Make free health care realistic

Editorial, Normal

The National, Thursday November 19th, 2015

 GOROKA MP Bire Kimisopa was reportedly moved to tears by the state of public health facilities in the Western province during a fact-finding trip as chairman of the parliamentary committee on public sector reform and service delivery.

His committee has been to other similar places in the country and the scenes and stories that greeted them were largely similar throughout.

Much has been said and heard of the problems affecting hospitals, such as mothers delivering their babies on a bare concrete floor of a full-house labour ward at Port Moresby General Hospital; termites eating away at the very heart of Angau Memorial, Goroka Base’s management woes and Boram’s need for a complete overhaul or better still, relocation.

Daru and other smaller centres throughout the country have certainly been out of sight and out of mind and their problems of chronic money shortages and steadily deteriorating infrastructure have rarely made the news. 

Kimisopa and his committee, in their travels around the country, came across some such well-documented deficiencies of the public health system and much else besides.

Upon returning to Port Moresby, the committee then began hearing submissions from public health specialists and managers from institutions.

The committee ended its public hearings yesterday at the Parliament House with a meeting with top Department of Health officials.

At one of the sessions this week, Kimisopa’s committee was told that the Government’s free health care policy was yet to be realised by Papua New Guineans.

Some of the main impediments to quality health care noted by the committee include the big money question, the departure of professional health workers to the private sector and the lack of effective health leadership or management.

In a hearing on Tuesday, the sister-in-charge of the Malahang health centre in Lae told the committee that the centre continued to charge sick people fees in order to keep the facility operating.

This is despite the Government’s free health care policy, but what else can Malahang health centre do with the level of funding it had and needed to stretch to cover a year’s operations? 

The clinic was allocated K12,500 in 2013, all of which had been exhausted. And it is yet to receive its allocation from the 2014 and 2015 national budgets.

“If I can be allocated K200,000, it can cater for me for the whole year at the implementation level,” the sister-in-charge of the health facility told the committee. 

Compare the above figures: The sister-in-charge at Malahang is saying that she would be happy to run with a K200,000 annual budget but gets a paltry K12,500 instead. She somehow managed to keep the facility up and running throughout the year with a mere 6.25 per cent of the amount she needs to provide a satisfactory level of health care there.

And the Government expects Malahang and other similar public health facilities to provide free health care! That is not being realistic.

For there to be any level of realisation of the Government’s free health care policy, a lot needs to be done about the yawning disparity between policy and reality in funding levels.

The committee heard concerns about health professionals being drawn into the private sector by better working conditions and remuneration.  Their departure has created staffing problems not only in numbers but more importantly in levels of expertise.

Although better remuneration in the private sector can be the main attraction, it is not everything; some specially trained medical officers in public health institutions have been left to work with run-down medical equipment or none at all and they are under-utilising their acquired skills and expertise.

This can be a frustrating situation bordering on contempt by an employer who is unable to equip and motivate its employees to better serve the public.

The free health care policy is a brainchild of the current government which allocated K1.565 billion to the Department of Health in the 2016 budget. That is 11 per cent of the total 2016 government expenditure.

It is now up to the implementing agency, the Department of Health to ensure that the public benefited from the policy, and that primary health care at government-run health facilities is truly free.