Malawi budget funding cut put lives at risk

The impact of reducing funding to government ministries and departments has reached crisis level as public hospitals are failing to settle over K85 million bill with Mwaiwathu Private Hospital in Blantyre, The Nation has learnt.

This threatens to negatively affect patients referred to the health facility from public hospitals for specialist treatment.

While government is saying it is too early to describe the funding reduction as a crisis, Mwaiwathu Private Hospital says their resources are overstretched to the extent that it may not be possible to provide services to referral patients from public hospitals.

This is happening at a time when Malawians are struggling to come to terms with the puzzle on how billions of taxpayers and donor money, which is more than enough to settle the bill and buy medical supplies in public hospitals, were looted at Capital Hill.

Sources say Mwaiwathu Private Hospital is now saying enough is enough as its resources are overstretched to attend to patients referred there by Queen Elizabeth Central Hospital (QECH) in Blantyre, Kamuzu Central Hospital (KCH) in Lilongwe and other public hospitals.

Said a source: “Although Queens [QECH] and KCH have dialysis machines, most of the time they [machines] are not working, especially for Queens or the demand is high so the hospitals refer the patients to Mwaiwathu but because they [government] are not paying, Mwaiwathu is now refusing to provide those services.

“When ministers or high profile people fall sick, they are immediately flown abroad for specialised treatment. People with money can afford to pay for health services. It is the poor who rely on public hospitals that are suffering as a result of this stealing of money.”

Mwaiwathu Private Hospital finance manager Chrispine Banda confirmed in a questionnaire interview this week that the accumulative bill for QECH and KCH is in excess of K85 million

Banda, who said the hospital has already engaged government on its impending decision to stop providing services to the referral patients from public health facilities, said this decision will affect those that need dialysis machine services, surgery and intensive care unit (ICU) facilities.

He said: “The amount owing is indeed in excess of K85 million as at October 2013 and this is between KCH and QECH. We have not stopped yet, but at the moment our resources are very much stretched and soon we may not be able to assist the patients.”

Banda said Mwaiwathu Private Hospital has written to the authorities several times before but there has been little effort to settle the bill. He said the hospital plans to continue to engage government to prioritise the health sector.

However, Ministry of Health public relations officer Henry Chimbali said Mwaiwathu has not officially communicated to government on their decision and could not say how many patients would be affected if the decision is implemented.

But information sourced from the hospital indicates that Mwaiwathu provides health services to an average of five patients every week referred by public hospitals.

On how much government owes the private hospital, Chimbali said there is need to verify the debt although the ministry is aware that Mwaiwathu is owed by several public health facilities.

Said Chimbali: “We have not been officially communicated to on this decision by Mwaiwathu and once we get hold of the letter, we will engage them because we have coexisted with Mwaiwathu for a very long time and our partnership over the years has been good.

“We know of the funding gap and also our own assessment has shown that district hospitals and central hospitals are experiencing financial challenges to manage operations and provision of health care to all who seek medical care. We have presented this matter to Treasury and we expect positive feedback.”

He also confirmed that specialist doctors and other general physicians from QECH joined their KCH counterparts to petition the ministry on various issues affecting health service delivery in public hospitals.

Chimbali said Minister of Health Catherine Gotani Hara and the ministry’s management recently visited QECH to engage the petitioners and hospital management and that the outcome of the meeting was positive.

“We agreed on short, medium and long-term interventions. We are very much committed to addressing these challenges and their observations, concerns and desire to help and do more for the patients are quite genuine and understandable. We toured the facility together with the doctors to verify some of the issues raised after the meeting,” he said.

Ministry of Finance spokesperson Nations Msowoya said funding to all government institutions has been a challenge in the wake of the suspension of aid disbursement by developing partners after revelations of looting at Capital Hill.

He said as government has started re-engaging its development partners to revisit their decision, an appeal has been made to public institutions to do their best within the limited resources as the country finds itself in this awkward situation which has to be managed.

Said Msowoya: “The Ministry of Health has not been spared in this reduced funding. As government, we are trying to manage the situation within the little available funding, which is mainly coming from local revenues.”

He said it would be regrettable if there would be loss of life due to the suspension of services by Mwaiwathu because of the outstanding bill which government is struggling to settle.

Malawi Health Equity Network (Mhen) executive director Martha Kwataine said theft of public funds at Capital Hill which has resulted in shortage of essential drugs is a gross violation of the right to life and the right to health especially of the poor.

She said there is need to strengthen health service delivery systems, especially in central hospitals to enable them provide specialist treatment to those who cannot access private hospitals.

Said Kwataine: “When people steal government funds, they must know that they are committing murder through diversion of resources which could have been used to save lives. Malawi has more murderers outside prison than those in prisons.

“The impact [of cash-gate] is an open secret. People are either losing lives or being deformed. The right to life and the right to health especially of the poor is being violated. Those who steal public funds rarely access health care from public health facilities. The poor are paying with their lives.”

The activist faulted all three arms of government—the Executive, the Legislature and the Judiciary—saying they have all failed to provide checks and balances to each other which has resulted in the people who steal public money getting away with it.