MBABANE – At least E181 million is said to be owed to South African (SA) hospitals and other service providers by government, through the Phalala Fund.
This was disclosed by Principal Secretary (PS) in the Ministry of Health, Dr Simon Zwane, when sought to comment on the crisis faced by Phalala Fund beneficiaries, who are currently in dire straits in SA. According to impeccable sources, a total of 23 cancer patients in need of chemotherapy are concerned about their worsening conditions due to government not paying their hospital fees and accommodation. The patients are currently in SA, awaiting treatment from the Chris Hani Baragwanath Academy Hospital and Charlotte Maxeke Johannesburg Academy Hospital. It was said both hospitals, including Concordia Lodge, where they are accommodated during the course of their treatment, are owed monies dating back to 2018. One of the patients diagnosed with cancer and in need of chemotherapy, said they were not getting the treatment as hospital authorities declined to treat them due to the arrears by Eswatini Government. This has also resulted in some patients returning to the Kingdom without the necessary treatment, while some were discharged.
Stuck
The patients said: “We have been stuck here for quite some time now and we do not know why this issue has not been resolved. “I was supposed to undergo chemotherapy treatment but because blood samples had to be taken prior, which costs money. I cannot continue with treatment. There is nothing we can do right now as even the lodge we are staying in is also owed.”
Sibusiso Mkhize, who is the caretaker responsible for the patients’ upkeep at the lodge, shared that the plight of the patients was worrying. He recalled an incident when a cancer patient, who was refused treatment in one of the hospitals, returned to the country prematurely because of the arrears. He said: “It was a dire situation which compelled us to drive the patient ourselves to the border gate, where we handed him over to Eswatini authorities. He was driven in an ambulance and admitted to one of the hospitals there at our cost. Even one of the ambulances normally hired to ferry the patients back to Eswatini refused to transport the man because of non-payment.”
Mkhize further mentioned that the patients could only be assisted with radiotherapy but not chemotherapy since Lancet Laboratories charged for the blood samples. On the other hand, two parents of minors diagnosed with cancer said their children were getting the necessary treatment as they were currently undergoing chemotherapy treatment.
Cancer
Radiotherapy is an imaging technique used to diagnose cancer patients using x-ray, gamma rays, or similar ionizing radiation to view the internal form of an object and chemotherapy is a type of cancer treatment that uses one or more anti-cancer drugs as part of a standardised chemotherapy regimen. Meanwhile, the PS, when responding to questions on why some patients had to be returned back without receiving treatment, said: “Not even a single patient was returned. Only 11 patients who had completed their treatment came back.” However, his view differed from that of Director of Health Services Dr Velephi Okello, as she admitted that some patients were turned back. Dr Okello said: “Some patients had to be returned due to the lodge complaining of outstanding bills. Negotiations are ongoing and hopefully a solution will be found soon.”
When the Finance Minister, Neal Rijkenberg, was asked about the payments not being made to the service providers, he said the ministry had submitted payments for Phalala Fund during the month of July, amounting to E58 million. “The Ministry of Health has submitted a lot of payments for Phalala during the month of July amounting to E58m. E13 million was paid last week and Treasury paid the balance of E45 million yesterday.” He further mentioned that the balance of E181 million Dr Zwane mentioned had not been submitted to the Treasury Department by the end of last week. The objective of the Phalala Fund is to assist deserving emaSwati citizens, who would otherwise not have access to specialist medical care, to secure such care either, within the country or, in special circumstances, outside the Kingdom of Eswatini . The committee set up for the referrals scrutinises all requests for referrals and decides on the needs for each referral. The Ministry of Health has strengthened the medical ambulance services for patients who are in need of specialised care services in SA. This comes after government spent about E2.8 billion to pay off its arrears owed to suppliers as of the end of June as announced by Finance Minister Rijkenberg at a press conference on July 19, 2023.
Estimated
It is worth noting that this is not the first time that Phalala Fund has not been able to foot the bill for patients. In 2019, the fund owed SA hospitals medical bills estimated to be around E66 million. It is stated that some of the outstanding bills dated back to the year 2013. These millions owed by the fund combine all six referral hospitals and clinics, which accept local cancer patients to be treated in SA. In 2014, the same occurred as the Phalala Fund was haunted by debts to the tune of nearly E40 million. The debts, mainly unpaid remunerations to health service providers, in and outside the kingdom, were accrued from the year 2008 to 2012. In the same year, about 128 patients could not benefit from the Phalala Fund as the state was defrauded E9 million due to multiple payments in the past three years.
Accountant General (AG) Phestecia Nxumalo, in her performance audit report on the utilisation of Phalala fund, said the state lost the money due to multiple payments. “An estimated 128 patients (E8 990 882.92) could have benefitted when using the average service charge of E70 000 per patient.” She said when reviewing the payment vouchers, auditors discovered that 297 invoices were double paid or even paid three times. “There were four invoices that were paid by cheque and also by bank transfers in the 2012/2013 financial year.” The auditors discovered that payments amounting to E1 068 810.51 were overpaid for 2010/2011, while the 2011/2012 financial year was heavily overpaid with E6 412 264.62. She said 2012/2013 was the second most overpaid period, with E1 509 807.79.