Why anti-corruption drive at hospitals must target institutions

Monday March 7 2016

Research shows that a large number of hospitals

Research shows that a large number of hospitals across the country do not display set costs for medical services at their facilities. 

By Syriacus Buguzi @buguzi sbuguzi@tz.nationmedia.com

Dar es Salaam. There are strong reasons why the government’s anti-corruption drive in hospitals must aim at rooting out the loopholes of petty corruption in the health facilities instead of targeting errant health workers alone.

This reality manifests itself in the recent event at Mtwara Regional Hospital, where Prime Minister Kassim Majaliwa ordered the suspension of a doctor following a complaint from one relative of a patient who claimed that the medic had solicited a bribe from her.

While there is no justification for any health worker to discuss any payments for healthcare with a patient at a hospital, the fact remains undisputed that most public health facilities across Tanzania do not publicly display the costs for medical services on the walls.

It has therefore become a norm at public hospitals, to find patients and their relatives seeking for clarification from doctors, nurses and ward attendants—or any anyone dressed in a white coat—on matters to do with the cost of treatment and where to access certain medicines.

Such circumstances may have created room for some dishonest health workers to discuss clandestine payments. This has perhaps also fueled the rise of the so-called “fake doctors” who cash in on the ignorance of the patients. According to some researchers, the lack of clear directions and displays, coupled with poor governance systems, are to blame for the rising trend of petty corruption in hospitals across the country.

Sikika, a health advocacy NGO, has once published a study which exposed the loopholes of bribery at the facilities, in the study titled: Institutional factors influencing petty corruption in public health services in Tanzania.

According to the study, over 80 percent of community members who were interviewed by researchers, did not report their complaints about corruption to the Health Facility Governance Committee (HFGC) because they did not know its members.

The failure to report corruption complaints to the HFGC was associated with the increasing perception that the efforts in dealing with corruption were not adequate, said the study.

It remains to be seen if every case of corruption at the hospitals will have to wait for the intervention of the PM or other government officials.

Last week, when the PM visited the Mtwara Regional Hospital, he was visibly angry when he realised that the facility lacked a special desk for receiving elderly patients and another for dealing with patients on health insurance.

However, what the Premier did not ask was, if the facility had a special desk or section where the corrupt and errant health workers would be reported by the patients.

Instead, he made an outright decision of suspending the doctor who had been implicated in a bribery incident. This was, after a complaint from one relative of a patient, Ms Tatu Abdallah, who claimed she offered a bribe to the doctor.

Ms Tatu told the PM that she was forced to sell her 2.5 acre of land to pay for her ailing father who had to go to a private hospital in order to undergo an operation after being thrown out of the Mtwara Regional Hospital for failing to foot medical bills.

Narrating the incident, she said, “On February 1, 2016, I brought my sick father here. I was told he needed an operation. A prescription was written for me to buy medicine to the tune of Sh85, 000 from one drug store outside the hospital (she couldn’t recall its name), and pay stitching for Sh25, 000.”

In the end, she said, “The doctor (she couldn’t recall the name) wanted me to give him Sh100, 000 to put it into his pocket. But until February 7 he had not been operated on.”

Later, when the PM held a meeting with the hospital staff, he ordered all doctors to stand and introduce themselves. It was then that he asked the woman to go and hold by hand the doctor who demanded a bribe from her. The woman did.

Perhaps angered by the incident, Mr Majaliwa ordered the suspension of the doctor and instructed the Prevention and Combating Corruption Bureau (PCCB) to investigate the matter.