MASERU – The government is yet to decide on whether or not it will seek the services of a private company to manage Queen ’Mamohato Memorial Hospital (QMMH) or turn it into a parastatal, health ministry has said. QMMH serves as the country’s main referral healthcare facility. The 425-bed hospital, and a network of refurbished filter clinics, were built through a public-private partnership (PPP) initiative, with the Tšepong consortium as the principal contractor in the PPP agreement.
QMMH and four primary care clinics opened doors to patients in 2011 to replace the run-down 100-year old Queen Elizabeth II hospital. The hospital features eight operating rooms, a maternity wing including a 40-bed nursery, a 10-bed adult Intensive Care Unit (ICU), and an ophthalmology unit.
Netcare Hospital Group was sub-contracted to manage Tšepong, providing all clinical services required to operate the hospital and the primary care clinics on behalf of the consortium. Tšepong’s shareholders comprised Netcare, which held a 40 percent stake while the remaining 60 percent shareholding was held by Health (Pty) Ltd (Afrinnai) (20 percent – South African based), Excel Health Services (Pty) Ltd (Excel) (20 percent – Lesotho based).
Lesotho based D10 Investments (Pty) Ltd (D10) and Women Investment Company (Pty) Ltd (WIC) each held 10 percent. The 18-year contract was terminated by government this year accusing Tšepong Consortium of breaching its contractual obligations in terms of the PPP agreement.
Relations had never been smooth between Tšepong and government and the former’s decision to fire over 200 nurses brought matters to a head. The hospital accused the nurses of participating in an illegal strike which started on February 1, 2021. “Netcare has started a process of handing over operations at QMMH and its four primary care clinics in Maseru to the Government of Lesotho,” Netcare said in a statement on July 14, adding this was as a result of the PPP agreement being prematurely terminated, with effect from August 31, 2021.
The hospital was handed over to the government. Health minister, Semano Sekatle, told Public Eye yesterday that government was giving consideration on the hospital’s future and will make an announcement as soon as a decision has been made. “We will make an announcement,” Sekatle said. On August 4 this year, Netcare said government was ignoring crucial transitionary arrangements and agreements that it said were essential for a seamless handover to secure the safe continuation of healthcare services to the Basotho citizens.
It said these included clarity on the transfer of more than 800 Tšepong employees comprising clinicians, nurses, other staff and sub-contractor employees who are expecting formal offer letters of employment from the government, as contemplated in the PPP agreement.
“This improper handover further ignores the basic employment rights of Tšepong workers, who have loyally provided care for the past 11 years,” it said. QMMH public relations officer, Thakane Mapeshoane-Sepipi, has since confirmed that the employees have been employed by the government for a year. “That is just for transitional purposes,” Mapeshoane-Sepipi said. “Workers will have permanent employment when government has made a decision on whether it gets another contractor to manage the hospital, turns it into a parastatal or keeps it as a government-run hospital,” she added.
An independent study conducted by Boston University found that QMMH delivered significantly more services and services of higher quality in 2012 than at baseline comparison of Queen Elizabeth II hospital it replaced. The number of admissions, according to the study, increased by 51 percent, while outpatient visits more than doubled, and the hospital and filter clinics assisted 45 percent more deliveries compared to baseline.
But in 2014, Oxfam published a report showing how the PPP was draining the budget of the Ministry of Health and diverting scarce resources away from primary healthcare services in rural areas, where death rates are rising and where three-quarters of the population live.
In 2013/14, the Oxfam study found, the PPP cost the government US$67 million (or about M1 billion) – consuming 51 percent of the total government health budget. This was up from 41 percent the year before. “The hospital is being run at nearly two and a half times the amount that was agreed as affordable between the Government of Lesotho and the IFC before the contract was awarded,” read the report.