South African company does referrals for local hospitals
The Ministry of Health Strategy office’s decision to outsource referrals to a South African company is said to have ballooned costs associated with the exercise. Hospitals were bullied into giving up conducting referrals by a newly set up Strategy Office in the Ministry in 2012.
Today Princess Marina Hospital has to conduct its referrals through a South African based company, Healthshare which was awarded the tender four years ago, and it has not been a merry go round exercise. Sources reveal that patients have had to wait for many days to secure appointments, even in cases where specialists are available in Botswana at the two private hospitals, Bokamoso Private Hospital and Gaborone Private Hospital.
Bookings for local and foreign patients to be referred to South Africa are done in that country by Healthshare. Initially Marina even conducted foreign referrals. When government decided to go the outsourcing route, hell broke loose with every little function being tossed from the employed cadres of the hospitals.
Weekend Post has established that Healthshare is paid P319 000 per month by the Ministry of Health. Annually the company raked P3 828 000 from the Ministry. The figure is a flat rate and it does not consider if there were transactions or not. The company was paid P15 312 000 in the last four years.
Referrals are done when there is no equipment to handle a particular medical condition, or when there is no expertise available locally, or there is need for an urgent service, and sometimes when the Marina Hospital Intensive Care Unit (ICU), which has a capacity of eight (8), is full.
“It is shocking that even in cases where there is one known specialist at a private hospital like Bokamoso; we have to wait for the Healthshare representatives based in South Africa to make a call to that doctor before we can take a patient there. Sometimes the process takes too long and some patients deteriorate further and I have heard of a few cases where some lost lives,” said a Medical Officer who used to work at Marina Hospital.
Challenges relating to the Healthshare contract have been communicated to the Ministry of Health’s permanent secretary, Kolaatamo Malefho but there has not been any movement on his side. Malefho has been described as a “My way or the High Way” kind of supervisor and his juniors crumble at his feet. “Some of the issues about Healthshare he would know, some he wouldn’t because people are not open to him. Our bosses are just happy with cooked up figures submitted to President Lt Gen Ian Khama, which falsely state that the Ministry is performing well when all is in tatters,” said an official at the Ministry headquarters.
Accommodation of patients in South Africa has also become a teething problem. Costs have gone up because patients take long waiting to see specialists. Deputy Permanent Secretary – Clinical Services is responsible for this portfolio and has been noticed about the condition of a lodge which was awarded a tender to host patients from Botswana before Healthshare ensures that they see specialists. There have been complaints about the hygiene at the hotel, the person who does landscaping, also prepares meals for patients.
Dr Tony de Coito, Managing Director of Healthshare pointed out that the accusations levelled against his company are incorrect. He shared that they charge the Ministry of Health a flat monthly rate which he could not share because they are currently involved in a bidding process and his competitors could pick on the prices.
Tony pointed out that four years ago the Botswana Ministry of Health was paying 40 percent more than they are paying today. He said they were involved in a tender process when they got the job and their case management skills have helped Botswana reduce costs by over 70 percent.
“We are giving the Ministry of Health value for money. You must note that there are more specialists in South Africa than Botswana hence our involvement,” he said.
According to Tony, Botswana should increase the skills levels in the country if there is to be a reduction in referrals and the costs involved. He said flatly there are no skills in Botswana; hence South Africa is the ultimate destination for specialist needs from Botswana hospitals. He dismissed suggestions that they delay to book or respond to requests from Marina Hospital. He stated that they give feedback every day; the only delay could be finding a slot with the specialist because sometimes it takes about a week or two to get a booking. “It also depends on specific cases, some patients need highly specialised medical experts and it may be difficult to get an immediate booking,” he said.
The Healthshare Managing Director is of the view that the fact that they are currently involved in the process of tendering to get a renewal of this very tender might have evoked some local politics. He said there is also competition to get the job.
Tony is a medical doctor who is passionate about business. Apart from being on the Healthshare Board of Directors, his main contribution is in operations, but Tony also contributes at a strategic level.
Princess Marina Hospital spokesperson, Donnel Kutlapye referred all questions to the Ministry where the Healthshare account is managed. He explained that the hospital was consulted when the decision to outsource was taken. He further pointed out that if there is anything relating to referrals it is communicated to the Ministry’s Strategy Office; hence the Ministry should be in a position to respond to queries from this publication.
Individuals challenged by disabilities encounter formidable obstacles when endeavoring to partake in political processes within the context of Botswana. Political involvement, a cornerstone of democratic governance, empowers citizens to shape the legislative landscape that impacts their daily existence. Despite Botswana’s reputation for upholding democratic ideals, recent insights unveil a troubling reality – those with disabilities find themselves marginalized in the realm of politics, contending with substantial barriers obstructing the exercise of their democratic liberties.
A recent inquiry in Botswana unveiled a panorama where individuals with disabilities confront hurdles in navigating the political arena, their involvement often restricted to the basic act of voting. Voices emerged from the study, underscoring the critical necessity of fostering environments that are accessible and welcoming, affording individuals with disabilities the active engagement they rightfully deserve in political processes. Noteworthy was the account of a participant grappling with physical impairments, shedding light on the glaring absence of ramps at polling stations and the urgent call for enhanced support mechanisms to ensure an equitable electoral participation.
The echoes reverberating from these narratives serve as poignant reminders of the entrenched obstacles impeding the full integration of individuals with disabilities into the democratic tapestry. The inaccessibility of polling stations and the glaring absence of provisions tailored to the needs of persons with disabilities loom large as formidable barricades to their political engagement. Particularly pronounced is the plight of those grappling with severe impairments and intellectual challenges, who face even steeper hurdles in seizing political participation opportunities, often grappling with feelings of isolation and exclusion from the political discourse.
Calls for decisive action cascade forth, urging the establishment of more inclusive and accessible political ecosystems that embrace individuals with disabilities in Botswana. Government bodies and concerned stakeholders are urged to prioritize the enactment of laws and policies designed to safeguard the political rights of individuals with disabilities. Furthermore, initiatives geared towards enhancing awareness and education on political processes and rights for this segment of society must be spearheaded, alongside the adoption of inclusive measures within political institutions and party structures.
By dismantling these barriers and nurturing a political landscape that is truly inclusive, Botswana can earnestly uphold its democratic ethos and afford every citizen, including those with disabilities, a substantive opportunity to partake in the political fabric of the nation.
In the heartwarming tale of Neo Kirchway, a beacon of inspiration emerges, shining brightly amid life’s adversities.
Defying the constraints of destiny, Neo Kirchway, a resilient Motswana soul now thriving in the United States, stands tall despite the absence of her lower limbs. With unwavering determination, she tends to her cherished family – a loving husband and four children – engaging in the daily symphony of household tasks with remarkable grace.
Neo’s indomitable spirit traces back to the fateful year of 1994, a time when medical intervention called for the amputation of her curled legs. Embracing this pivotal juncture with unwavering courage and the blessing of her mother, she ventured forth into a world adorned with prosthetic legs, eager to script a tale of triumph.
Venturing beyond borders, Neo’s journey led her to the embrace of the United States, where serendipity intertwined her fate with that of her soulmate, Garrett Kirchway. Together, this harmonious duo navigates the ebbs and flows of life, their bond fortified by unwavering love and unyielding support.
In a bid to illuminate paths and embolden hearts, Neo leverages the digital realm, crafting a sanctuary of empowerment on her YouTube channel. Brimming with authenticity and raw emotion, her videos chronicle the tapestry of her daily life, serving as a testament to resilience and the unwavering human spirit.
Amidst the digital cosmos, Neo, affectionately known as “KirchBaby,” reigns supreme, a luminary in the hearts of 658,000 enraptured subscribers. Through her captivating content, she not only navigates the mundane tasks of cooking, cleaning, and childcare but also dances with celestial grace, a testament to her boundless spirit and unyielding zest for life.
In the cathedral of Neo Kirchway’s narrative, resilience reigns supreme, echoing a universal truth – that amidst life’s gales, the human spirit, when kindled by hope and fortitude, emerges as a beacon of light, illuminating even the darkest of paths.
The government’s efforts to integrate individuals with disabilities in Botswana society are being hampered by budgetary constraints. Those with disabilities face inequalities in budgetary allocations in the health and education sectors. For instance, it is reported that the government allocates higher budgetary funds to the general health sector, while marginal allocations are proposed for the development and implementation of the National Primary Health Care guidelines and Standards for those with Disabilities. This shows that in terms of budgetary solutions, the government’s proposed initiatives in improving the health and well-being of those with disabilities remain futile as there is not enough money going towards disability-specific health programs. On the other hand, limited budgetary allocations to the Special Education Unit also are a primary contributor to the inequalities faced by children with disabilities. The government only provides for the employment of 15 teachers with qualifications in special education despite the large numbers of children with intellectual disabilities that are in need of special education throughout Botswana. Such disproportional allocation of resources inhibits the capacity to provide affordable and accessible assisted technology and residential support services for those with disabilities. Given the fact that a different amount of resources have been availed to the education and health sectors, the general understanding is that the government is not doing enough to ensure that adequate resources are distributed to disability-specific programs and facilities such as barrier-free environments, residential homes, and special education schools for children with disabilities.