Museveni hints on ban of govt medics from private practice

In his October 16 letter addressed to the Minister of Public Service Wilson Muruli Mukasa, Mr Museveni cited the example of Dr Godfrey Pariyo Bonane, an orthopaedic consultant, formerly attached to Masaka Regional Referral Hospital, whom he accused of frequently being absent from work.

“I have received complaints regarding Dr Pariyo previously working in Masaka government hospital. The complaints are that he does not work, and he is most of the time absent. These complaints rhyme with the sentiment that was being expressed in one of the caucuses. This annoyance with traitorous public servants has led some people to talk of removing public servants from the permanent and pensionable terms to contacts, which I have never supported. Why?” the President said.

“…it is because I don’t want our public servants to kuhahaara (when somebody is ever worried about something). This can be exploited by bad supervisors to coerce public servants to do bad things. In my counter-argument against contracts for public servants, I have cited examples of UPDF. Their terms are permanent and pensionable. However, their SOPs are very strict,” Mr Museveni wrote. 

In the same letter, the President ordered the Minister for Public Service Mukasa to issue revised Public Standing Orders to make it easier to punish civil servants who absent themselves from duty without sound reasons.

In the case of Dr Pariyo, the President said he would dismiss him in public interest. “Should government doctors continue to be allowed to have or work for private practice? We had allowed this because we had few doctors, now the doctors are many and some are unemployed. Could we now make it a point for dismissal from government service for any government doctor to own or work for private practice? Consult the patriotic doctors for advice,” Mr Museveni ordered.

However, the Masaka Hospital Principal Administrator, Mr Charles Tumushiime, said Dr Pariyo was interdicted and transferred to Arua Regional Referral Hospital about four years ago.

“He contested the interdiction and later dragged the hospital to court where he won the case, and he was given back his job before being transferred to Arua,” he said.

“By the time we took over office here about two years ago, he [Dr Pariyo] had already left and our records, however, show that he was a habitual absentee,” Mr Tumushiime said.

Masaka Regional Referral Hospital records show that Dr Pariyo was interdicted in a letter dated April 10, 2019, due to absconding. He took the hospital to court, which gave a ruling in his favour on April 28, 2022, and he was reinstated before he was transferred to Arua Regional Referral Hospital. 

Dr Adrian Tamale, the proprietor of Jetam Health Care Services in Mbirizi Lwengo District, said public servants should choose whether to work in public service or private practice.

“You can’t serve two masters at ago, you’re either in private or public. If the government doesn’t crack the whip, service delivery will continue to decline in public facilities,” he said.

According to information from the Health ministry, “total absenteeism including absenteeism with approval still averages 50 percent [in public health facilities].” The unauthorised public sector absenteeism rate is 11 percent and authorised absenteeism is 38 percent.

The absenteeism of the medical staff, coupled with low staffing in public health facilities, means patients will spend more time waiting to be attended to.

Mr Swaibu Makumbi Sulambaya, the chairperson of Masaka Hospital Patients Association, asked the President to consider banning doctors from operating private clinics and pharmacies in the same areas where they are deployed in public hospitals. 

He cited incidents where patients are denied services from public facilities and are referred to private clinics owned by the same doctors.

“What is surprising us is that most of those districts where public servants abscond from duty, there are people like RDCs, CAOs who are paid by the government to supervise them, the President should also take action against such people,” he said. 

UMA SPEAKS OUT

Reacting to the concerns and the dismissal of Dr Pariyo, Dr Herbert Luswata, the president of the Uganda Medical Association (UMA), said they do not have enough details about the issue. Dr Luswata, however, said if the government wants to revise the standing orders, it should respect international laws and acknowledge the unpaid overtime work that health workers regularly perform. “We have also seen recommendations where the President is saying that the Ministry of Public Service should come up with new standing orders to ensure that public servants adhere to their work and their duties. However, we request the President that let not this only target the health workers if it should be done, let it be done for all public servants so that it doesn’t look like a witch-hunt to us the doctors,” he added. Dr Luswata also said the government should be aware that the country is struggling with a shortage of orthopaedic surgeons. “As we stand today, we have less than 100 in the whole country for over 45 million people. We have a deficit for this type of speciality,” he said. “Their demand is very high, both in government and private sector. I am not trying to justify what he did but the government needs to put in place measures to ensure we get enough orthopaedic surgeons,” he added. Dr Luswata also said the health system is struggling with a shortage of health workers that should be addressed. “In Uganda today, the human resource coverage in government hospitals is at 42 percent on average. The existing gap, 58 percent, is being covered by the few health workers in the facilities,” he said.

Compiled by Al Mahdi Ssenkabirwa, Tonny Abet & Malik F Jjingo.