Government resolute on hospital user fees
Cabinet is “seriously” pondering to introduce user fees in public hospitals and is currently awaiting a final recommendation from a special task force on reforming the health sector, The Nation has learnt.
Minister of Health Jean Kalilani revealed this in an interview in Ntcheu on the sidelines of the official opening of a maternity waiting shelter on Friday.
She said: “We [government] know how devisive the matter is, but we are seriously looking at whatever ways we believe will best help improve health service delivery.”
Under the leadership of founding president the late Hastings Kamuzu Banda, the infamous Cabinet crisis of 1966 erupted following disagreements within Cabinet on, among other things, whether user fees should be introduced in public hospitals.
Kalilani said the task force, in a preliminary proposal, recommends that new taxation on alcohol alongside the user fees be used to finance a health fund.
Reacting to the proposal in an interview yesterday, Malawi Health Equity Network (Mhen) executive director Martha Kwataine welcomed the development, saying it will go a long way in addressing the challenges rocking the country’s health sector.
Said Kwataine: “The much touted [public service] reforms are not only for the civil service; just as many may be taking them to be. They [reforms] go beyond the report the President [Peter Mutharika] launched recently and the introduction of such fees is just one of them to help improve our health sector.
“Actually, this would have been adopted way back just as all our neighbouring countries do. The rapid population growth is not in tandem with the resources in our health institutions and the continued withholding of support by the traditional donors is only worsening the situation. So, yes, I strongly feel this is the way to go.”
Neighbouring countries such as Mozambique, Zambia and Tanzania have user fees in their public hospitals. However, in border districts such as Ntcheu, Mwanza and Dedza, the influx of foreign nationals seeking free health care has also been blamed for increasing the strain on the services.
But user fees remain contentious.
Global development and advocacy charity, Oxfam, recently warned government against heeding calls to introduce user fees in the country’s hospitals, warning that the move will hurt the country’s poor.
In a statement signed by Oxfam country director John Makina, the organisation opposed the move, saying government has capacity to increase funding to the health sector without introducing a burden to the poor.
“Reports that some technocrats, civil society organisations and political leaders are advising government to scale-up paying services in public health facilities are not only sad but an attempt to violate poor people’s right to quality health care,” said Makina.
During a drug crisis in 2013, some doctors and other health sector players who met former president Joyce Banda at New State House during an emergency meeting also suggested user fees as one way of improving quality of health services in the country.
The maternity shelter that Kalilani launched was constructed by the Safe Motherhood Initiative with support from the Electricity Supply Corporation of Malawi (Escom) and National Aids Commission (NAC).
The minister also assured the public that government was working on plans to reduce congestion in several maternity wings.
However, she lamented high population growth rate which, she said, was impacting negatively on attempts to improve delivery.
DPP should tread carefully on this issue becoz the main problem with Malawians is that they like handouts, and this is why our nation shall and will never develop.
Kamuzu tried to introduce hospital fees but he failed, in fact this was one of the issues that led to the cabinet crisis in 1964, when Masauko Chibembere, Kanyama Chiume, Bwanausi, Chokani, Orton Chirwa, Yatuta Chisiza, and others revolted against the MCP Kamuzu govt.
Here in the UK although a very rich country people pay for their medication at the pharmacies. except in special cases when you are admitted at the hospital, or have gone to the hospital for minor surgery or you are an asylum seeker.
Just because Malawians are spoilt and dont know how to take responsibility for thier own needs does not make DPP’s policy wrong! Malawi needs money to run it’s health services. Donors have dried out and thank God for that! or esle we would never have to think on our feet! it’s time we Malawians learned that there is no such a thing as a free service! every thing has to be paid for.We are so used to begging, mnchere ukatha kwa ami or a next door neighbour kukpemphaa, ufa weni weni! why don’t we organise ourselves so that we are self reliant? This is the beginning of appreciating that it all costs money and so we should all collectively look after any of the services in our country!
One up DPP! yes let’s pay for our hospitals and when people are assessing their earning power they ought to take into account how they are going to face the hospital bills when they are sick! Tough love I am afraid is all that is going to make change in Malawi.People pay private clinics for treatment, they will have to do it! I agree very strongly agree with this move!
It’s a good move. There is nothing that is for
free. Withholding of donors support may
be a blessing to us in the sense that we should learn to stand on our own. I
know it is a bitter pill to swallow; but let remember that when a woman is
giving birth to a child, she experiences child birth pains, but at the end of
pains there is a blessing and happiness for the new born babe (Nthungululu/Kamphundwe
lulululu from azamba apa mudzi). In fact the second time that MCP Government
planned to introduce fees in hospitals was, I think, on 1st April 1992, but the plan was not carried out
because it was during the time of political pressure for multiparty democracy. I
remember MOH had a huge ngongole, with Medical stores, which it was failing to
settle until donors came to the rescue. I participated in a training workshop
in Primary Health Care services costs analysis in Arusha (1989) and each participating country was assigned to
develop a pilot study project for hospital fees.
well said! Full marks DPP