Malawi Government has dispelled assertions that it intends to introduce user fees in public hospitals.
Minister of Health Honorable Dr. Jean Kalilani says government has no plans to introduce user fees in public hospitals and therefore the ongoing debate on the matter is just confusion of reforms being carried out by the Ministry particularly on "Revitalizing Medical Insurance Schemes in the Country."
"Ministry of health is doing various reforms and one of the reforms is to revitalize Medical Insurance Schemes in the country. Our plans are to have as many people as possible and those that can
afford to be on a Medical Insurance scheme. This will ensure that all those with Medical Insurances can ably access fee paying Health Services across the country using their medical insurances. This will mean that people will have more options for accessing health services but also on the part of health service providers,
it will mean that there is an opportunity to decongest public hospitals as some people will opt for fee paying services whereby they will use their medical insurances."
"In this same proposal, we are also exploring possibility of extending fee paying sections in public facilities so that they work side by side with non paying sections. The idea is to have all those without medical insurance and preferring to access free services to continue accessing public health services free while for those with medical insurances and
preferring to access fee paying services sections
in public facilities be able to do so. This system is already in existence in all Central
Hospitals where they have fee paying services sections and what is being explored now is whether such fee paying services sections can also be rolled out to other public Hospitals." Explained Kalilani
She therefore said this is probably the area that has created some confusion
among the general public
and some civil society groups.
"I must say clearly here that we do not have any intentions to ask people to pay for health
services. Our proposal is to have more people on medical insurance and access paying services in public hospitals." Assured Kalilani
"We have observed the debates around this issue and we want to inform the
general public that any debate that ensues on user fees is invalid and may not
contribute to the final outcome of our proposed reforms."
The health minister further informed that, Department of Economics in Chancellor
College in conjunction with the College of Medicine are analysing such aspect to gauge its efficacy and will be advising on what is possible and how best it can be done.
"Once they have concluded their work, there will be consultations on the subject
matter with various stakeholder groups and once
the ideas have been refined
and agreed, the Ministry of Health will take up the matter with Cabinet to seek its endorsement and approval."
She alsi said a Bill will be prepared and get submitted to the National Assembly so that a specific law on Health Insurance can be debated and passed by the National Assembly and have it implemented from July, 2016.
Other reforms that the ministry of health is conducting includes of establishing a Health Fund to support health service delivery in the country; Reviewing the current arrangement between the Ministry and Christian Health
Association of Malawi (CHAM) as the current Memorandum of Understanding (MoU) dates back to 2002 and; reforming Hospital Operations.
Under Hospital Operation reforms, the ministry is considering ways of making all Central Hospitals autonomous and independent so that they have independent
oversight bodies in form of
Board of directors; to have management of District Health Services separated from the Management of District
Hospitals and; to have non-core services in public Hospitals delinked from core services of Hospitals so that
non-core services are run in partnership with Public Partnership (PPPs).
Dr. Kalilani has since emphasised that under the Hospital autonomy reform, the plan is to have representatives of the people participate in running of public hospitals while the Ministry of Health concentrates on its core business of providing policy guidance, setting standards and operating procedures, guidelines, supportive
supervision and other functions.