Regulating private clinics critical to attaining universal health coverage

Access to quality healthcare remains a pipe dream for poor Kenyans. [iStockphoto] It is improbable that Kenya will attain the ideals of Universal Health Coverage (UHC) by 2030 as envisaged. Nothing exposes this farce more than the just concluded nationwide doctors' strike. Access to a full range of quality health services, when and where needed, without financial hardship remains a pipe dream for millions of poor Kenyans. With glaring disparities in terms of cost and services offered in public and private hospitals, the actualisation of UHC will remain a mirage. For most doctors, private practice is the goose that lays the golden eggs. The more cunning among them make a killing from dispensing government-acquired medicines in their private clinics, or by making referrals for simple medical tests to private clinics and laboratories that they own, or are run by their friends. Notwithstanding that the Kenya Medical Supplies Agency dispatches drugs to public hospitals regularly, it is no brainer that patients in public hospitals buy their own medications. Empty shelves are the hallmark of pharmacies in public hospitals. Irrespective of what the government says about it, National Health Insurance Fund is a scam, and a serious one at that. Instances in which patients from public hospitals are referred for scans and other tests to private clinics abound. By whatever measure, this is preposterous. Could it be that the government cannot afford scanners and other machines, or that those available in public hospitals have been sabotaged to create avenues for corruption to thrive? The fact that this has been going on for years unchecked points to serious dysfunctionality in the parent ministry. Unless the government exerts tighter control on this sector, and specifically, private practice, it will always be held to ransom by doctors who stand to lose nothing during a contest of wills between them and the government. Not surprisingly, the government has a handle on doctors should there be political goodwill to level the playing field in the medical sector, yet, it is reluctant to yank it. In a country whose other name is 'corruption', it is not hard to surmise that powerful individuals in the corridors of power, and their lackeys, stand to benefit immensely from disturbances in the Health ministry. There are a number of high-profile scandals to attest to this. When, if at all, statistics for the post-March 15, 2024 period -the time doctors downed tools- are declared, the number of deaths that could have been prevented would shock. Poor folk die at home because they cannot afford private hospital services. Where malaria test and treatment in a public hospital would cost, say, Sh300, a patient requires about Sh5,000 for the same process in a private clinic, inclusive of the exploitative 'consultation fee'. Most of the clinics are run by unqualified staff in the absence of their proprietors; doctors on government payroll. This raises the matter of conflict of interest which, to a larger extent, accounts for referrals and missing drugs in public hospitals and an abundance in private clinics. No matter the ailment, private clinics will hardly ask a patient to buy medication from a pharmacy; they always have drugs ready. Ours is a liberalised economy, no doubt, but a responsible government will pull out all stops to ensure healthcare is within reach of all, regardless of station in life. A healthy nation, as oft said, is a working nation. If the government were to put operations of private clinics on a leash and dictate uniform and reasonable charges for services rendered, it would be a relief to the hustlers, most of whom sell land and property to raise money for treatment. This perpetuates the cycle of poverty our founding fathers committed to get rid of at independence. Competent and reliable services in public hospitals will take the edge off private clinics and with it, their exploitative nature.

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