Uganda’s private health institutions await the government’s decision on Covid charges.

Following a court judgement last week, owners of private health institutions have raised concern over how the government will manage the costs they offer Covid-19 customers.

The High Court in Kampala ordered that the Health Minister, Dr Jane Ruth Aceng, and the Attorney General must promulgate laws establishing appropriate costs for hospitals to care and treat Covid-19 patients.
Additionally, the court directed the Uganda Medical and Dental Practitioners Council (UMDPC) to give fee recommendations to the Minister of Health.

Mr Moses Mulumba, the executive director of the Centre for Health, Human Rights, and Development, a health advocacy organization, petitioned the Kampala High Court for intervention on June 28.

Ms Grace Kiwanuka, executive director of the Uganda Healthcare Federation, explained in a Daily Monitor publication seen by NCMP that they are awaiting direction from the ministry on how the policy will be implemented.

Ms Kiwanuka stated that private health facilities are now grappling with high operational costs and expressed concern about how all of this will be weighed in to arrive at “fair pricing.”

“We have had open discussions with the MOH and UMDPC and are awaiting their guidance on how to proceed. We will almost certainly need to be informed about the mechanisms and methodology for determining this because each facility is unique in its setup and business obligations, from the rental of infrastructure and equipment to the location of inputs. We purchase consumables from a variety of suppliers, whose prices fluctuate according to market forces,” she explained.

Ms Kiwanuka stated that they have not reached a conclusion yet and will await the ministry’s response before agreeing.
“At this point, it is premature to say what we will do, except that we will continue to serve clients and do our best to assist the national response to this pandemic,” she added.

Dr Aceng and Dr Katumba Ssentongo, UMDPC’s registrar, were unavailable to comment on how they intend to implement the judgement. The Attorney General, Mr Kiryowa Kiwanuka, stated last week that his office would advise the government to comply with the order.

Additionally, it has been revealed that the government is suffering enormous costs associated with the treatment of Covid-19 patients in critical care units (ICUs) and high dependency units (HDU).

“Treating Covid-19 is costly, and our rates are comparable to those charged by private clinics. The government spends up to Shs3 million per day on ICU patients and Shs780,000 on HDU patients. I cannot vouch for the ministry, but you can chat with the minister, as she was before Parliament last week and gave them the figures,” a source said.

Dr Aceng did not return our repeated phone calls on this matter.
Ms Kiwanuka verified similar estimates and stated that while private facilities are being targeted, the government is incurring enormous costs, adding that the Shs3m figure is actually quite low.

“That’s even lower since it excludes overheads, indirect costs, statutory charges, licence and registration costs, and NSSF, which purchases in bulk through NMS, whereas we purchase through wholesalers and occasionally retail,” she explained.

“The reality is that the government claims to want Uganda to become a medical tourism destination on a par with Kenya, India, and even Tunisia and Ethiopia. How when we come up with notions like price fixing in an already suffering sector. There are numerous more mechanisms for price regulation,” she stated.
She stated that the government should have provided subsidies to private health facilities in order to reduce the cost of supplies and thus the cost of treatment.
“The issue in Uganda is that many of our policymakers are not exposed to novel approaches. You may provide incentives…subsidize to drive down prices…increase competition to drive down prices…offer a competitive alternative,” Kiwanuka explained.
Private health care facilities speak out about the charges levied against them.

Ms Grace Kiwanuka, executive director of the Uganda Healthcare Federation, stated that while Ugandans have criticised them for charging exorbitant prices, they have never enquired as to why. “When asked where they go and why, they say private because they have the equipment and medications.

Accept that we are not flawless, but also accept that private facilities are not profiting, that we have ethics and morals, and that we do not exploit Ugandans,” she stated. According to Ms Kiwanuka, stigma affects health care professionals in private health facilities. She stated that the facilities are not profitable due to hefty operating costs and tax obligations.

“It has a detrimental effect on the mental health of private health care facilities. As we previously stated in Parliament, health facilities in Uganda are extremely inefficient, and the majority have been acquired by equity investors. Indigenous entrepreneurs have all had to secure equity investors, as it is a very difficult business to sustain,” Ms Kiwanuka explained.

She was perplexed as to how Uganda could compete with other countries in terms of providing the greatest care when the government sets costs.