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Free user policy crippling Parirenyatwa Hospital, nurses and doctors retire en-masse, medical equipment malfunctioning 

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By Mary Taruvinga


Parirenyatwa Hospital is in dire need of attention with crippling problems ranging from brain drain to obsolete equipment in the critical renal and radiotherapy units, officials have said.

The major challenge, according to the authorities, is the issue of free medication for selected exempted groups which has compounded poor service delivery.

The situation was unearthed when the Parliamentary Health Committee visited the hospital on Tuesday following a similar visit last year.

According to the acting Chief Executive Officer, Tsitsi Magure, the hospital has a shortage of 368 specialists including gynaecologists, pathologists, oncologists, and palliative care among other areas.

She said the largest referral centre’s radiotherapy machines have been down for over two years.

The hospital does not have radiology and imaging services, chemotherapy medicines, surgical anaesthetic equipment including the complimenting sundries which affects service delivery.

In few cases where the equipment is available – it is obsolete.

“We have reduced the number of dialysis patients so that we cater for all patients that are on the waiting list. We have 100 chronic patients. So chronic patients, instead of having three, we are having two sessions in order for us to cater for everyone.

“The machines are old and we need a replacement. We did a tender two years ago and it was not successful, the ministry of health is promising us to buy through the head office but that has not materialized.

“It’s too much (the problems). We cannot do so much with what we have,” she said.

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Finance director Mercy Sanzira said the hospital is failing to sustain itself because it is not getting any funding from the treasury.

As a result, the facility is swimming in debt, arrived at while sourcing medicines and services for patients who do not pay a penny.

“Right now we don’t get any reimbursements for mental health patients.

“Then we go to maternity. Mbuya Nehanda maternity hospital is a 238-bed hospital and most of the time we have floor beds because of the free user policy.

“So what happens to this area is we are supposed to get reimbursements from the treasury but we are not getting adequate reimbursements.

“Just as an example, last year we only got for three months out of 12, and we are now in May and we have only received for one month,” she said.

While this is happening, according to Sanzira, the hospital is over-admitted to the extent that they have created floor beds to cater for all exempted patients.

“We also have a free user policy for the under five and when I talk about free user policy we are talking about free ward fees, free food, free medicine free radiology, free lab services, free theatre, free everything so that’s under five, and it’s also completely free for the over 65s.

“We have Sekuru Kaguvi eye hospital, where our elderly go and it’s also free,” she said.

Out of 17 dialysis machines only six are functional.

A total of US$20 000 is required for spares while US$300 000 is needed for haemo-dialysis consumables.

“It is free to the user so what it means is the government is supposed to give us money for the haemo-dialysis consumables but we are not getting adequate and timeous disbursements for that.

“We are supposed to get blood and blood services from the National Blood Services using the coupons system but they are experiencing some shortages due to funding.

“So that has a ripping effect on the hospital because we use blood for renal patients, theatre patients.

“So the free user policy is cutting across the hospital and it is giving us a nightmare as far as resourcing this hospital is concerned and even for the medical equipment, the budget was housed at the head office so we are not able to buy the mammograms and the like because that budget was at the head office for the past three years so as a result we are not able to buy. This is compounded by the free user policy because we are getting goods and services from different suppliers but we are not able to pay,” she explained.

They continue to get medicines without paying resulting in the debt accumulating.

“As a result, we can pay Natpharm and that includes other suppliers. So we are no longer self-sufficient because of the free user policy. The treasury has said you have to charge but this free user policy has not been reviewed to date.

According to Sanzira it no longer makes sense to repair radiotherapy machines.

“At the radiotherapy centre, the machines are there, but they are gobbling a lot of money in terms of repairs so right now what we need are new machines.

“So as far as self-sufficiency is needed, as long as the free user policy is not reviewed we are going to remain in this situation and it will be very difficult to deliver on our  mandate, that is to offer a very good service to our patients.”

Parirenyatwa has private wards offering private services but the number is quite small compared to the general who are not paying.

But parliamentarians blame hospital officials

However, the parliamentary health committee blamed the hospital authority for being too reluctant, also for aiding preventable deaths.

The committee chairperson, Daniel Molokele said there is too much medical tourism in Zimbabwe but hospital authorities “were not thinking outside the box.”

“You cannot continue to give this excuse when you can see that people around you are selling, taking patients from you, which you should be having.

He said the leaders should learn from other countries.

“A lot of Zimbabweans are going to South Africa, Zambia, India seeking services which Mpilo, Parirenyatwa can provide or could provide.

“But you are just watching, you are complaining, there is no money, you have been waiting for two years when you can procure these things.

“You should think outside the box, you are the ones who should recommend changes….

“I have heard that 80 percent of your patients are dying and you think it’s normal. Hospitals are supposed to bring life but here you help them go to heaven.

“You might as well expand the mortuary,” he said.

Molokele further fumed, “What we see here is a lack of innovation. You just accept the status quo. You are accountable for all the patients who are dying here.”