Seriously ill people, including cancer patients, in
Swaziland / eSwatini are being denied life-saving treatment because the
government had not paid its bills to hospitals.
At least E66 million (US$4.6 million) is owed through the
government-funded Phalala Fund that pays for Swazi people to travel to
neighbouring South Africa for treatment. Some of the unpaid bills date back
to 2013.
The objective
of the Phalala Fund is to assist deserving Swazi citizens who would
otherwise not have access to specialist medical care to get it either, within
Swaziland or ‘in special circumstances’ outside the kingdom.
The size of the debt was revealed by Phalala Fund
Administrator Thabsile Dlamini, following media reports in Swaziland that
cancer patient were not being assisted by the fund.
The Swazi Observer reported that the E66 million owed was
not the only debt, that included unpaid bills for optical treatment.
In 2017, the Swazi Government owed E170 million through the Phalala Fund. In
March 2018 South African health institutions stopped giving medical assistance because
of the unpaid bills and more than 100 people were immediately denied treatment.
The Phalala Fund has been
riddled with incompetence and corruption for many years. Many times in the past
South Africa stopped taking patients because of unpaid bills. For example, in
2014 a Ministry of Health’s Senate Portfolio Committee Report said
E40 million was unpaid and patients were being refused treatment.
In November 2014, the Accountant General Phestecia
Nxumalo reported that the Phalala
Fund had been defrauded of E9 million because single
bills had been paid multiple times.
As long ago as 2006 a
report published by the World Bank recommended sweeping reforms to the funding scheme, but these have not
taken place.
The report said ‘only a
tiny segment’ of the Swazi population benefitted from the large medical subsidy
the government paid. It said there were no cost-effective guidelines so the
fund could be used on patients who were too sick to benefit from treatment.
Also, fees and other prices
were not negotiated before treatment and were ‘completely supplier-determined’.
The report concluded the Phalala
Fund provided a ‘blank cheque’ for South African doctors
and hospitals: whatever amount they asked was paid by Government, ‘since it has
no recourse but to pay up.’
It also said that
management of the funds were poor and it was easy to mistakenly pay bills more
than once ‘due to multiple reminder billings’.
The report recommended that
as far as possible medical care should take place within Swaziland rather than
outside using both public and private health facilities and investment should
be made to make this happen.
See also
Food collection points set up in Swaziland as
hospital patients unfed after Govt fails to pay suppliers
HIV
drugs not available across Swaziland as health crisis deepens
Swaziland
health crisis getting worse as budgets cut. Rural areas most affected
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