QMMH nurses’ future in limbo



MASERU – The nursing staff at the Queen ’Mamohato Memorial Hospital (QMMH) is yet to receive an official notice from government regarding their continued engagement at the facility following termination of the Tšepong Consortium contract in the public-private partnership (PPP) that operated the hospital. The PPP project collapsed in its 13th year of an 18-year contract, with the Lesotho government terminating following a long drawn-out dispute in which Tšepong was being accused of non-compliance.

The consortium, on the other hand, accused government of missing payments for services rendered. The face-off resulted in a nurses’ strike that resulted in 265 of them being dismissed and, with termination of the Tšepong consortium effective on August 31, the fate of nurses remains unclear following government’s announcement of a new management team this week. Netcare, the South African company that has been running hospital’s operations, handed over operations at QMMH and its four filter clinics in Maseru to the government.

The Tšepong consortium is the principal contractor in the PPP agreement and Netcare has been sub-contracted to manage Tšepong, providing all clinical services required to operate the hospital and primary care clinical services on behalf of the consortium. Dr Chale Moji is now the new Managing Director of the hospital. During the official handover in Maseru this week, Principal Secretary in the Ministry of Health, Khothatso Tšooana, was vague on whether government will absorb the soon-to-be-out-of-work nurses into the new arrangement.

“The government will see what it can do with the workers and will update them on the progress on Friday (today). We are currently in the middle of the transition process with Tšepong,” Tšooana said. He encouraged the nurses to continue with their duties while the health ministry resolves the issue of their employment. “We are working on issues concerning your jobs. We will update you as soon as the task has been completed. However, in the meantime, continue with your respective tasks and stay assured that we will do what is right by you,” he said.

In an interview with this paper a fortnight ago, the health minister, Semano Sekatle, also said government was yet to decide what will happen to the workers. He did not mince words, however, in telling this reporter that the nurses were not left to be absorbed into government’s new operational arrangement in the hospital, noting also that Tšepong was obligated to pay them until August 31 and making formal and legal departure with its staff from the facility.

Sekatle said the government is not obliged to secure jobs for the Tšepong staff, but that as a responsible government they can only provide jobs if opportunities are available. “The government is yet to decide on a way forward regarding Tšepong staff. We are a responsible government and ensuring job opportunities for Basotho is our priority. We will do what is right and doable, but we do not promise to absorb the staff,” Sekatle said.

Speaking on behalf of Tšepong consortium at the handing over ceremony, Dr Lehlohonolo Mosotho lamented the premature ending of the contract, blaming Netcare for this eventuality. He said the appointment of Netcare to manage the hospital did not benefit them or the government much but resulted in mismanagement of funds and dismissal of nurses – among a litany of misdeeds the company is accused of.

Dr Mosotho continued further that once the transition process is complete, they will monitor developments and ensure job security for all of the Tšepong employees. Health Director General, ’Nyane Letsie, said QMMH will continue to operate as a national referral hospital and that its two clinics of Likotsi and Ha Mabote, which had been operated by Tšepong, will now be serviced with rest of the other district clinics.

In a statement following these developments, Netcare claimed that the decision to terminate the partnership and commence the handover of the facilities and operations follows repeated failure by government to settle arrears payments for services rendered. Netcare noted that despite the government being four months in arrears, it has been persistent in demanding that Netcare continues providing its services until August 31.

“In its capacity as a shareholder of Tšepong, and as the major provider of services to Tšepong, Netcare has continued to act in good faith and provided ample written notice to Tšepong and Government of Lesotho (GOL), as well as follow-up reminders that GoL is substantially in default of its payment obligations under the PPP agreement.

“The government has repeatedly reiterated that it has no intention of making these scheduled, contractual payments at this stage, and will only consider making payment after the PPP termination date of 31 August, 2021.

“In light of these circumstances, Netcare is no longer prepared to fund ongoing operations on behalf of PPP. Netcare has provided financial support on numerous occasions over recent years to enable continued operations at the hospital and primary care clinics when government of Lesotho failed to make timely payment of services.

“The refusal by the GoL to pay the outstanding fees clearly places an unreasonable expectation on suppliers to continue providing full services at a substantial level of commercial risk to their business,” writes Netcare. Netcare, however, noted that despite not being paid, they will continue to treat all patients during the transitional period until it is deemed clinically appropriate and safe to discharge them.

The Tšepong consortium was the principal contractor in the PPP agreement and Netcare has been sub contracted to manage the QMMH, providing all clinical services required to operate the hospital and the primary care clinical services on behalf of the consortium.

The Tšepong consortium comprises Netcare, which holds a 40 percent interest, while the remaining 60 percent shareholding is held by South Africa-based Afinnai Health (Pty) Ltd (20 percent), Lesotho Based Exel Health Services (Pty) Ltd (20 percent), D10 investments (Pty) Ltd (10 percent), also Lesotho based, and women Investment company (Pty) Ltd (10 percent), which is also Lesotho based.


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