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.
Minister of Health Dr Edwin Dikoloti says Africa member states call on World Health Organization (WHO) to ensure equitable resource allocation for 2024-2025. Dr Dikoloti was speaking this week at the WHO Executive Board Meeting in Geneva, Switzerland.
He said countries agreed that there is need to address the budget and funding imbalances by increasing the programme budget share of countries and regions to 75% for the next year.
“The proposed budget for 2024-2025 marks an important milestone as it is the first in Programme Budget in which country offices will be allocated more than half of the total budget for the biennium. We highly welcome this approach which will enable the organization to deliver on its mandate while fulfilling the expectations for transparency, efficiency and accountability.”
The Botswana Health Minister commended member states on the extension of the General Programme of Work (GPD 13) and the Secretariat work to monitor the progress towards the triple billion targets, and the health-related SDGs.
“We welcome the Director’s general proposed five priorities which have crystalized into the “five Ps” that are aligned with the GPW 13 extension. Impact can only be achieved through close coordination with, and support to national health authorities. As such, the strengthening of country offices is instrumental, with particular focus on strengthening national health systems and on promoting more equitable access to health services.”
According to Dr Dikoloti, the majority of countries with UHC index that is below the global median are in the WHO Africa region. “For that, we call on the WHO to enhance capacity at the regional and national levels in order to accelerate progress. Currently, the regional office needs both technical and financial support in order to effectively address and support country needs.”
The Minister of Foreign Affairs, Dr. Lemogang Kwape says Botswana has not taken any position regarding the killing of a renowned human rights lawyer, Thulani Maseko, who was gunned down at his house in Mbabane, Eswatini.
In a brief interview with WeekendPost, Dr Kwape said Botswana has not yet taken any position regarding his death. He said the purported incident should be thoroughly probed before Botswana can form an opinion based on the findings of the inquiries.
“Botswana generally condemns any killing of human life by all means,” says Dr. Kwape. He wouldn’t want to be dragged on whether Botswana will support the suspension of Eswatini from SADC.
“We will be guided by SADC organ Troika if they can be an emergency meeting. I am not sure when the meeting will be called by Namibian president,“ he said.
However, the Namibian president Hage Geingob notes with deep concern reports coming out of Eswatini about the killing of Mr. Maseko. In a statement, he called upon the “Government of the Kingdom of Eswatini to ensure that the killing of Maseko is swiftly, transparently and comprehensively investigated, and that any or all persons suspected of committing this heinous crime are brought to justice.”
Maseko was chairperson of the Multi-Stakeholder Forum which was established as a coalition of non-State actors to advocate for a process of national political dialogue aimed at resolving the security and political challenges confronting the Kingdom.
“SADC expresses its deepest and heartfelt condolences to the family of Mr. Maseko, his friends, colleagues, and to the people of the Kingdom of Eswatini for the loss of Mr. Maseko. In this context, SADC further calls upon the people of the Kingdom of Eswatini to remain calm, exercise due care and consideration whilst the appropriate structures conduct the investigations and bring the matter to completion,” the statement says.
Geingob reiterated the need for peaceful resolution of the political and security challenges affecting the country.
Meanwhile political activists are calling on SADC to suspend Eswatini from the block including the African Union as well.
State prosecutor, Seeletso Ookeditse revealed before the Broadhurst Magistrate Jobbie Moilatshimo that the third accused involved in the murder of Barulaganye Aston, has interfered with the State witnesses again.
The second and third accused (Lefty Kosie and Outlwile Aston) were previously accused of interference when they were caught in possession of cellphones in prison. They were further accused of planning to kill the deceased’s brother, who is currently the guardian to the children of the deceased.
Ookeditse indicated that Outlwile had earlier went to challenge the magistrate’s decision of denying him bail at the High Court before Judge Michael Motlhabi.
“The third accused approached the High Court and made a bail application, which was dismissed on the same day,” Ookeditse said.
However, even after the High Court verdict on their bail application, the duo (Kosie and Aston) has once again applied for bail this week.
Ookeditse plead with the court to stop the accused from abusing the court process.
“Yesterday, Directorate of Public Prosecutions (DPP) received papers of his bail application filed before the Broadhurst Magistrates Court. However, the papers do not speak to changed circumstances, therefore this back and forth about bail must be put to a stop,” said the State prosecutor.
While giving evidence before court, the Investigations Officer, Detective Inspector Quite Zhalamonto, said his investigations have proved that there is interference continuing regarding the accused trio.
He told the court that on the 12th of January 2023, he received a report from Thato Aston, who is the son of the accused and the deceased. The son had alleged to the Investigation Officer that he received a call from one Phillip Molwantwa.
According to Zhalamonto, Thato revealed that Molwatwa indicated that he was from prison on a visit to the Outlwile Aston and went on to ask where he was staying and where his siblings (Aston’s children) are staying.
“Thato revealed that Phillip went on to ask if he or his siblings saw their father murdering their mother, and he was referring to the crime scene. Thato told me that he, however, refused to answer the questions as he was afraid especially because he was asked about where him and his siblings stay,” said Zhalamonto.
Zhalamonto alluded to the court that he then went to Orange to confirm the communication between Thato and Molwantwa where he found the case.
“I have arrested Philip yesterday and when I interviewed him, he did not deny that he knows Aston and that he has indeed called Thato and asked questions as to where him and his siblings resides even though he failed to give reasons for asking such questions,” Zhalamonto told the court.
He further revealed that Molwantwa indicated that he had received a call from an unknown man who refused to reveal himself.
“Phillip told me that the unknown man said he was sent by the accused (Aston), and that Aston had instructed him to tell me to check if there was still some money in his bank accounts, and he also wanted to know where the kids were residing, the unknown man even asked him to meet at Main Mall” the Investigation Officer told the court.
He further informed the court that he is working tirelessly to identify the “unknown caller” and the route of the cell number.
Furthermore, the fourth accused, Kebaleboge Ntsebe, has revealed to the court through a letter that she was abused and tortured by the Botswana Police Services. She wrote in her letter that she suffered miscarriage as a result of being beaten by the police.
Ntsebe is on bail, while a bail ruling for Aston and Kosie will be delivered on the 6th of next month