Private hospitals breach government pact


Some private and Christian Health Association of Malawi (Cham) hospitals that have an agreement with the Ministry of Health to provide under-five and maternal health services are contributing to the depletion of drugs budgets for public health facilities, Malawi News has learnt.

We also have it on good authority that Cham and private mobile clinics in hard-to-reach areas which get government drugs also breach the agreement by charging patients who seek medical help from the facilities even though the services are supposed to be for free.

This results into those seeking maternal health services and people in remote areas still going to public hospitals, thereby straining the drugs budgets.


For instance, information from Lilongwe District Council indicates that 33 private health facilities order drugs from Lilongwe District Health Office (DHO) and still charge patients who seek medical help from them within the agreement.

Just like in many other districts, this together with other factors including overcharging by the Central Medical Stores Trust (CMST), has resulted into the hospital depleting its drugs budget by January this year, five months before the next financial year.

During a Lilongwe District Full Council meeting on Thursday, chairperson of the Health Committee, Councillor Fernando Zulu, presented minutes of the Health and Finance committees meeting which had recommended that Lilongwe DHO should suspend the provision of drugs to Cham and private hospitals until the matter is resolved.


“We also recommend that the council should inform the Ministry of Health [the] dropping of the private clinics in the next financial year and the Memorandum of Understanding to be done at council.

“…The council should write the Secretary to Treasury, through the National Local Government Finance Committee (NLGFC) with copies to Ministry of Health and Ministry of Local Government requesting for a supplementary budget,” he said.

Lilongwe District Council chairperson, Samson Chaziya, observed that issues of drugs demand a lot of attention because they are about human life.

He said while many other factors might have contributed to the depletion of the Lilongwe District Hospital drugs budget, it was incumbent upon the hospital’s administration to ensure proper mechanisms are put in place to control the supply of the drugs.

Lilongwe Mapuyu North Member of Parliament (MP), Horace Chipuwa, wondered why the DHO continues supplying drugs to private hospitals when the facilities charge Malawians who seek medical help there.

“Women who seek maternal health services from these private hospitals pay about K10,000 yet the hospitals get drugs from the DHO. Something has to be done because it means the agreement is being breached,” said Chipuwa.

Lilongwe District Health Officer, Alinafe Mbewe, admitted that it is not proper for Cham and private clinics to be charging clients who seek services from the facilities within the agreement.

“It is not supposed to be like that. Of course, we are supposed to monitor how the drugs are being used but because we have too many things to do, this does not usually happen,” she said.

On the other hand, Lilongwe District Commissioner, Charles Makanga, said in the past drugs budgets used to be depleted before the end of the financial year but public hospitals were allowed to overdraw so that they could accumulate arrears.

“Now, government says there should be sanity in the management of drugs budgets such that a facility that has depleted its budget is not allowed to overdraw. Another thing is that CMST is charging in dollars and with the fluctuation of drugs prices, the trust is charging more than private pharmacies,” said Makanga.

In an interview yesterday, Ministry of Health spokesperson, Adrian Chikumbe, said the ministry has not received any reports regarding the breach of agreement by Cham and private hospitals.

He was, however, quick to point out that once the ministry gets the reports, it will review the agreement so that it does not continue short-changing government.

Regarding public hospitals that have already exhausted their drugs budgets, Chikumbe said government will use alternative means of ensuring patients who seek services from the facilities are not affected.

“After learning of the depletion of drugs budgets in some hospitals, we, Ministry of Health, the Ministry of Local Government, Treasury and the Malawi Local Government Finance Committee had a meeting where it was decided that the hospitals should still be supplied with drugs.

“We cannot close the hospitals because of drugs. The K10.2 billion health sector budget has not been depleted and some hospitals have only used a small part of their budgets. So those that have exhausted their budgets will benefit from those that still have their budgets and from the larger health sector budget,” said Chikumbe.

He added that an analysis of what had happened for some hospitals to exhaust their drugs budget was made and that the findings would be presented to Parliament for discussion.

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