Dr. Diana Atwine, Permanent Secretary Ministry of Health acknowledged that a number of consultants don’t want to go upcountry
A section of lawmakers on Public Accounts Committee (PAC) have raised concerned over the increasing refusal of medical consultants declining to take up positions in regional referral hospitals over meager pay, and called on Government to find long lasting solution to this challenge.
While interfacing with officials from Ministry of Health, who had been summoned to respond to audit queries in the 2021 auditor general report, Medard Lubega Sseggona (Busiro East) revealed that during all meetings held between PAC and regional referral hospitals, it was found that all positions in these health facilities are vacant because the people hired have declined to take up these positions upcountry.
“This committee is concerned and parliament generally is concerned that while you are waiting for these people to go there with your meagre pay, the services are actually not there. Actually all the regional referral hospitals that we visited lack these consultants and yet they are in the structure, they are approved by health service commission, the money has been approved, but those people aren’t there. This is a policy matter which has to be dealt with,” Sseggona said.
According to the Ministry of Health, there are 72 functional public hospitals and these include; 5 Specialized Hospitals, 5 National Referral Hospitals located in Kampala, 16 Regional Referral Hospitals and 46 functional General Hospitals.
Salaries of medical workers were increased with Senior consultants pay rising from Shs3,447,065 in 2017/2018 to Shs7,307,602 in 2019/2020, while the pay for Consultants rose from 2,628,075 to Shs6,035,667 in 2019/2020.
Sseggona wondered why the Ministry of Health doesn’t consider the rotational policy where these consultants can be allocated say two days in a month where they can attend to patients upcountry and have Government give them fairly attractive allowances in order to avoid cases of patients moving long distances in search for treatment in Kampala.
Dr. Diana Atwine, Permanent Secretary Ministry of Health acknowledged that a number of consultants don’t want to go upcountry, but at the same time, there are actually some specialists who want to go and work upcountry but the Health Service Commission has declined both the names of people fronted by the Ministry of Health as well as refused to have these specialists included on the payroll before undergoing the routine recruitment process.
She explained, “We got specialists whom we convinced to go and work but they can’t access the payroll because Health Service Commission is still stuck on their advertise, shortlist. Because it is very easy for us to get these consultants and we submit their names to Health Service Commission and they regularize them.”
“Where we have done this, it has worked but somehow, we are still stuck in bureaucratic processes that are still denying services to the people,” added Atwine.
However, Sseggona rejected her explanation arguing that the Health Service Commission is right to insist on following the law during the recruitment process, as using the method of fronting names would open flood gates of nepotism into the health sector.
“To me that isn’t a big deal, the issue is, if they are stuck in the bureaucratic practices and procedures, we have gone without these consultants for years. Even when they insist on the bureaucracy, which I am okay with because it is the law, otherwise, you are going to pick cousins,” said Sseggona.
In the September 2021 Statement to Parliament on the State of Public Healthcare Service Delivery in Uganda by Minister Aceng highlighted that the staffing norms in the public sector established in 1995 and revised in 2005 are not adequate to effectively respond to the service needs which have changed due to rapid population growth and changing disease burden and the staffing level in public health facilities stands at 65%.
The Minister further revealed that Uganda has 3,133 Public health facilities and in all these facilities require 77,087 health workers, yet the filled positions are 50,135, leaving a human resource gap of 26,952 positions.
At the moment, Uganda is grappling with shortages of critical cadres including; Doctors (51%); Anesthetic Officers (30%); Dispensers (440/o); Pharmacists (50%); and theatre staff (32%).