January 2016 TheMonitor; The Uganda Medical and Dental Practitioners Council, the body that regulates medical practice, has come up with guidelines on consultation fees to be paid by patients when they visit health facilities.
Dr Katumba Sentongo, the Council registrar, said the guidelines were prompted by the increasing cases of patients being detained in hospitals or being denied services because they are unable to pay their medical bills.
The report titled: ‘Professional Fee Guidelines for Health Care Professionals in Uganda’, authored by the Council, indicates that the guidelines were developed following a review and analysis of the current data on medical and dental professional fees in Uganda and the rest of East African region.
The need to set professional fee guidelines, the report states, follows widespread variation in consultation and procedure fees charged by medical and dental practitioners in the private health sector in Uganda.
“Different practitioners charge up to five times higher than others yet there is hardly any correlation between cost and quality. In fact, there is little evidence to suggest that paying for the most expensive treatment or procedure yields better outcomes,” the report reads in part.
While the streamlining of charges should be a welcome relief to patients, in some cases, the cap on the new proposed average, lowest and highest professional fees are higher than the current prevailing professional fees.
For instance, the average fee for consultation of a super specialist has been set at Shs85,000 compared to the current average fee at Shs52,857. For general practitioners, the proposed consultation fee is Shs15,952 with a cap of Shs30,000 compared to the current Shs10,738.
When it comes to follow-up consultation, the proposed fee for general practitioner is Shs12,188 against the current fee of Shs7,222.
Similarly, the proposed follow-up consultation fee for a super specialist has been increased from the current Shs28,000 to Shs60,000.
Under the category of Intensive Care Unit, the new guide lines propose Shs275,000 with a cap of Shs500,000 for general practitioners though the current fee for the general practitioner is Shs160,000.
Still under the Intensive Care Unit category, the guidelines propose that a super specialist be paid Shs75,000 with a cap of Shs200,000 though the current fee stands at Shs50,000.
Fees paid to general practitioners for performing postmortem comes with relief as it is set at ShsShs50,000 against the current fee of Shs125,000.
Under this same category, a proposed fee of Shs100,000 has been set for a super specialist who performs a postmortem up from the current Shs500,000.
The other category is that of theatre attendance where it’s proposed that a general practitioner gets Shs96,111 with a cap of Shs150,000 against the current Shs90,625. Under the same category of theatre attendance, a super specialist’s proposed fee is Shs45,000 against the current Shs40,000.
For night emergencies, for general practitioners, the proposed new fee is Shs11,400 which is lower than the current fee of Shs13,583.
Some procedures such as general surgery for splenectomy by a specialist have been increased from the current Shs420,975 on average to the proposed Shs513,130 on average. The cap on the same procedure has been put at Shs876,260 from the current 761,950 as highest fee.
The proposed consultation fees in Kampala city, however, differ from those in the upcountry municipalities. For example, under the general practitioner’s category in municipalities, the proposed fee is Shs20,000 against the current same fee of Shs20,000 and yet their counter parts in the city, the proposal for them is to be paid Shs25,000 lower than the current Shs40,000 that they are being paid.
Under the category of super specialist in the municipalities, its proposed that they be paid Shs200,000 as consultation fee against the current Shs100,000.
However, for their city counterparts, it’s proposed that their consultation fee be much less than their municipality counterparts at Shs80,000 against the same current figure of Shs80,000.
When asked about the hiked fees, Dr Katumba said these were left to be proposed by Uganda Medical Association (UMA), the national professional organization.
“We asked them (UMA) to agree among themselves on two grounds that they remain in business but also continue with their professional role of providing health services,” he added.
Dr Nathan Kenya-Mugisha, the immediate first president of UMA, told Daily Monitor that the proposed fees will be presented to the doctors for further discussion before they are handed over to the medical council to approve and gazette them.
“We are not using them (fees) to impose the charges but our aim is to give patients an idea before they go to hospital,” Dr Kenya-Mugisha told Daily Monitor in a phone interview yesterday.
Nevertheless, the idea has been welcomed by some operators of private hospitals with Dr Ian Clarke, the founder of International Hospital Kampala (IHK), saying it will help them not to be overcharged by medical professionals.
“It is something private hospitals should welcome. Regulating the fees is good because doctors have been making a lot of money from the hospitals,” he said.
Dr Clarke was, however, hesitant to comment on the specific hiked fees saying he needed to first look at the report. Mr Moses Mulumba, the Executive Director of Centre for Health, Human Rights and Development (CEHURD), a health rights advocacy non-government organization, welcomed the guidelines but insisted “they should set not the minimum charges but the ceiling.”
He said: “It is fantastic but they should be conscious that the fees are elastic and provide for those in private and not for the not-for-profit hospitals.”
The report states that on comparison of medical consultation fees with other professions such as lawyers, the lawyers’ fees are much higher than theirs; sometimes by 3 to 5 times more.
The report also states that the fees for medical and dental practitioners in the neighbouring countries are higher than for facilities in Uganda. For example, consultation fee is about four to five times more comparable to Kenya.