‘Tše­pong de­pletes govt cof­fers’

Lesotho Times - - News - Pas­cali­nah Kabi

D eputy prime Min­is­ter Monyane Moleleki says health ser­vices pro­vided at the Queen ‘Mamo­hato Memorial Hos­pi­tal, com­monly known as tše­pong, were hem­or­rhag­ing gov­ern­ment cof­fers de­spite the gov­ern­ment’s good in­ten­tions when it signed a pub­lic pri­vate part­ner­ship (ppp) agree­ment with Net­care 10 years ago.

the gov­ern­ment owes tše­pong nearly M400 mil­lion (ex­act amount: M399,634,963.54) for its pro­vi­sion of ex­tra ser­vices.

the amount owed is slightly the same amount of M400 mil­lion (33 per­cent) the gov­ern­ment of Le­sotho com­mit­ted to­wards the cap­i­tal costs of the con­struc­tion of the tše­pong hos­pi­tal in 2008.

Based on the con­tract with the gov­ern­ment, the hos­pi­tal is sup­posed to at­tend to a max­i­mum of 310 000 out­pa­tients and 20 000 in­pa­tients per year and any­thing be­yond the agreed num­bers, the gov­ern­ment is charged an un­fixed amount per pa­tient and re­ferred to as “ex­tra ser­vices”.

In the cur­rent fi­nan­cial year, the gov­ern­ment has al­lo­cated M2 bil­lion to the Min­istry of Health, of which, M763 mil­lion will be used to pay tše­pong and this in­cludes the M550 mil­lion, which will go to­wards the an­nual sub­ven­tion paid to sup­port the hos­pi­tal’s op­er­a­tions.

the gov­ern­ment has since said it wanted the tše­pong con­tract re­vised as it felt it had no say in the run­ning and mon­i­tor­ing of the hos­pi­tal although it pro­vides bud­getary sup­port.

Ad­dress­ing the Na­tional Assem­bly last week, Mr Moleleki said gov­ern­ment re­serves were dry be­cause of griev­ous mis­takes that the coun­try com­mit­ted in the past years.

He fin­gered the Bid­vest Fleet Man­age­ment con­tract and tše­pong hos­pi­tal as a cause for con­cern, adding that the con­struc­tion and op­er­a­tion costs of the Queen ‘Mamo­hato Memorial Hos­pi­tal were un­sus­tain­able.

“Although the pri­mary ob­jec­tives of this hos­pi­tal were good, it has its own short­com­ings along the way that have chowed down the gov­ern­ment re­sources to such an ex­tent that the BBC Ra­dio re­ferred to it as cri­sis that had hit Le­sotho.

“More­over, what hap­pened in this cur­rent fi­nan­cial year will go down in his­tory re­flect­ing how the hos­pi­tal is fi­nan­cially bleed­ing Le­sotho dry,” Mr Moleleki said.

Net­care, formed the tše­pong con­sor­tium in part­ner­ship with lo­cal com­pa­nies — ex­cel Health (20 per­cent share­hold­ing), Women In­vest­ment Com­pany (10 per­cent) and D10 In­vest­ments (10 per­cent) and a South African com­pany, Afri’nnai, (20 per­cent).

un­der the ppp, the gov­ern­ment en­tered into an agree­ment with tše­pong Con­sor­tium in 2008 to op­er­ate the hos­pi­tal, which serves as the coun­try’s main re­fer­ral health­care fa­cil­ity.

In ad­di­tion to the hos­pi­tal, tše­pong has four clin­ics as part of the Le­sotho health net­work un­der the ppp agree­ment. the hos­pi­tal opened its doors to pa­tients in 2012.

the Min­istry of Health ear­lier this month re­leased a doc­u­ment ti­tled: the Na­tional Re­fer­ral Hos­pi­tal pub­lic pri­vate part­ner­ship project Brief, dated March 2018, in which they ex­plained the gov­ern­ment needed to pay for ad­di­tional ser­vices pro­vided be­tween 2014 and 2017.

In 2014, ad­di­tional ser­vices were pro­vided to a to­tal 40 274 peo­ple treated as out­pa­tients while 6 148 were at­tended as in­pa­tients, amount­ing to M87 mil­lion and that the out­stand­ing bal­ance is M12.2 mil­lion.

In 2015, the hos­pi­tal billed the gov­ern­ment M107 mil­lion (ex­act amount: M107, 159, 891.79) for ser­vices pro­vided to 38 941 out­pa­tients and 7 388 in­pa­tients.

the gov­ern­ment is also ex­pected to cough-out M124 mil­lion (ex­act amount: M124, 240, 180.98) to pay for ex­tra ser­vices pro­vided to 35 283 out­pa­tients and 8 196 in­pa­tients in 2016 while in 2017 the gov­ern­ment in­curred ex­tra ser­vices cost amount­ing to M108 mil­lion (M108,486,930.32) for 29 065 out­pa­tients and 6 811 in­pa­tients.

the costs per pa­tient (un­der ex­tra ser­vices) have been es­ca­lat­ing since 2014 dur­ing when the con­sor­tium charged gov­ern­ment M13, 597 for an ad­mit­ted pa­tient and M81 for an out­pa­tient.

It is not clear whether these costs are based on the var­i­ous num­ber of days each ad­mit­ted pa­tient spent in hos­pi­tal or it’s a blan­ket fee.

the costs went up in 2015 to M14, 059 for an ad­mit­ted pa­tient and M84 for an out­pa­tient while in 2016 the cost for an ad­mit­ted pa­tient was M14, 776 and for an out­pa­tient at M89; and in 2017 the gov­ern­ment paid M15, 530 for an ad­mit­ted pa­tient and M93 for an out­pa­tient.

Still ex­plain­ing the high costs en­dured by the gov­ern­ment, Mr Moleleki said tše­pong ex­penses were cou­pled with those of Bid­vest Fleet Man­age­ment con­tract, which the pre­vi­ous gov­ern­ment un­for­tu­nately en­tered.

“the Bid­vest deal wors­ened the sit­u­a­tion which had been af­fected by the fact that the South­ern African Cus­tom union (SACU) re­mit­tances had dras­ti­cally dropped, im­pact­ing the al­ready af­fected state re­serves.

“the then par­lia­ment did not ex­pect to hear these things, but these are the facts this par­lia­ment should know,” Mr Moleleki said.

He how­ever said there was still hope for gov­ern­ment to re­cover from this fi­nan­cial drought through the new bud­get pre­sen­ta­tion meth­ods in­tro­duced in the 2018/19 na­tional bud­get by Fi­nance Min­is­ter Moeketsi Ma­joro.

Queen “Mamo­hato Memorial Hos­pi­tal.

Deputy Prime Min­is­ter Monyane Moleleki

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