as it had always done. The stakeholders said the government should shoulder the extra costs until it had fully staffed and fully equipped its district hospitals to reduce the burden off Queen ‘Mamohato Memorial Hospital.
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.
All along the hospital would take in patients whenever they sought treatment for various ailments but that changed last October when the hospital management announced that they 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 in-patients beyond the contractual number of 20 000 in-patients 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 in-patients was first reached in September 2018 but the hospital could still be admitting more patients to its private wards and other departments had it not been for the government’s announcement that it would not pay for any extra admissions.
The situation had eased from the beginning of this year as some patients were discharged and the hospital had been taking in new admissions. However, last Wednesday, the hospital’s public relations officer, Mothepane Thahane, announced that the hospital was once again filled to the brim and they would no longer admit new patients.
“It is with greatest regret that I wish to announce that the hospital is full to capacity. We cannot continue to admit patients,” Ms Thahane said, adding, “Please let patients to go nearest hospitals”.
“We are working together with the Ministry of Health to collect patients here (at Tšepong) and transfer them to the district hospitals. We are filled to the brim and there is no way we can continue to admit patients.”
In a subsequent weekend interview with this publication, Ms Thahane said they were forced to turn away patients from the hospital because they had already reached the quota of patients in terms of their agreement with the government.
“You will remember that the government gave us a quota last year and as we speak, we have reached that number and we are sticking to that agreement. We have reached the limit and cannot admit any more patients. Government said, ‘please stick to the agreement’ and this is us sticking to it,” Ms Thabane said.
Before the government told the hospital to stick to the quota, the hospital always helped patients whenever they sought medical attention and it would also assist patients who had not been referred to the hospital.
The Health Ministry’s Director General for Health Services, Dr Nyane Letsie, also weighed in on the saga, saying the government had to transfer patients from Tšepong to the district hospitals because all the beds at Tšepong were fully occupied.
Dr Letsie said there was the worrying issue of at least 100 patients who had to be given new dates for biopsy tests after Tšepong said it was full and could not take in more patients.
“The biggest setback is that of 100 patients who have had to be given new appointments for their biopsy tests. These are male patients who are supposed to be screened for prostate cancer and this is a crucial test that should not be missed,” Dr Letsie said.
“Every month end the number of patients presenting with wounds from knife stabbing, head injuries, trauma and labour issues increase drastically and appointments for people who were booked for operations have had to be postponed because all the beds are occupied.
“Secondly, district hospitals have a tendency of delaying to collect their patients after they have been discharged from Tšepong. For instance, some patients are only collected from the hospital by their respective district hospitals four days after they have been discharged. This means they continue to occupy beds that should be occupied by new patients,” Dr Letsie said.
She said that the country was again experiencing high numbers of patients presenting with complications from illegal abortions. She said most of the patients were factory workers who were only able to access illegal abortion services after their payday.
The majority of factories pay their workers on the last Friday of every month and factory workers received their August salaries on 30 August 2019. Shortly after their payday, Tšepong announced that the hospital was fully booked.
“The labour ward is full with most of the patients in that ward presenting with complications from illegal abortions. The patients only come to the hospital when the situation is dire and we now have a maternal death because of this issue. Those patients cannot be turned away from Tšepong because it is an emergency situation,” Dr Letsie said.
She said patients with complications from illegal abortions were now being transferred to Berea district hospital to make way for others.
Dr Letsie said the situation at Tšepong was worsened by the delays in re-opening the Maseru District Hospital from its new temporary base at the BEDCO premises in Maseru.
The Maseru District Hospital, also known as Queen Elizabeth II, will soon be demolished and the health ministry is making arrangements to have it temporarily operate from BEDCO.
“Currently there are 35 patients with wounds. Fourteen of them are from the districts and this means that the majority of those patients are from Maseru. District hospitals have pulled up their socks and are doing relatively well and if we had Maseru District hospital, the situation would not be this way (at Tšepong),” Dr Letsie said.
Meanwhile, some stakeholders in the health sector who spoke to the Lesotho Times on condition of anonymity, urged the government to reconsider its stance and allow Tšepong to admit more patients into its private and other wards as it had always done.
“The government should swallow its pride and allow to admit patients as it always done until September 2018. It (government) shoulder the extra costs of admitting new patients until it has refurbished the district hospitals, recruited adequate staff and fully the district hospitals to take the load off Tšepong.
“There is no point is ordering Tšepong not to admit new patients when they can’t be admitted elsewhere. The stand-off only affects the poorest of the poor because government officials and other well-to-do patients can always seek treatment outside Lesotho,” one stakeholder said.