ATLANTA May 11, 2015 (MaraviPost): Ministry of health policy of making district Hospitals in the country to start paying fees for any referral cases made to a central hospital once the health reforms being proposed by the Ministry of Health are adopted is both dumb and very dangerous. It will almost guarantee that patients will die in these poor ill-equipped hospitals.
A health economist, who is also Head of Policy in the Ministry of Health Dr Dominic Nkhoma, told journalists recently during a sensitization meeting that the proposal is part of the health reforms which, among other things, call for decentralization of central hospitals.
Dr Nkhoma said the reforms will put aside guidelines that health institutions must follow in order to reduce deaths that occur due to “negligence of health institutions that make unnecessary referrals on simple cases”.
Dr Nkhoma should realise the two reasons a hospital will refer a patient are:
One, lack of expertise and equipment to take care of that particular illness, therefore it is imperative that these patients be immediately referred to the better equipped hospitals just like Kalirani would send herself to South Africa If she was ill with a disease that cannot be cured in Malawi hospitals.
Two, a patient that cannot afford to pay for his or her treatment, I would say these are the minority of cases and the hospital or doctors that refuse to treat patience If government mandated health care for all would need to be punished, their license revoked or suspended
“The guidelines will make district hospitals to pay a particular fee for any referral made to a central hospital, a development that will help ensure that only critical cases are referred.
This is not reform but incompetence If not total arrogance on the part of the policy makers. If not lack of understanding of the problems they face.
Malawians many of us with the exception of a few that are covered by insurance cannot afford to pay for health care. Even one as poor as that offered by the Malawi government. To demand that hospitals pay for referring patients to better equipped hospitals is as good as signing their death warrant. Hospitals will just make sure they die instead of subjecting themselves to fees they themselves cannot afford to pay.
Health care in the so called government reforms should be treated as a human rights issue and should be made available to all Malawians. In countries with good health care systems like Canada, United Kingdom and even the US the referring hospital is the one that gets paid not the other way round.
“This will reduce unnecessary pressure on central hospitals since only critical cases will be referred to them for fear of incurring extra costs by referring hospitals,” he said, Once again wishful thinking. This will just make sure patients will be left to die instead of being referred for proper treatment. Where are these hospitals going to get money to pay hospitals like Kamuzu Central Hospital?
Nkhoma added that the development will ensure that patients are not just ‘dumped’ after referral, but are properly taken care of.
Galaxy Media Consultants, an independent firm that encourages journalists to report on health issues and organised the sensitisation meeting, called on the media to take part in sensitizing people on the reforms through the stories they write.
He then called on stakeholders to support the reforms arguing that if hospitals are run as a Public Trust, hospital administrations will be answerable to the citizenry in situations where service delivery is compromised unlike now where citizens have no say on performance of the workforce under Ministry of Health.
“The media have power to influence decisions and we hope that hearing about the reforms from a policy maker in the Ministry of Health itself has given you [journalists] a chance to hear first-hand information,” said Benson Nkhoma-Nsomba, Galaxy Media Consultant’s Project Manager.
I agree that the Media has power not to promote government bad policy that will surely guarantee the death of many patients. We need to inform the public that these policies are ill-fated and will kill many Malawians.
Other health reforms being proposed by the ministry include: revitalizing medical insurance scheme alongside the expansion of paying services in public hospitals, establishment of a Health Fund and Reviewing of the Government-CHAM partnership.
Minister Kalirani and the Mutharika government need to rethink these policies before burdening rural hospitals with patients they cannot take care of.
Source: MANA
