UGANDA — The Committee on Government Assurances and Implementation has urged the Ministry of Health to harmonize its stance on user fees for computed tomography (CT) scan services at government hospitals.

This declaration was made during an oversight visit to Uganda’s eastern region to review the level of execution of government guarantees in the health sector.

Earlier in September, the permanent secretary of the Ministry of Health, Dr. Diana Atwine, had directed the management of Masaka Regional Referral Hospital to give a waiver to patients seeking CT scan services in the facility.

Dr. Atwine noted at the time that, in severe circumstances, patients from low-income families could not afford the cost.

She advised hospitals to consider providing free CT scan services, stating, “The rates for CT scans are already subsidized, but there are situations where a patient may not afford standard fees. The hospital board of governors should sit and consider such cases by giving patients a waiver.”

Dr. Atwine’s reaction came in response to public outrage that patients seeking X-ray and CT scan services were being charged exorbitant rates at a public facility where services were ostensibly provided for free.

The MPs detected a variance in the Ministry of Health’s opinions on CT-scan user costs during their visit to Mbale Regional Referral Hospital on Friday, October 27, 2023.

For example, Stephen Obbo, the hospital director at Mbale Regional Referral Hospital, informed the MPs that they charge Shs150,000 (US$39.65) for CT-scan services, which are used to acquire consumables, perform repairs and maintenance on the equipment, and ensure its long-term viability.

The MPs highlighted that this claim contradicts Hon. Anifa Kawooya, Minister of State for Health (General Duties), assertion for declaring that CT-scan services are free.

“Last week, the minister met with this committee and told us that CT-scan services are free of charge. Ugandans pay taxes for such services, and just like ferries on water bodies, such services should be free. Parliament can allocate funds to maintain such equipment,” stated Hon. Betty Nambooze, Chairperson of the Committee.

To the surprise of the MPs, the hospital director displayed a letter from the Permanent Secretary, Ministry of Health, dated June 2, 2023, directing hospitals to charge a fee for CT-scan services in contravention of the minister’s proclamation.

“The purpose of this committee is to fight political deception. A minister cannot tell Parliament that the service is free of charge, walk out, and then enforce the directive of the Permanent Secretary. The Ministry should revise its position and harmonize,” Nambooze remarked.

Hon. Robert Ssekitoleeko (NUP, Bamunanika County) pointed out a glaring issue within the ministry – the absence of a consistent user charge for CT-scan services in government hospitals, potentially opening the door to exploitation.

He stated, “The charges for CT scan services lack uniformity. They are charging Shs120,000 (US$31.72) in Jinja, while here in Mbale, it’s Sh.150,000 (US$39.65). As we visit more hospitals, the price variations seem to deepen.”

Nambooze further highlighted the disparities, noting that CT-scan services in Mukono cost Sh. 50,000 (US$13.22), while they are provided for free in Mbarara.

The absence of a clear policy framework is a matter of concern for Hon. Julius Emigu (FDC, Ochero County) and Hon. Connie Galiwango (Indep., Mbale City), who fear that the lack of pricing consistency may lead to the discontinuation of CT-scan services.

In response to this issue, the MPs have pledged to raise it in the upcoming parliamentary session, considering it a matter of national importance.

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