Malawi govt backtracks on hospital user fees

The government has backtracked on plans to introduce hospital user fees with the Ministry of Health saying hat medical services in all public health facilities will remain free.

Minister of Health spokesperson Henry Chimbali told Nyasa Times in an exclusive telephone interview that the introduction of user fees are not part of public health reform programmes.

“What we are saying is that we have introduced by-pass fees [and not user fees] in referral hospitals in order to deconjest the facilities,” said Chimbali.

Chimbali said Ministry of Health is currently implementing health reforms in order to improve health sector and assured there will be no user fees at all government run health institutions..

He said the ministry will review the current arrangement between the Ministry and Christian Health Association of Malawi (CHAM) saying the current Memorandum of Understanding (MoU) dates back to 2002 and is well overdue for review and it needs to take into account some of the emerging issues that have taken place in our country such as the passing into law of the new Act on Public Private Partnership Agreements (PPPs) which is the basis of the arrangement between the Ministry of Health and CHAM.

Chimbali said the Ministry of Health will therefore engage CHAM once the broad principles covering the agreement have been reached within Government however the health PRO hinted that  the proposal is to work out a mechanism that will see greater access to quality health services by all Malawians especially those in rural and hard to reach areas so that the quality of life of all Malawians is improved.

He said second reform area for the Ministry of Health is that of establishing a Health Fund to support health service delivery in this country.

Chimbali said the third reform which the ministry will undertake will be 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,” said Chimbali.

Chimbali said the ministry is weighing possibilities of extending the existing 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,” said Chimbali.

Chimbali noted that the area on paying sections has created confusion among the general public and some civil society groups.

“There are assertions that Government intends to introduce user fees in the government hospitals. 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.

“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,” Chimbali clarified.