January 2019 Business Daily;Auditor-General Edward Ouko has revealed the rot at Mathari Hospital that has seen the national referral facility struggle to provide required psychiatric services.
Mr Ouko in his latest report cited congestion, lack of diagnostic equipment, stock-out on critical drugs and inadequate personnel as factors crippling the facility. Average bed occupancy at the national referral hospital is at 115 per cent even as the Level 6 facilility grapples with inadequate funding from government.
“The effect is that patients receive poor services, sometimes the diagnosis is delayed and the condition could become worse,” said Mr Ouko.
The only public hospital offering specialised psychiatric services and training lacks critical equipment such as Computerised Tomography (CT) Scan and Magnetic Resonance Imaging (MRI) machines. This means that it cannot offer proper diagnosis for psychiatric patients from across the country who rely on it
“The patients and their families then continue suffering since these patients are totally dependent on it,” said Mr Ouko in the audit covering five financial years -2011/2012 to 2015/2016.
An analysis of the number of psychiatric inpatients indicated that at the time of the audit, Mathari Hospital was offering services to an average of 906 patients per day, translating to 330,690 yearly.
Mr Ouko said documentary review of financial records indicate that funding for the hospital’s recurrent budget has been dwindling, making it difficult for the facility to operate as it should.
The hospital received approximately Sh280 million, Sh220 million and Sh215 million in financial years 2013/14, 2014/15 and 2015/16 respectively for recurrent expenditure. This was against a requirement of Sh1.2 billion, meaning the referral facility is operating on a fifth of the funds it requires.
Part of the financial challenges have been blamed on the reporting structure for Mathari Hospital, where the Medical Superintendent reports to about five different offices at the Ministry of Health.
“The hospital therefore lacks a defined level of autonomy, thereby lacking the benefits that the other semi-autonomous referral hospitals have,” said Mr Ouko.
He recommends that the Ministry consider making Mathari a semi-autonomous government agency managed by a board of directors and headed by a chief executive officer. This would mean that budgetary provisions are appropriated directly to the hospital whose management is then able to secure all the required resources and run the hospital independently.
According to the Kenya Health Sector Referral Strategy, national referral hospitals provide specialised healthcare services and should operate with a defined level of autonomy.