Fix the Tšepong mess

Fix the Tšepong mess

POLITICIANS loathe accepting culpability when there is a disaster.
That is why it was refreshing to hear Health Minister Nkaku Kabi accepting that government officials and politicians should shoulder part of the blame for the overcrowding at Queen ’Mamohato Memorial Hospital (Tšepong).

It was a candid admission that should trigger introspection in the corridors of power. Kabi said government officials were forcing the hospital to accept patients without referral letters from district hospitals.

The minister was thus confirming that the referral procedures at the hospital have been compromised by politicians for expediency.
It can be argued that politicians have corrupted the system to appease the public. The result is a referral hospital teeming with patients who should be treated at district hospitals and village clinics.

Tšepong, a national referral hospital, has now been turned into a primary health centre dealing with cases like minor wounds, headaches, fever and common colds.
For years government has accused of Tšepong of gobbling more than its fair share of the health budget.
Now, for the first time, a minister of health is admitting that the hospital is not entirely to blame for the galloping costs.
There is little doubt that the government now faces an eye-watering bill from Tšepong because of the upsurge in the number of patients. We hope when that happens the government will not seek to disperse blame.

Kabi should not be shocked that Tšepong is overcrowded because several reports have warned that this would happen. The quarterly reports from the hospital must have alerted the ministry to this impending disaster. But even without those reports the minister should have foreseen this crisis.

For signs he needed to only look at the poor state of Queen Elizabeth II Hospital, which is supposed to serve as the main district health centre for Maseru.
The hospital is only dealing with outpatients and less complicated tests. That is why most patients force their way into Tšepong.
Kabi said the overcrowding at Tšepong does not mean that the primary health system is broken. He is right but only to an extent.
The truth is that even if the district hospitals and clinics are functional people are not confident that they are doing a good job.

There is a perception that Tšepong is a centre of excellence that has the best services and equipment. Ideally, the loss of confidence in the primary health centres should not automatically lead to an overcrowding at the referral hospital. The trouble here is that the government is not enforcing the same rules it imposed on Tšepong. The agreement is that Tšepong can only admit cases referred from district hospitals.

But, as Kabi admits, you only need a referral letter if you don’t know a politician who can help you force your way into the hospital. In some cases all it takes is for a patient to scream on a local radio station to make politicians and government officials jump to break the rules.

The solution is clear: insist on the referral letters, stop politicians from interfering and build a hospital for Maseru district. This must be done while educating people about the role of Tšepong.
Until then Tšepong will remain a referral hospital functioning as a district health centre or village clinic.
Its charges to government will however remain that of a referral hospital. The result, of course, is more pain in the pocket for a government that is already in financial trouble.

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