Hit by slew of prob­lems, hospi­tals threaten strike

The Daily Star (Lebanon) - - FRONT PAGE - By Abby Sewell

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.”

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