Swaziland cancer patients refused treatment because Govt. has not paid hospital bills

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

https://swazimedia.blogspot.com/2019/07/food-collection-points-set-up-in.html

 

HIV drugs not available across Swaziland as health crisis deepens

https://swazimedia.blogspot.com/2019/06/hiv-drugs-not-available-across.html

Swaziland health crisis getting worse as budgets cut. Rural areas most affected

https://swazimedia.blogspot.com/2019/02/swaziland-health-crisis-getting-worse.html

SICK TURNED AWAY AS GOVT BILLS UNPAID

The Swaziland Government has not paid medical bills running into millions of dollars in neighbouring South Africa and as a result sick Swazis are being denied treatment.

South African health institutions stopped giving medical assistance under the Phalala Fund on 19 March 2018, according to a report in the Swazi Observer newspaper on Friday (4 May 2018). More than 100 people have been denied treatment, the newspaper reported.

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.

Somntongo Member of Parliament Sandile Nxumalo the chair of the parliament select committee set up in 2017 to investigate the administration of the Phalala Fund said people would die if government did not attend to the situation as a matter of urgency.

The suspension of services is nothing new. The Phalala Fund has been riddled with corruption and inefficiencies for years.

In October 2017, the Times of Swaziland reported at least three people had died because they could not get treatment after services were suspended because bills had not been paid.

At the time the Swazi Government owed E170 million (US$12 million).

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 (less than a quarter of the 2017 debt) 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 of the 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 fund provided a ‘blank cheque’ for South African doctors and hospitals: whatever amount they asked is paid for by Government, since it had no choice but to pay up.

Meanwhile, within Swaziland itself a health crisis continues because the government has not paid bills for medicines and supplies.

Early in January 2018 health facilities were reported to have run out of vaccines against polio and tuberculosis and new-born babies were being put a risk.

In June 2017, Senator Prince Kekela told parliament that at least five people had died as a result of the drug shortages. About US$18 million was reportedly owed to drug companies in May 2017.

As ordinary people died the Prime Minister Barnabas Dlamini revealed that King Mswati and the Queen Mother paid for him to travel to Taiwan for his own medical treatment.  Dlamini was not elected PM by the people of Swaziland. He was personally appointed by the King, as were all other government ministers and top judges in the kingdom. None of Swaziland’s senators are elected by the people.

Dlamini celebrated his 75^th birthday in 2017. The Swazi Observer, a newspaper in effect owned by King Mswati, reported (5 June 2017), ‘The Prime Minister said he was grateful that when Their Majesties were informed about his ailment in April, they responded hastily and ordered that he be taken to the best doctors in Taiwan, Taipei.  

‘“Their Majesties gave orders that I go to the best and well experienced doctors in Taiwan. I am now looking forward to turning 76 years and I thank God for keeping me safe,” he said.’

The nature of his illness has not been publicly revealed.

See also

MEDICINE SHORTAGE: FIVE DIE

http://swazimedia.blogspot.com/2017/06/medicine-shortage-five-die.html

DRUG SHORTAGE CRISIS DEEPENS

http://swazimedia.blogspot.com/2017/05/swazi-drug-shortage-crisis-deepens.html

SWAZI GOVT ‘KILLING ITS OWN PEOPLE’

http://swazimedia.blogspot.com/2017/05/swazi-govt-killing-its-own-people.html

PEOPLE DIE AS GOVT. BILLS GO UNPAID

Hundreds of lives are being put at risk and at least three people have died because the Swaziland Government has not paid its bills to South African medical service providers.

This has led to health facilities refusing to accept patients under the Phalala Fund. According to the Times of Swaziland newspaper on Thursday (26 October 2017), the Swazi Government has unpaid debts of E170 million (US$12 million).

Patients on both the Phalala scheme and the Civil Servants Medical Referral Scheme are affected, according to the newspaper.

According to the Swaziland Government, 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 newspaper said in the present financial year (2017/18), 455 Phalala Fund patients and 130 civil servants had been referred, several suffering from cancer.

There is nothing new in this situation. 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 (less than a quarter of the present day debt) 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 both funding schemes, 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, ‘Thus the two funds provide a “blank cheque” for South African doctors and hospitals: whatever amount they ask is paid for 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

SWAZI GOVERNMENT ‘IS BROKE’

https://swazimedia.blogspot.co.uk/2017/10/swazi-government-is-broke.html

SHORTAGE OF HIV DRUGS FOR BABIES

https://swazimedia.blogspot.co.uk/2017/10/shortage-of-hiv-drugs-for-babies.html

 

DRUG SHORTAGE CRISIS DEEPENS

http://swazimedia.blogspot.com/2017/05/swazi-drug-shortage-crisis-deepens.html

THREAT TO LIFE AS GOVERNMENT DOESN’T PAY BILLS

https://swazimedia.blogspot.co.uk/2017/04/threat-to-life-as-govt-doesnt-pay-bills.html

SWAZI KING’S BUDGET INCREASES US$14 MILLION

https://swazimedia.blogspot.co.uk/2017/04/swazi-kings-budget-increases-14-mil.html

KING’S PAL GETS SPECIAL TREATMENT

In Swaziland, there’s one rule for the pals of King Mswati III, and another rule for everyone else.

This is confirmed by the case of Jim Gama, the ‘traditional prime minister’ of Swaziland, who has received financial support ‘from the King’ to travel to South Africa for medical treatment after he suffered a stroke.

Meanwhile, ordinary Swazi people, including cancer sufferers, have been denied treatment in South African hospitals because the Swazi Government won’t pay its bills.

Jim Gama first. He is the ‘traditional’ prime minister of Swaziland and that makes him more important than Barnabas Dlamini, the ‘real’ prime minister. It also makes Gama one of King Mswati’s most important supporters. In Swaziland, when there is a dispute over the two, cultural and traditional law trumps constitutional law. When Gama pronounces on a matter, he speaks with more authority than Barnabas Dlamini.

Gama has been sick since suffering a stroke in 2009 and Swaziland’s appalling health service hasn’t been able to treat him. So, Gama has been sent off to Johannesburg, South Africa, for treatment. He left Swaziland on Friday (28 January 2011) in a Ministry of Health ambulance, accompanied by a senior nurse.

The Weekend Observer, a newspaper in effect owned and edited by King Mswati, reported that over the past two years the King has seen to it that ‘Gama receives the best treatment from premier hospitals in the country [Swaziland] and in South Africa to heal him of the effects of a stroke he suffered’.

The newspaper said ‘the King’ also pays ‘a substantial allowance’ to Gama’s wife who looks after him. It is not clear if this money comes out of the King’s own pocket (he has a personal fortune estimated by Forbes in 2009 to be $US200 million), as the newspaper also reported that assistance came from a health fund administered by the King’s Office and another at Tibiyo TakaNgwane (which is the conglomerate of businesses that the King owns ‘on behalf of the nation’).

Bhekie Dlamini, Chief Officer in the King’s Office, told the newspaper that the King was a caring father and leader. Dlamini said there were many people from all backgrounds who had received assistance from him, be it in education, health or other challenges they may face.

‘It is just that we do not go to the roof top to pronounce to the world what the King has done to help his people,’ Dlamini said.

So, Gama, the King’s pal is well taken care of. What about the rest of the King’s subjects, seven in ten of whom live in abject poverty, earning less than one US dollar a day?

Because Swaziland’s health service is so bad, the Swazi Government administers a fund called Phalala, which allows sick Swazis to travel to hospital in South Africa for treatment, which the Government then pays for.

But, of course, this is the Swazi Government we’re talking about here, and the bills don’t get paid, so sick people get turned away at the door when they arrive at hospital.

It happens all the time. Earlier this month (January 2011), it was revealed that cancer sufferers who needed chemotherapy treatment were ‘blacklisted’ by hospitals in South Africa because the government hadn’t paid bills for treatment given to previous patients. It was reported that one hospital threatened to recover the outstanding monies from individual patients.

One estimate was that bills amount to E100,000 ($US14,000) per patient.

Some of the patients have been receiving calls allegedly from debt collectors hired by some of the doctors to track them down.

As recently as Friday (28 January 2011), it was reported that a number of patients who were transferred to different hospitals in South Africa had been turned back because government had not settled outstanding payments.

The hospitals would not do some medical procedures or admit any of the patients from Swaziland until government paid its bills.

The non-payments are not connected to the present meltdown of the Swaziland economy: the Swazi Government has a long history of incompetence in handling the Phalala fund and there have been many reports of corrupt misuse of monies.