Cabinet has approved the proposal to have the three hospitals of Kiruddu, Kawempe and Naguru in Kampala gazetted as referral hospitals in a bid to boost their capacity to offer specialized medical services.
The move will also go along way in decongesting Mulago National Referral Hospital of the minor medical cases as government positions it to entirely become a super specialized health facility.
Minister of ICT and National Guidance, Frank Tumwebaze made the revelation on Wednesday while briefing the press on the decisions passed by Cabinet which sat on Monday at State House in Entebbe.
“Cabinet approved the proposal from the Minister of Health to retain Kiruddu, Kawempe and Naguru hospitals as semi autonomous institutions under the Ministry of Health,” Tumwebaze said.
Tumwebaze said that new ‘referral’ status for the three hospitals will among others bridge the patient-referral gap between the lower health facilities and Mulago specialized hospital, thus improving health service delivery in Kampala.
It will also strengthen the professional medical training capacity at Makerere University College of Health Sciences to provide additional training centres for medical interns.
“It will allow the three referral hospitals to have a semi autonomous status that enables them to expedite implementation of management decisions, carry out their own procurement and improve the quality of services while reporting to the Ministry of Health on technical and financial issues,” Tumwebaze told the press.
The three facilities will as well have the capacity to raise alternative revenue such on top of the government allocated funds for wage, non wage, recurrent and development obligations.
Kiruddu and Kawempe hospitals were both commissioned in 2016 as satellite hospitals to reduce the pressure of demand for selected services at Mulago hospital which was undergoing major renovations.
On the other hand, Naguru hospital was built by the Chinese government and was handed over to government in 2012 upon its completion.
SoftPower News spoke with the Minister of Health, Dr Ruth Aceng to understand what upgrading the three hospitals to Divisional Referrals means and the likely impact especially on the services they offer to patients.
She began by explaining that for a health facility to be regarded as a referral hospital, it means that it has the technical and human resource capacity to offer specialized services.
“When you are a referral facility, it means you serve a certain catchment area. Kiruddu is serving a Division of Makindye, Kawempe if serving the Division of Kawempe while Naguru is serving Nakawa,” she explained.
“In this case, smaller health centres situated in Makindye Division will refer patients to Kiruddu hospital. It will have services and equipment that the others don’t have. But Kiruddu isn’t an end in its self; it will then refer (where there is need) to Mulago which is the ultimate,” Dr Aceng told SoftPower News in a telephone interview on Wednesday evening.
Decongesting Mulago
For many years, there have been concerns by the Ministry of Health and other technocracts who attribute the under delivery and congestion at the national referral hospital to the fact that it handles cases meant for lower health facilities.
In several cases, patients of malaria and other minor illnesses like cough, headaches and small injuries have flocked Mulago hospital, overwhelming the already inadequate resources.
But Minister Aceng says transforming Kiruddu, Naguru and Kawemoe into referrals will remedy this problem.
“The concept of putting referral hospitals in Divisions was to decongest Mulago. But we couldn’t do that without proper facilities in the different Divisions,” the Minister said.
“The idea behind renovating Mulago was to enable it take up its proper position as a specialized facility”.
According to Dr Aceng, Mulago should only handle specialized cases such as complex transplants and surgical procedures as well as other serious cases that the lower facilities can not handle.
Funding
Regarding the issue of funding, the Minister explained that the three referral hospitals will now have autonomy to generate and spend their funds. Each of the new referrals will now get a separate vote from the Ministry of Finance as opposed to sharing the Ministry of Health budget.
“All our referral and regional referral facilities are semi autonomous institutions and they have a vote. They have an Accounting Officer, they get their money directly from the Ministry of Finance and are accountable to the Public Accounts Committee of Parliament,” he said.
Their functions will also be overseen by a Board of Directors on behalf of the Minister of Health.
The same semi autonomous status gives referrals (both Regional and Divisional) a window to find ways of raising their revenue. Part of these ways is to create paid-for services.
“Each of a referral hospital must have a private wing. There are certain people who don’t want to be treated on the general ward and those are the ones that can afford. So they choose to go to the private wing and pay a fee,” the Minister said.