Rwanda: Only Mental Health Hospital cries out for help over unpaid bills
Ndera Neuropsychiatric Hospital, the country’s only specialised facility for mental health is facing a financial crisis that could paralyse its services.
IN SUMMARY
- Finance minister says the government—through Ministry of Local Government, Ministry of Health — and related institutions are conducting a study that will determine the amount of arrears owed to different hospitals.
Rwanda Today has learnt that the government is yet to disburse Rwf800 million in accumulated hospital bills to cater for vulnerable patients who failed to meet their financial obligations.
This has left the hospital operating without sufficient funds, which is likely to compromise services at the hospital.
The management of the hospital, which derives most of its funds from faith-based organisations with Catholic Church as the majority shareholder, is worried of inefficiency in health service provision if it does not get enough money to cover its expenses.
Officials allege unpaid bills piled up after several patients — who had no one to pay their bills — sought emergency medical services. Or those whose medical insurance could not cover services provided.
Charles Nkubili, the director-general of the hospital, who runs the facility on behalf of ‘Brothers of Charity’, said that he had raised the issue before parliament for consideration.
“We are waiting for a response from them,” he said.
Addressing the plenary session on the aspired projects by the government in the next fiscal year, Constance Rwaka Mukayuhi, the chairperson of the parliamentary standing committee in charge of budget said that the deficit at the hospital is worrying.
“The same issue was discussed even before the approval of the current fiscal year budget. We need to understand that the hospital is not fully government sponsored; we should jointly find a way of addressing it. The owners need to be helped. We cannot ignore mental patients who seek medical services there and had no means to pay,” she said.
The hospital that treats several cases of drug-related diseases is said to have treated at least 88,000 people with epilepsy and 22,000 with schizophrenia last year.
Finance Minister Claver Gatete said that while the case may sound unique, the government will treat it alongside other hospitals with same concerns.
“There is some bit of complexity involving many hospitals. We have seen cases where hospitals deliberately inflate medical bills to charge the government or insurers highly. You might go to the hospital today and upon diagnosis you are prescribed with a lot of medications even those that are not necessary, simply because you have medical insurance. The Cabinet will decide on the way forward on this,” he said.
According to him, the government—through Ministry of Local Government, Ministry of Health — and related institutions are conducting a study that will determine the amount of arrears owed to different hospitals.
“Upon the findings we shall table our report to the Cabinet and wait for the decision,” he added.
Inflated bills had earlier triggered mistrust between insurers and hospital managers as both parties could not agree on the standard charges, this left insurers with no choice but to pay
The government has on the other hand finalised plans where more than 1,700 workers handling the health flagship insurance scheme (Mutuelle) from the Ministry of Health will be transferred to Rwanda Social Security Board (RSSB) for efficiency.
The financial concerns come as government seeks to decentralise health services of non-communicable diseases at district hospitals from which treatment of illnesses like mental disorders, cancer, diabetes and heart ailments will be carried out at the lowest level.
This call for more money for the sector, which is struggling to finance its activities at least by 50 per cent, comes after major donors threatened to scale down funds channelled to the sector.
Antoinette Habinshuti, managing director of Partners in Health, a US-funded health organisation that has been among premium sponsors for the past 10 years, said that cut in funding is not in their plan although there will be a shift of focus in areas of intervention.
“We want to shift from communicable diseases like HIV and services like neonatal services to early prevention and treatment of non-communicable diseases. We will continue support government in these preferential areas at the level of district where we are supporting in terms of personnel and provision of facilities including hospitals,” she said.
Partners in Health spent around Rwf11.7 billion annually on its activities, although the support is not directly channelled to the national budget.
Two years ago, with the support of the organisation and other donors like Clinton Foundation, the government of Rwanda received a fully functional Rwf4.8 billion cancer centre of excellence.
