Lubowa Hospital controversy

Some critics have argued that the money going to the new hospital could have been better used elsewhere. And the list of better options, according to critics, appears endless. It includes going into enhancing the salaries for nurses and doctors, improving existing facilities such as district hospitals and health centres, and ensuring that government health facilities do not suffer drug stock outs or instead get an equipment upgrade.

Kapwepwe of UDN says the government should be working on improving Uganda’s existing facilities.

“Uganda has already moved towards the improving of its referral systems. African Development Bank loans have been used to put up Kiruddu and Kawempe hospitals so that the main Mulago hospital can be used for the core referrals of cancer and others can go to the new Women’s Hospital and others,” Kapwepwe said.

He adds that Uganda has already sent out several medical doctors in several places across the globe.

There is also a view that the government should be focusing on injecting more resources into the Mulago National Referral Hospital; Uganda’s premier health facility located in Kampala.

The Uganda Medical Association (UMA) says this would have been a better approach. Mulago has been undergoing some major infrastructure renovations, equipment upgrades, and human resource improvements. But the government has been criticised for failing to release all the money needed for Mulago’s renovation to be completed. Some estimates indicate that $379million, the cost for the construction of the hospital is roughly half the annual budget of the Ministry of Health.

The doctors’ umbrella body in mid-March petitioned the Speaker of Parliament and President of Uganda, saying the lack of consultation of Ugandan medical professionals on the project undermines government’s stated Buy Uganda Build Uganda (BUBU) policy.

UMA urged government to prioritise refurbishment of Mulago Hospital Complex which has 900 beds and is likely to afford more services to Ugandans than the Lubowa Hospital. Mulago needs only Shs24 billion to complete its renovation.

Hospital overpriced?

Dr Ekwaro Obuku, the president of UMA, told The Independent that the Lubowa Project is over-priced. He said, for example, phase one of the Lubowa project will take $379m for 264 beds, which is $1.1m per bed.

“Such hospitals cost about $100,000 to $300,000 per bed,” he said.

One of the reasons the government cited for the establishment of an internationally credited health facility like the International Specialised Hospital of Uganda is to counter the growing burden of Non Communicable Diseases (NCDs) like cancer and heart and kidney complications among other things.

But Okwaro said more effective ways of curbing the endemic problem of NCDs involve primary prevention since NCDs are diseases of lifestyle.

“Otherwise for the treatment of NCDs, we need to strengthen the Regional Referral Hospitals with doctors and diagnostic equipment,” said Okwaro said.

He added that since treating NCDs are costly, the government needs to quickly institute innovative financing mechanisms, key of which is a public health insurance scheme.

He said the government should have weighed the opportunity cost for investing in Mulago, the Uganda Heart Institute and Regional Referral hospitals.

But Lawrence Bategeka, an economist and vice chairperson of the Parliamentary Committee on National Economy says boosting existing medical facilities is not the same thing as building a specialised hospital of the proposed Lubowa standards.

“No matter how you improve your hospitals, you may lack the capacity or even the incentive to do the right thing. Therefore, this hospital is the right thing for us Ugandans,” Bategeka told The Independent.

He says not many countries have such facilities and, therefore, Ugandans should look out for this opportunity.

“To the Ugandans who go to Kenya for treatment, why do you think they don’t go to Nairobi Hospital and go to Aga Khan Hospital?” he said, “It is because Aga Khan has that rating and Nairobi does not.”

Bategeka chose to look at the medical benefits accruing from the hospital once it is completed and not bother so much about the financial implications.

****