Hit by slew of problems, hospitals threaten strike
BEIRUT: Beset by long-running deficits in government payments, now compounded by the country’s currency issues, Lebanon’s private hospitals announced that they would go on strike unless authorities take immediate steps.
At a news conference convened Friday by the Syndicate of Private Hospitals, the Order of Physicians and a group of importers of medical supplies and equipment, representatives announced that the hospitals would carry out a one-day strike next Friday, Nov. 15, closing to patients with the exception of emergency services, chemotherapy and dialysis.
Sleiman Haroun, the president of the Syndicate of Private Hospitals, said the government’s unpaid bills had reached $1.3 billion, with an unpaid balance building up each year since 2011. He warned that a “big health catastrophe will ensue” if the problems for hospitals and suppliers are not addressed.
“We have a deficit every year, and it has been accumulating over the years,” Haroun told The Daily Star. “The currency problems added to it additional complications, but we had a problem already, since quite some time.”
Last year, Haroun said, the private hospitals had received half of the government payments owed. The hospitals have not received any payments for 2019 to date, he said.
Caretaker Finance Minister Ali Hasan Khalil, whose ministry is ultimately responsible for releasing the payments, reached by phone, declined to comment. Health Minister Jamil Jabak could not be reached.
Lebanon has 121 private hospitals with 12,578 beds, and 32 public hospitals with 2,653 beds – a split of roughly 4-to-1, private to public.
As early as June of this year, private hospitals were sounding the alarm over the unpaid balance, with some saying they had been forced to reduce services. The syndicate posted billboards around Beirut announcing, “Our situation is critical – hospitals are heading toward closure.”
Now, as a result of the hospitals’ cash flow problems, Haroun said, suppliers of medical supplies like stents, sutures and orthopedic implant shave also not been paid. Further compounding the situation is the shortage of dollars in the country, requiring medical supply importers, who must pay suppliers in dollars, to go to exchange houses that often charge considerably higher than the official rate of LL1507.5 to the dollar – if they have dollars to sell.
“The supplies available in the warehouse are enough for a maximum one month,” a medical suppliers’ representative warned at Friday’s news conference.
“They are 100 percent imported, and there are no alternatives available for them in Lebanon.”
Haroun said the hospitals had asked Central Bank Gov. Riad Salameh to extend to medical supply importers the same conditions that have been given to drug importers, providing them with dollars at the official rate and allowing them to transfer dollars outside of the country to the companies they purchase from. He said Salameh had promised to find a solution by next week.
The financial problems are not only relegated to private hospitals. A resident from the Lebanese University medical school, currently stationed at Baabda Governmental Hospital, told The Daily Star that both residents and staff there had gone without salaries for the past four months and that some materials for diagnostic exams and other procedures had been in short supply.
“We care about providing the best management for the patients,” she said. “It’s their right to have a decent health care system. That is why we wouldn’t stop [caring for] them even if we are not getting paid.”
But, she said, many are struggling. “I get help from my parents, but I have friends who can’t afford even their taxis to the hospital.”
A resident at another, private hospital said residents there had been told this month that their salaries would likely be reduced, although it was not yet clear by how much.
“Obviously, it’s going to affect us a lot, because my rent is kind of 45 percent of my salary,” she said. If the salaries are reduced, “I can barely cover my rent, besides food and all of the other necessities.”
Lebanese Hospital Geitaoui director Boutros Yared, who is also the dean of the Faculty of Medicine at Lebanese University, told The Daily Star that the Geitaoui hospital was considering salary reductions if the situation does not improve and that most hospitals are in a similar situation.
“There is no cash money in the hospitals now, and the government is not paying, and the insurance companies are delaying their payments,” he said. “So we made a plan, if the situation will continue like that, we will have to diminish the salaries for all the workers in the health field by 20 percent.”
Yared said he hopes to avoid that, but that the hospitals are running out of options.
“It’s sad to say, but it’s a catastrophic situation in the country,” he said. “Everybody will suffer from this situation, everybody – the patients, the doctors, and the health workers.”