Ministry of Health and Medical Council of Malawi have supported health workers in public and Christian Health Association of Malawi (Cham) facilities to be allowed to work at private hospitals on part time.
But health activists have criticised the ministry for poor monitoring as most health workers are not committed to their employer.
Deputy Registrar for Medical Council of Malawi, Kondwani Mkandawire said medical doctors, clinical officers, medical assistants and lab technicians working in public hospitals are allowed to do part time private practice and are given a special licence.
Mkandawire said the requirement was that private practice should be done outside official hours and outside government or Cham premises.
“The question, why the law allows such a practice is an unfair one because it presupposes that they should not earn extra income and they are well paid.
“This is far from the truth as frequent complaints of low salaries and perks (which you too may relate to) are heard from these practitioners times without number in order to mitigate against such, this window of opportunity was opened for them so long as it is not abused,” he said in response to a questionnaire.
He said, in terms of monitoring, it is the responsibility of heads of institutions from where these practitioners are stationed.
“It is important to note that all practitioners take an Oath of Allegiance to the profession (Hippocratic Oath) at the time of graduation. Additionally, practitioners are expected to abide by a Code of Ethics and Professional Conduct. These instruments are designed to ensure that they do no harm in discharging their duties,” he explained.
Mkandawire emphasised that practitioners also know that they are encouraged to report any hint of misconduct or malpractice to their superiors and council lest they too risk sanctions from the regulator, if they do not.
“These are in-built mechanisms that if followed religiously, ensure safe and best practices instead of round the clock surveillance which is humanly not possible to do in this profession,” he said.
Ministry of Health Spokesperson, Adrian Chikumbe said the ministry understands that medical practice elsewhere pays better and since the country’s doctors deserve better than what government can afford, they are allowed to do private practice after official working hours.
“This has been working well as the ministry has never received any complaints of underperformance due to this arrangement. If doctors or health workers have failed to deliver, this should be reported to their controlling officers and appropriate action will be [taken],” he said.
Executive Director for Malawi Health Equity Network, George Jobe said, he has noted that there is inadequate monitoring of the time which these health care workers spend at the public facility and the time spent at the private facility.
“Some healthcare workers report late for duties in the public facility because they were busy at a private facility. For some people who are prescribing medicine, it may be difficult to ascertain that a prescription which a patient has taken to the public facility pharmacy was written to a patient who accessed care from a public facility and not at a private facility, if the prescriber works at a public and also a private institution,” he said.
Jobe stressed that there is need to put in place means of verification to avoid misappropriation of drugs, this also applies to some machines and equipment such as laboratory and X-ray equipment.
“The general public also has a role to play in informing authorities at health facilities should they note that one is spending more time at private facilities than the acceptable time,” he said.
According to Chikumbe, Malawi has 600 doctors and the doctor, patient ratio is far below standards just like nurse to patient ratio.
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