Malawi introduces hospital ‘bypass’ fees: Pegged at K1,500

Malawi government has introduced user fees for walk in patients in major public hospitals who seek treatment without being referred by either nearest health facilities which is pegged at K1500 per patient.

Minister of Health Dr Jean Kalirani disclosed recently that government will introduce paying fees in all its public hospitals be used to finance a health fund to address underfunding within the health sector.

Ministry of Health spokesperson Henry Chimbali said Wednesday that the fees would be levied on patients bypassing government health centres within their vicinity opting to access medical services at major referral hospitals.

“Government has introduced these paying services in the major referral hospitals to address underfunding within the health sector,” he added

Through the “bypass”, he said, the government wished to allocate 40 percent of the collected revenue from the charges towards hospital staff incentives and the remaining would be earmarked for maintenance.

Kamuzu Central Hospital (KCH) director Jonathan Ngoma said the fee called ‘bypass’ is a token designed to decongest the hospital and encouraging sufferers to seek treatment at the health centres.

Malawi’s government hospitals offer free services to the citizenry. Often times the hospitals have suffered drug and medical equipment shortages – problems that have been blamed on lack of enough funding.

However, the issue of user fees remain contentious with  with Global Hope Mobilisation (Glohomo) executive director Caleb Thole criticised the introduction of consultation charges as a violation of access to free and quality healthcare services.

“Research has shown that user fees or any form of payment in a government hospitals is no an effective form of health financing as it is only capable of mobilising five percent to 10 percent of recurrent budgets,

“In the long run it also reduces efficiency of demand for health services through decreasing demand for appropriate health care among poorer and vulnerable groups and the beginning of bypass fee is part
of it, there is just no difference, the poor is paying anway,” Thole said .

Global development and advocacy charity, Oxfam, recently warned government against heeding calls to introduce user fees in the country’s hospitals, warning that the move will hurt the country’s poor.

Government was also urged in a local newspaper editorial to put in place measures that would ensure money made from the user fees from public health institutions indeed goes towards improving delivery of health services “and not towards enriching people who only care about their pockets even where they put a number of lives at risk.”

Currently, Ministry of Health has proposed introduction of health risk taxes on alcohol and cigarretes as one way of revenue generation measures to complement resources it gets from its partners and the national budget.

In the K780 billion revised 2014/2015 national buget, Parliament allocated K69 billion to the Ministry of Health. In contrast, the ministry’s total health expenditure was projected at K274 billion for the year.

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