Alvine Kapitako
Windhoek-The Minister of Health and Social Services, Dr Bernard Haufiku, yesterday stressed that had the Ministry of Finance managed the Public Service Employees Medical Aid (Psemas) properly the catastrophic events that could lead to the collapse of the fund would have been avoided.
Speaking to New Era on the cancellation of contracts between the Ministry of Finance, Psemas and health care professionals, Haufiku said other private medical aids have been managed properly and are hence not experiencing the current problems.
“If Psemas was managed properly, let’s say five years ago, things would not have been this way. The Ministry of Finance must just accept,” asserted the minister of health.
He said the finance ministry ineffectively managed Psemas and some of the doctors “looted” the fund in cahoots with officials from the finance ministry as well as the claims department.
Haufiku said Psemas clients make up 15 percent of the population and an impression should not be given that both the private and public health sectors are on the verge of collapse.
“There was no money. The Ministry of Finance had no money,” he noted when responding to why some medical practitioners as well as private pharmacies have not been paid for services rendered.
The “economic crisis that’s grappling the country (lack of cash flow) as well as the inefficient manner in which Psemas was managed contributed to the delays in payments”, explained Haufiku. Meetings between officials from the health and finance ministries were held to discuss the way forward regarding Psemas.
The finance ministry has confirmed it will cancel all contracts between the ministry, Psemas and health care professionals effective June 30.
On Thursday, Andreas Ileka, the personal assistant to finance permanent secretary Ericah Shafudah said the cancellation would give way to a new contract that is “under development”.
Health professionals would further have to meet the new terms to become part of the new reform.
“If you do not meet the requirements, you cannot enter into the agreement,” stated Ileka, who however could not elaborate on what the requirements for the new contract would be.
Haufiku in March this year said Psemas was being revamped to make it sustainable and less susceptible to fraudulent claims.
Psemas funds have been depleted following some unscrupulous private doctors submitting suspect claims, turning it into a cash cow.
Pharmacists who spoke to New Era on Wednesday said many private practices and pharmacies had resorted to turning away Psemas clients who sought medical attention because of the government’s delay in payments and cancellation of contracts.
In April, New Era reported that Minister of Finance Calle Schlettwein authorised the use of N$200 million in state funds to partially honour payments for medical services provided to Psemas members.
The president of the Pharmaceutical Society of Namibia, Benjamin Khumalo, noted the situation could negatively affect many people in need of medical services.
“We’re reaching a point where you have to have money in the pocket to access private health care services, and you can no longer rely on medical aid. However, what will happen to people with medical aid but yet have low-paying jobs?” Khumalo said.
Those affected include government cleaners and police officials, amongst others.
Psemas clients make up the majority of medical aid customers, and Khumalo estimates that outside Windhoek about 90 percent of medical aid clients are Psemas members while in Windhoek they are at least 60 percent of all clients.
Psemas has a total of 293,250 members of whom about 124,000 are principal members and the rest are pensioners and dependants.
The membership and dependants constitute about 13.1 percent of the total population, and therefore financial shortfalls at Psemas have a substantial impact on the population and households.
Khumalo further disclosed that five pharmacies have already closed shop and retrenched their staff because of the delays in payments by the government.
“Professionals are moving to neighbouring countries, and their argument is if it’s stable in other countries why not move there?” Khumalo said.
The majority of those moving to other countries are foreign health professionals but they also include a few Namibians.
Furthermore, the new professionals in the health field were the ones that struggled most to survive.
Khumalo emphasised the delays had “a serious impact on services and some pharmacies are unable to help Psemas clients. Not everybody (pharmacies) has the money to survive.
“The newly established ones (pharmacies) can’t survive, because of the delays in payments by the government.”
The situation seriously affected patients because they had to go from one pharmacy to another to buy drugs as some pharmacies had stopped stocking up on certain drugs.
For example, HIV-positive patients do not take only one drug, but in most cases medicines available at one pharmacy may not be available at another.
“As a result people are not complying with their treatment,” Khumalo added.
Many patients are on life-sustaining medication such as HIV-positive and hypertensive people. Patients with one rare condition need to spend as much as N$150,000 a month for their medication, which they can’t live without.
“These are people with serious conditions,” Khumalo said.
He highlighted a case where one such client had not taken medication since February because the pharmacy could no longer afford to buy the medication because of the delays in payments.
“Pharmacies don’t make medicines. They buy them from suppliers, and suppliers outside the country don’t know the problems the government faces, so they do not understand when we explain the delay in payments.”
A pharmaceutical distributor, who preferred to remain anonymous, said the problem was serious.
“We have had to make plans for additional cash flow in order to pay our suppliers,” the distributor said.
“There’s been some improvements I must say, because the government tried to cover up (pay debts) until last year,” Khumalo said, adding that the government had been paying pharmacies.
However, “payments come at random and not all pharmacies have received payment.”