Monday, May 20, 2024

Government’s U-Turn on Circular banning public health workers in private facilities welcomed

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Medical staff on a Mobile Phone
Medical staff on a Mobile Phone

THE Zambia Medical Association has welcomed the move by the Ministry of Health to withdraw a circular that banned public health workers from working in private facilities.There was an uproar last week from health workers when Government issued a ban on the practice, with the Zambia Union of Nurses Organisation arguing that there is no regulation banning health workers engaging in any economic activities.

ZMA general secretary Francis Mupeta said the issue of doctors in public institutions working in private hospitals is a complex one that needs thorough consideration

On Friday evening the government temporarily suspended a circular banning health workers from engaging in extra work in the private sector after it received a backlash.

In a circular addressed to all provincial medical directors, early this week, Ministry of Health Permanent Secretary Kennedy Malama directed that no medical doctor, nurse, midwife, clinical officer or indeed any other public service employee employed in the Ministry of Health shall be allowed to work in any private institution as it was an abrogation of their conditions of service.

However the circular received a backlash from health workers who rejected it, saying there was no law in the country that stops citizens from engaging in extra activities outside their jobs.

But Minister of Health Chitalu Chilufya said the circular has been withdrawn in order to allow for more consultations with stakeholders.

He said in a statement that a final circular will be issued at the end of this month which will also include views from other stakeholders.

The Zambian minister however said the government will not condone a clique of health workers who were only spending 30 percent in delivering services in public health institutions while they spent 70 percent at private institutions.

And private clinics and hospitals have been warned to get their own workforce in place as required by law or be deregistered.

Health minister, Dr Chitalu Chilufya charged that there were private hospitals calling themselves specialist hospitals that had no staff.

They have created an impression that they are modern specialists hospitals but rely on medical specialists on government payroll, a move he condemned and would not allow to continue.

He has directed that Health Professional Council of Zambia will not issue licences to hospitals that do not have human resource and any institution found wanting will not be given licence to practice.

He has since called on the Health Professional Council of Zambia (HPCZ) to revoke any health practicing licence of institutions without a workforce, as well as deregister any such facility that operate under the pretext of specialist institutions when they had no such experts and depend on part-timers.

“Going forward the HPCZ will carry out inspections and will not issue licences to health institutions that do not meet the set standards,” Dr Chilufya said.

He explained that private hospitals had a requirement to have an establishment of their own expert workforce, and Government would not condone a parasitic relationship were Government pays salaries to health workers while private facilities focus on exorbitant fees for private services and fail to meet the requirements. He charged that most private hospitals flourished on public health workforce even earning themselves false titles as specialist hospitals yet thrived on public health workers.

“Doctors and nurses are paid from a pool of public resources and must pay back to the public by paying attention to patients in government hospitals because they are not inferior to patients in private hospitals,” the minister said. He alleged that some of those treacherous health workers had gone to the extent of recruiting patients from public facilities as though they offered better services at private institutions.

Dr Chilufya charged that patients in public institutions were not being attended to because doctors and nurses rushed through their duties to go for private practice.

He said some professional bodies had submitted reactions to the Permanent Secretary’s circular and others issued statements on social media .

He paid tribute to vast majority of health workers who provide service in hospitals diligently in Lusaka and all parts of the country. Government has put on hold implementation of circular banning medical personnel from working in practice to allow for dialogue with stakeholders on the matter. Dr Chilufya clarified that moonlighting was allowed as long as it was done in medical personnel’s own time when they were on leave or off duty.

44 COMMENTS

  1. I have a son who is a Medical Doctor practising at a State owned Hospital in Denmark. The Danish and many other developed countries believe the more experience a Doctor, nurse or any other medical professional gains with the more patients they treat in as many situations and institutions as possible the better it is for other patients they may encounter- this experience can save lives.

    So does this mean our Govt Doctors can volunteer to work in organisations like MSF, Doctors without borders etc???

    This is a dull decision by dull policy makers!

    • They will give sub standard service if they have private work which they can give more.

      Either give them more money and ban private work or continue to risk the lives of many at UTH through negligence and or durable diseases.

      Thanks

      BB2014,2016

    • This is not Mushota,how can anything sensible come from Mushota?This is an imposter

      I have a certificate in plumbing,thanks.

  2. Working in private practice exposes medica professional to different set of ailments often afflicting a different section of the population. Staying in a govt institution where you are confined to practising your medicine with the same type of complaints day in and day out is not good for medical staff. They need to gain as much experience as possible.

    Also the salaries medical staff get in Zambia are pathetic, allowing them to work in the private sector on their authorised leave reduces the risk of a brain drain of valuable staff especially to countries like South Africa which already has many Zambian Doctors in which case we will now have a more serious problem.

    • Same society same disease pattern baba. Its not like they get the chance to treat ebola in the private sector. “Pathetic salaries” affect every Zambian. On the other hand if private practices are made to compete for full time professionals, they naturally will have to offer competitive salaries vs govt. That competition for skilled workers is what brings about improved conditions of work and salaries. We have a lot of young medical professionals who are unable to get employment because those who are lucky to get government jobs go out to grab jobs in the private sector on part time basis for a fraction of what should be the right salary.

  3. It seems the crop of doctors running Ministry of Health and HPCZ are jealous of the achievement of some of their colleagues and will do everything to want to frustrate their colleagues using the so called Laws they don’t understand! Bane, don’t be Sadists who are always happy to inflict pain on others! We are a Liberalized Economy! Let the doctors practice with minimal disruption from regulations atase! If politicians are investing outside the country instead of doing so within the country, why do you want to apply double standards on our health workers? Grow up!

    • Why do we have so many of them at MOH…these people should be in clinics and hospitals including the crook Chilufya….in developed countries you will never see a medical doctor being appointed as a Health minister

  4. Has dr Chilufyana with a small d ever heard of Doctors Without Borders? Why does he want to kill Specialised Hospitals where visiting Specialists come to do state of the art procedures which have benefitted a lot of our people? Which visiting specialist will want to do an operation in UTH where supplies are lacking? Has our minister and his HPCZ cronies ever heard of Medical Tourism? We send patients to India and we don’t understand how those facilities are run! Please give professionals some professional space to bring out best innovations! Wanya wanya type of leadership doesn’t work when you are dealing with Professionals! Bwana minister and HPCZ, concentrate on addressing the thefts and corruption in your ministry instead of frustrating professionals with rules that don’t make sense…

  5. The original decision was knee jerk,rushed and without research and consultations which is typical of this admnistration and thus innumerable policy reversals.Even the National Health Insurance was rushed and should be shelved.Chitalu please do not make decisions based on personal interests or vendettas.Tekanya
    .

    • @kalima well said!

      Where are the articles? Your column is amongst the best on Lsk Times keep up the great comments and your objective analysis is the kind we need in this country!

  6. I support GRZ on this one. We can not have citizens waiting to be seen by medics because the medics are attending private bussiness while being paid by the tax payer.

    GRZ needs to work out a formula were the private medical institutions using GRZ work force pay part of their salary, for that limited time period, on top of taxes paid.

    • Health workers who opt to have a second job (moonlighting), do so on off days. They do not work from Monday to Friday like in other Organisations. They have duty rosters to follow, no patient will be inconvenienced because they are off duty.

  7. An inept administration always looks at exceptions and throws a blanket regulation over everything. This is akin to accusing your entire office of being thieves instead of quietly investigating who the thief really is. I advise the Ministry policy makers to lock their petty biases and personal beliefs firmly behind the doors of their homes every morning they go to work. Also, I advise the policy makers to examine strategy levers before effecting a policy so things like this are avoided in the future. When I predicted this reversed measure would not work I was voted down… I am sure some chimp will do the same on my advice too.

  8. Ok employ expatriates to monitor the issue of drugs and equipment at GRZ hospitals and see if the private clinics will survive. Just try it and see what comes out.

  9. Why don’t doctors respect each other the way Lawyers do? When you read the Doctor Oath, you realize these guys are supposed to treat each other as brothers and sisters but alas, that is not what we see in some when they are given leadership roles. Big up guys or you will lose the little respect left. Slow down Bwana Minister of Health! Don’t antagonize your colleagues! Instead engage them in decision-making through the ZMA! As minister, you have powers but not all the knowledge! You can use that power ignorantly through emotions and destroy everything or choose the way of dialogue and knowledge – knowledge is True Power!

  10. @2020… You and your Denmark son bla bla.
    Did you know, in Denmark, a patient can sue a medical doctor for negligence. The practitioners are therefore thorough in their practice, regardless of institution.

    Here, UTH patients at low cost wards are assumed expandable, as negligence would go unnoticed by the poor and uneducated. Some of our senior Doctors rush through, or hand over to juniors, without much care and consideration. In that lies the problem!

  11. Make a U turn on Swaziland plot

    Its being heartless for anyone foreign er to get land in country smaller than NRDC

  12. Ecl is a listener

    Let him also award a man who controls traffic every evening on kasangula road near railway

    Ecl has bad advisory team

    Give back Swaziland Plot

  13. Good move. I think the private sector releaves the burden of MoH. No need to engage into a fight. But maybe the government was looking at leveraging unemployment levels. Restricting their employees created vacancies for those unployed. But private sector won’t take raw workforce.

  14. Alternative Facts Fake News S**thole Countries Social Mobility Chinese Zambia Police Reservists Corruption scandals: Ambulances Fire Trucks Mukula Trees Ndola-Lusaka Rd Malawi Maizegate Fuelgate Swaziland landgate Zesco Loans Alternative Facts Fake News S**thole Countries Social Mobility Chinese Zambia Police Reservists Corruption scandals: Ambulances Fire Trucks Mukula Trees Ndola-Lusaka Rd Malawi Maizegate Fuelgate Swaziland landgate Zesco Loans

    I think this issue is complex than it is being trivialized. This govt as usual rushing things and policies without much thought, consideration and consultation. Due to their impulsive knee jerk behaviour, even when they are onto something meaningful, they end up messing the rollout and implementation.

    I’m on the fence on this one until I receive enough information on the issue. Reading through the arguments in the article, they certainly make sense. I would have thought that our medical staff would be stretched and too busy to even find time to go and do extra work elsewhere. I think they need to look at ethical issues here for doctors and nurses to only care more about patients in private hospitals.

    It comes down to money incentives and I reckon the govt need to look into the…

  15. It comes down to money incentives and I reckon the govt need to look into the issue objectively. This reminds me of that argument about public school teachers doing private lessons in govt school facilities during normal hours… not sure how that issue ended but it sounds very similar.

    I would support the idea of working full time either in public or private but not both. Or only working part-time in your own spare time (but I bet there are some who are abusing this and doing this during their normal govt working hours). And the issue of private hospitals getting drugs illegally from public hospitals needs to be investigated and addressed.

  16. Hon Minister, if any thing these Doctors who spend only 30 percent of their time at Public Hospitals, should be taken to COURT and jailed, because they are stealing from the Government, it’s not fair on the part of the Government and the poor Zambian, who can not afford your so called Expensive Private Hospital. You Doctors want the Government to pay you your full K25 000 and yet you only put in a few hours of work, Senior Doctors get even as much as K 30 000 to K35 000, guys let’s be serious. Same applies to the Night call Allowance, you Doctors go and sleep at your homes and some even go drinking beer, when you know very well that you are on call, and when called upon for an emergence, just how can you attend to it, when you are drunk, when you are on Call, you are supposed…

    • Do you know what Night Call allowance is before you criticize…it doesn’t mean they can not sleep at home ..they simply need to be available when required…its not like they are working as security agents!!

  17. You are supposed to sleep at the Hospital, that is why the Government pays you that allowance. Guys let’s improve on our service delivery, at the Public Hospitals.

    • Depends on what level ! A Resident Doctor is supposed to sleep there but above that supposed to be available when called and this is worldwide

  18. Dr Chilufya’s schemes have been laid bare. Moonlighting is a policy decision which can only be announced by a minister not a PS. In this case, Dr Chilufya instructed a pawn, his PS Dr Malama to issue a policy statement and later comes out to reverse it after an outcry from the union and Green Party President Sinkamba. This is cheap strategy. As Sinkamba stated, Dr Chilufya is a liability to medical service delivery and the sooner President Lungu comes to this realization and remove him from the ministerial position, the better for the nation.

  19. But this government sometimes forward sometimes backward, sometimes left sometimes right. No policy direction at all. Keystone cops.

  20. The minuster us 81% correct, 15% incorrect and 4% undecided. The truth making up the 81% is that doctors are overdoing it, they spend 85% of their time doing private practice and only pass through their main duty stations for a few minutes just to be seen. That is theft, corruption, and total immorality for so called educated persons. But these are attributes of upnd whuch is why you see upnd cadres above condemning the minister. To upnd (starting from its underfive head h.h, going downwards through his veep), immorality, theft, fraud, corruption is fine provided they are the beneficiaries. And this clique of shameless devils wants to rule Zambia! Not in my life time, U will continue to ecpise you where it matters until underfive reaches 95 years of age to become electable.

    • Spot on. Politicking for expediency. Ban should stay. Masses are in support coz they are terribly short changed.

      Can’t imagine a ranch allowing its herders or vets to go tend to cattle on another ranch while its cattle are in panic room!!

  21. …..correction
    I will continue to expose them where it matters until underfive reaches 95years of age to become electable.

  22. Imwe let us call a spade a spade salary yamu boma no ma change. Increase the salaries and bring back the circular

  23. Government without VISION , EVERYTHING NICHIPANTEPANTE, U U TTURNS Yaba The Green aprty in 2021 will NOT U TURN ON ANY POLICY COS. THEY KNOW HOW TO CONSULT AND RESEARCH. MeanWHILE MEDICAL PERSONNELS GET ALOT OF MONEY IN ZAMBIA FOR DOING NOTHING, THEY FAILED TO SEPARATE SIAMESE TWINS JOINTED IN THE STOMACH THEY HAD TO CALL RUSSIA INTERNS, THEN MALAMA PS WAONA MANJE JUST BECAUSE NDIWE PS TODAY YOU GO AGAINST UR FRIENDS U USED TO SUFFER TOGETHER WITH ..ANIONE ANIONE NYENDULE IPONA MTHOBWA

  24. Such work must be after a qualification say 10 years of public service otherwise govt will be training pros for the private service

  25. See how extra lessons has killed the education sector and made teachers to be corrupt.Learn from the teachers before this evil practice invade the sensitive ministry of Health. Don’t compare Zambia to other developed countries where citizens do things with a passion.
    Bwana Minister,a patient was admitted at a certain public hospital in lusaka with chronic kidney disease,a cartel of healthcare workers(Doctor,nurse and lab) puts fear into the patient .They create all sorts of stories about how dangerous the disease is and how many patients have died from it.They then talk to the relatives and suggest a private hospital where their patient could receive the best care and treatment.They continue talking negatively about that public hospital,how dirt it is and how bad the government is…

  26. Yes we also await a U-turn on the eSwatini nkonyeni land.Inyatsi withdraw the so called gift and give it to the poor people of Swaziland

  27. This issue looks like the work of the spin doctors aimed at moving attention from the Global Fund corruption. When you look at the timing, you would expect that the ministry would invest its time in arresting the corruption and theft tag but what do we see, someone brings in some unnecessary issue to divert attention

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