By The Insight Post –Uganda
Mukono- Uganda
Mukono General Hospital’s private wing has come under fire from irate residents who are demanding its immediate closure to avail the space for the extension of the inpatient department.
The demand follows reports of substandard services and the alleged mishandling of patients due to lack of enough space.
The facility situated at the heart of Mukono town in Mukono Municipality-Mukono district, underwent a transformation in July 2019. Its status was elevated from a health center-HCIV to that of a General Hospital.
Subsequently, the municipality authorities officially handed over the facility to the district for further management. However, the hospital management and the district collaborated to repurpose the second floor of the newly constructed building yet it was originally intended to serve as an extension for the in-patient department.
The hospital and district authorities converted into a setup for Grade ‘A’ (Private Wing) which has been operational for six months, providing top-notch healthcare services to patients.
The decision to convert the space that was initially intended to serve as an extension for the in-patient department has resulted in limited space, which has made life difficult for both patients and their caregivers.
The hospital experiences a massive daily influx of clients, with records indicating an average of 50, 000 people annually, in addition to approximately 800 deliveries annually.
Therefore the limited space has resulted in a situation where numerous patients requiring in-patient services have to share rooms. This means that men, women, and children often end up occupying the same ward.
The residents claim to have expressed their concerns about the overcrowding issue, stating that it has persisted for a while without any intervention from the district or hospital authorities.
According to the patients and caretakers, it becomes uncomfortable for those who may feel exposed or uneasy sharing a room with people of different genders or ages.
They say that it can pose a risk to patient privacy and confidentiality yet it is difficult for caregivers to provide adequate care and attention to patients in a shared room, as they have to navigate different needs and requirements.
They also pointed out how it can lead to the spread of infections and diseases due to the close proximity of patients.
“Generally, the practice of mixing male, female, and child patients in the same ward can have negative effects on the well-being and recovery of patients,” says Geoffrey Lwanga, one of the affected residents of Mulago Cell in Mukono Municipality.
Lwanga suggests that the hospital management considers constructing a new and distinct structure for the private business so as to have enough space for in-patients.
To avoid the congestion at the shared general ward, many patients are referred to the private wing to heavily pay for the same services provided in the Grade ‘B’ section.
Some residents have reported cases of patients being neglected, mistreated, and overcharged for various services. The said private wing has been a source of concern for many residents, with some calling for its complete overhaul or closure.
Richard Aliwaali, the Mukono District Chairperson for Persons Living with HIV/AIDS, has expressed his support for the private wing’s operation at the hospital. However, he feels that the hospital management has failed to establish a clear separation between the private and public wings.
Aliwaali suggests that the hospital management should erect signposts indicating that the private wing is a separate facility and should be housed desperately.
Additionally, he recommends that the hospital management should clearly communicate the rate structure for services provided in the private wing, as well as disclose the source of equipment and supplies used in the private wing.
“This will help to avoid depleting resources meant for Grade ‘B’ patients, who are the majority,” he says.
Critical Observation
The guidelines set by the Ministry of Health for managing private wings of healthcare units in the country stipulate that any private wing must be operated as a business entity with clearly defined transactions and a clear identification of resource exchange between the private wing and the rest of the hospital.
During our visit to the private facility, we noticed that there were no indicators such as signage to indicate a private wing and the services provided which violates the ministry’s set guidelines.
Furthermore, there was no policy on the amount to be charged and the prices of medicines were determined by the pharmacist who also acted as the cashier at his discretion.
Despite the hospital administrator Fred Bwogi’s claim that they had advised the pharmacist to charge slightly lower prices compared to other private facilities in the area, no action was taken, and there have been constant complaints because the guidance was not followed at all.
Still, the guidelines encourage hospitals to inform patients of the costs associated with every service they receive to avoid confusion and unnecessary surprises regarding high bills.
Moreover, the cash received from the patient must be deposited into the private wing’s bank account, as per the guidelines. But, when asked, the hospital administrator declined to reveal whether the private wing had a separate bank account from the general hospital.
Private Wing Using Gov’t facilities
The private facility is staffed by one medical doctor, a pharmacist, and two nursing assistants. Records show the private wing, receives an average of 40 patients with different ailments requiring various expertise daily.
During our observation, we noted that the curtains used in the private wing wards were not labelled for private use, but rather for general hospital use.
Additionally, the beds in use had been donated to the general hospitals’ Grade ‘B’ set up by the area member of parliament, Betty Nambooze. This was aimed to provide a comfortable sleeping environment for mothers in the maternity ward who previously had to sleep on the floor.
Still, according to the MoH guidelines, all equipment used in the private wing facility must be procured through the government procurement guidelines and existing procurement committees using local purchase orders.
The infuriated legislator (Nambooze) placed the blame for the lack of monitoring of activities at the facility under the mandate of the LC5 Chairperson, Rev. Peter Bakaluba Mukasa and his council.
She also expressed her disappointment that the hospital administration decided to use the beds she donated at the private wing without obtaining the stakeholders’ consent.
“We have come to the realization that it was a mistake for the municipal leadership to hand over the hospital management to the district,” she says, noting that Bakaluba and his team failed to carry out their duties on critical issues that affect the community.
‘Despite my efforts to advise him, Bakaluba has decided to ignore my advice,” states, adding that it is time to fight to regain the hospital’s management under the municipal authority.
However, the hospital management has acknowledged the issues raised and is committed to improving the services.
The hospital administrator (Bwogi) has assured the public that they are taking the matter seriously and are committed to providing quality healthcare services to all patients, regardless of whether they are in the private or public wing.
On the other hand, some residents remain skeptical and are calling for more action to be taken to address the ongoing issues.
Private Wing Committee
According to the MoH guidelines, a private wing should have a committee dedicated to its management. This committee should consist of a member of the hospital management or board of governors with business expertise, two heads of different service departments within the private wing, the hospital administrator, an accountant, and one senior clinician.
The formed private wing committee is then responsible for reporting to the hospital management team, which is chaired by the medical superintendent. The private wing administrator serves as the secretary for this team, and the chairperson is nominated by the hospital management team.
When asked about the members of the private wing management committee, Bwogi confirmed that the committee consists of himself as the hospital administrator, Dr. Geoffrey Kasirye, the medical superintendent, and the Principal Nursing Assistant, Sr. Alex Namala.
“We meet weekly to plan and make decisions regarding the facility’s future,” he emphasized.
END
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