THE Ministry of Health has resolved to terminate the contracts of health clinics that are owned by doctors who are full-time employees of the ministry.
This was revealed by the ministry of Health’s director of Primary Health Care, Thabelo Ramatlapeng, in a recent interview with the Sunday Express.
Eight private surgeries, including that of former Health minister Molotsi Monyamane, were contracted under the Health ministry’s Workplace Programme to provide free and convenient HIV and AIDS and Tuberculosis services to thousands of factory workers living with HIV.
Dr Ramatlapeng said the decision to terminate the contracts follows concerns raised by Finance minister Moeketsi Majoro that there could be conflict of interest in case of doctors who worked for the ministry and also provided private services under the workplace programme at the same time.
In March this year, the-then principal secretary in the Ministry of Health, Monaphathi Maraka, told the parliamentary Social Cluster Portfolio Committee that the ministry owed the eight health facilities payments in excess of M3, 5 million for their services.
Besides Dr Monyamane’s Healthy Lifestyle Clinic, seven other clinics including those of senior ministry staffers, Dr Nyane Letsie (Living and Loving Family Clinic) and Dr Limpho Maile (Bophelong Specialist Clinic) were contracted by the Ministry of Health.
The other clinics are Willies Hospital (run by a Dr Tšolo), Golden Touch Clinic (Dr Piet McPherson), Karabo Family Medicine (Dr Kose), Medical Arts Clinic (Dr Molapo) and Poly Clinic (Dr Jersey).
Mr Maraka told the Social Cluster committee that although payments for the private surgeries had been budgeted for, they could not be made because the Ministry of Finance had not transferred the funds to facilitate payment.
He said the Ministry of Finance queried the eight facilities’ payments, saying it suspected there could be conflict of interest especially where it came to some of the doctors who worked for the ministry and also provided private services under the workplace programme at the same time.
He said the programme brought the health services closer to thousands of factory workers but the Finance Ministry was reluctant to release the funds because of civil servants’ involvement.
He said he subsequently wrote to the Finance Ministry to motivate why these doctors should be paid.
“We have showed that it is true that there might have been a conflict of interest but Lesotho has a policy that allows its doctors to engage in private practice. Besides that, thousands of factory workers are on antiretroviral and tuberculosis medication and they still receiving these services from the same doctors owed by the ministry.
“These doctors have not stopped to deliver these services and based on these reasons we have asked the Ministry of Finance to process the payments. We have further indicated that we will terminate contracts of those doctors with conflict of interest. We are only left with few days before March 13, which is the cut-off date for the 2017/18 payments,” Mr Maraka said at the time.
The legislators concurred with Dr Majoro, arguing that the doctors could have had undue influence in the selection of their facilities because “they knew very well what is expected of their facilities in order to be accredited”.
And in a recent interview, Dr Ramatlapeng said although the payment arrears had been settled, her ministry had resolved to terminate the contracts with Dr Letsie’s two clinics with effect from yesterday.
She said her ministry took time to terminate the contracts to enable the arrears to be settled.
“We called a meeting with all the doctors in July to inform them of the Minister of Finance’s decision (to and that we needed to reallocate facilities in line with the Ministry’s policy. We also informed that we needed to look into the matter involving the doctors that we have been instructed to stop engaging on the workplace programme until the matter has been resolved. We also held the meeting with the said individuals.
“Dr Monyamane didn’t qualify to be amongst the people with conflict of interest because he had already existed the ministry. Although Dr McPherson responded to the call for Expression of Interest, he also did not qualify to attend the meeting because he had already existed the ministry and his facility is paid directly by one of our partners, EGPAF. We only have Dr Letsie and Dr Maile being affected by this matter,” Dr Ramatlapeng said.
She added: “Dr Letsie’s husband, Dr Sethinyane, wrote a letter informing me that immediately after the meeting he visited all his factory patients to officially inform them that he will no longer be working with them. He however expressed concerns that he was not supposed to be affected by this decision because he and his wife operate individually and their licenses are given to them as individuals, not as a couple.”
She said Dr Maile was technically no longer working under this programme because a signed contract, allocating her clinic to difference factories, was signed by Dr Tarumbi Tapiwa.
“Technically I was made aware that Dr Tapiwa was responsible for that, the trade unionist came to me to say that there was no doctor operating on the places I had allocated for Dr Maile and upon inquiries, I learnt that she was handing over everything to Dr Tapiwa,” Dr Ramatlapeng.
Dr Ramatlapeng said the controversy around the Workplace Programme only came to play after the Ministry of Health fully adopted the programme and directly paid all health facilities.
She said the programme had benefitted all factory workers enormously and that the ministry had learnt the workers want the programme to continue without fail as they do not sacrifice an hour to go of visiting health facilities.
“In the past, the workers would continue to carry on with their job despite that they were sick and would only decide to visit a health facility when their conditions had worsened. So they have individually benefitted a lot and as a country, we now have a healthy workforce and the factory produce are internationally acceptable because they have been produced to specifications by a healthy workforce.
“We have also extended the package of the services provided. We are no longer concentrating on HIV and Aids services only but tuberculosis, cancer screening, chronic conditions like asthma, diabetics and hypertension. There are also full-time nurses administering wider services like family planning and administering painkillers,” Dr Ramatlapeng said.
On his part, Ministry of Health Principal Secretary Mole Khumalo said it was his ministry’s policy to ensure that there was inclusive and accessible healthcare services to each and every person across the country.
“This will be achieved under the Universal Health Declaration and where people are concentrated like in the factories, doing demanding work like that, it says that the Ministry must focus more on such places. Besides, it is also important that the factory workers remain healthy at all times and this can only be achieved by bringing health services at their doorstep so that we can timely detect chronic diseases and put them under the medication,” Adv Khumalo said.