April 2017 Themonitor; The government has over the past three years spent at least Shs10.08 billion ($2.8m) on the treatment of 140 senior government officials abroad, according to Auditor General John Muwanga’s report for the period ending December 2016.
The VIPs’ treatment abroad on the recommendation of the ministry of Health’s Medical Board cost taxpayers an average of Shs72 million for every official. This apparently excluded the cost of air tickets, upkeep and expenditure on attendants.
The 140 officials, according to the report, received specialised treatment for heart and kidney conditions, eye problems, cancer, and diabetes, in hospitals in Kenya, South Africa, India, China, and United States in 2014, 2015 and 2016.
Six of the officials were referred for treatment of intestinal-liver complications; nine for eyesight issues; 14 for ailments related to bones, muscles and joints; 13 for heart conditions; 22 for cancer; 30 for kidney, and 46 for complications related to the nerves, spinal cord and brain.
“Since the analysis was limited to patients approved by the Medical Board, many other individuals could be incurring much higher expenditure resulting in foreign exchange authorised on treatment abroad and the demise of patients who are unable to afford the high costs,” the report submitted to Parliament reads in part.
Mr Muwanga, however, noted that some of the health complications for which the senior officials were referred abroad could as well be handled by [private] health facilities in Uganda.
He also recommended that government comes up “with a comprehensive Health Sector Strategic plan to develop capacity for treatment of the identified ailments locally so as to be able to serve a bigger population and minimise foreign exchange hemorrhage.
“Liaison with all relevant stakeholders to mobilise the necessary funding for infrastructure and staffing needs to be undertaken,” the report notes.
The continued referral of senior officials and the well-connected in the government system abroad for treatment is a polarising subject but one that has repeatedly put into sharp focus the country’s ailing health sector, especially government’s unenthusiastic response, particularly the failure to invest in facilities or adequately remunerate health workers.
In worst case scenarios, some Ugandans have turned to fundraising drives to raise money to go abroad for treatment.
Lack of staff
A report issued in March by Parliament’s Public Accounts Committee on the report of the Auditor General on health sector for the last financial year indicated that “not a single hospital” out of the nearly 15 main referral hospitals in the country is fully staffed “many being at about 45-50 per cent staffing capacity and are lacking critical staff, including surgeons and physicians; the problem exacerbated by staff who upon admission to the Public Service, fail to report to their respective work stations.
Health minister Dr Jane Aceng when asked yesterday to comment about the Auditor General’s latest finding, told Daily Monitor: “All endevours to eventually stop referrals abroad to gradually reduce that money cannot be a one-day thing but one thing I can assure you is that we have developed a strategic policy guideline which we are working with.”
She revealed that Shs25 billion ($7m) was the total bill for the treatment of both public and private citizens abroad for the three years which, however, she insisted was a slight reduction compared to what government was spending previously.
One key component in the strategy, Dr Aceng said since 2004, the government has nursed ambitions of constructing an ultra-modern hospital at Lubowa Hill off Entebbe Road; “which plans have eventually taken off.”
“Construction is underway for this super-specialised facility that we hope will be completed by 2019-2020. Once completed, this facility will be our main referral for all patients we have been referring abroad,” the minister said.
The specialised treatment facility, the minister said, is being constructed under a Public-Private Partnership (PPP) between government and an Italian healthcare developer, Finasi, under a “build, operate and transfer” (BOT) arrangement of 10 years.
Once completed, it is expected to handle specialised treatment ranging from human organs transplantation, neuro and heart surgery and cancer treatment.
Dr Aceng listed plans in the offing to construct a paediatric hospital; the ongoing renovation and upgrading of Mulago National Referral Hospital as some of the attempts at hand by government to cut back on the financial hemorrhaging that comes with referring people abroad for treatment.
She said the ministry is working on a bill to be tabled before Parliament that will streamline the management of both Mulago Hospital and the Uganda Cancer Institute with the aim of making them more efficient.