Government must reexamine public health funding

Malvern Mkudu

On Saturday we woke up to the news that one of the biggest Private hospitals in the country, St Annes Hospital had closed its doors to the public.

The hospital management claim the hospital  closed for renovations but there are other versions to the story claiming that proprietors of the hospital were ordered off the property by the owners of the property over a dispute on rentals. The truth is probably somewhere in between but it has opened debate on healthcare funding in the country.

It is not surprising that the hospital may have hit hard times considering the current state of the economy.The majority of private hospitals came as public healthcare institutions crumbled and  many of the private institutions were able to post huge profits especially during the era of government of national unity.

During this time private healthcare seemed brisk business especially as companies were paying high salaries to a good number of people who subscribed to medical aid societies for medical services. Millionaires were created as private hospitals mushroomed to cash in on the boom with hospitals such as Corporate 24 emerging.

These hospitals only catered for the elite as the marginalized poor often found themselves confined to underfunded and under-resourced public hospitals. This pursuit of health capitalism has not improved health care provision in the country in my opinion. We hear of many cases of negligence and poor services in many of these private health institutions.

Things started to deteriorate around 2014 as the liquidity crunch started to bite. Companies were closing down and were struggling to pay their employees. This obviously began to affect medical aid companies.  I remember having a small talk with one of the CIMAS bosses at his offices and he told me that the society was raising less money and he was not sure about the future viability of the society.

Medical aid societies such as PSMAS were blacklisted by medical practitioners as they were struggling to pay. One could go to a private health institution and the doctors would insist on cash upfront.This upheaval in medical aid societies and economy in general has probably affected the viability of  private health institutions. People simply do not have the money to pay for the services anymore.

Developed countries such as the UK have the National Health Services ( NHS) which is primarily funded through the general taxation system. ‘The system provides healthcare to every legal resident in the United Kingdom, with most services free at the point of use. Some services, such as emergency treatment and treatment of infectious diseases are free for everyone, including visitors.’

This system is not perfect but it at least ensures that even the poorest in the society can access basic healthcare. President Obama in the United States of America also hinged his election campaign on provision of decent health care to the general public. This probably the reason he managed to win the election.

The closure of the St Annes Hospital must make us re-examine our priorities in funding public health. It is pointless to rely on private entrepreneurs to provide health care to the public. Private institutions are very sensitive to economic conditions obtaining in the country such as the current liquidity crunch.

Secondly private institutions are driven by a profit motive and are likely to close down at any sign of financial trouble. This is especially true in a country like Zimbabwe were corporate governance oversight is poor where there is no mechanism to ensure that the interests of patients is prioritized over the business interests of the hospitals.

Private health care certainly is useful to any country but it must never form the backbone of the healthcare system as has become the case in Zimbabwe. The situation has probably been allowed to unravel this way because the country has a leadership that resorts to private health care in foreign countries. President Mugabe and his ministers are notorious for seeking health care in far away foreign countries.

As it stands over 11 million Zimbabweans are not covered by any sort of medical cover making private health care inaccessible to most citizens. Statistics say over 90 % of the population are unemployed and most Zimbabweans are working in the informal sector. Most Zimbabweans live on less than $1 a day.

The majority of Zimbabweans cannot afford the $30 charged by private doctors for consultation. One has to fork out more money on medication. This effectively means the majority of our citizens cannot access private healthcare.

If the economy does not improve, then it is highly likely that the majority of private heath institutions will fall on hard times. The people simply cannot afford their services. This will further worsen the situation in the country.

Until the government of President Mugabe re-examines its priorities we must expect health care to become more and more inaccessible to the majority of citizens.  The recent budget relegated funding of healthcare to fifth down from second the previous year meaning this government does not prioritize national healthcare.

President Mugabe confessed that $15 billion was lost to corrupt activities in the diamond fields. Such money would have been channeled to public health care to ensure that at least all citizens  enjoyed the fruits of their natural resources.This proves that when the money has been there , the government has simply decided to mismanage it.

We must insist that government become more accountable with public revenue in order to ensure that critical sectors of the economy and society are adequately funded.

The economy is likely to get worse under the leadership of President Mugabe and as more medical aid societies and companies struggle we must expect private health care institutions to struggle. Perhaps it is now time to borrow from other countries and prioritize public health provision. While private health entrepreneurs must be supported it is folly to entrust them with reliable health provision for the majority of our people.

 

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