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Wednesday 16 January 2019
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Haufiku angered as bureaucracy blocks health reforms

A “comprehensive bill” to reform the country’s ageing health sector has not been able to make its way to Parliament because of cumbersome processes it has to undergo at the Ministry of Justice, health minister Bernard Haufiku has revealed. The minister made the revelation during a one-on-one interview with this publication this week, saying the delay to release the bill for tabling in the National Assembly is frustrating him and the situation is prohibiting him from enacting laws needed to improve the health sector. “I was hoping to table the bill this year but clearly I cannot do so because it is stuck with the Ministry of Justice. I spoke to the Minister [Dr. Albert Kawana] but it appears there are so many factors in his ministry such as a lack of legal drafters that are delaying the process,” bemoaned Haufiku.
He said the Health Professions Bill was tabled and cleared in Cabinet in April already and sent to the justice ministry, but he is yet to receive it for tabling in Parliament.  He lamented that Bills that have been submitted to the justice ministry after the Health Professions Bill has already been tabled in Parliament.  “They are saying the Bill was poorly drafted but it went through the Cabinet Committee on Legislation, which Minister Kawana is also part of…I cannot understand their reason,” he said. Haufiku said the Health Professions Bill will ensure positive transformation in the health sector and subsequently amalgamate all councils in the health sector such as dentistry, nursing and medical, among others.  “Now it seems as if I am just doing operational and management things, but there is nothing I can do because the instrument that must be in place to implement new laws is holding me back,” he said.

Health challenges
The Patriot recently reported that the healthcare space is emerging as a source of friction between local and foreign doctors, with expats standing accused of cashing in on public healthcare funding at the expense of delivering quality healthcare.   The simmering tensions between local and foreign culminated in the compilation of an emotionally charged letter addressed to the health minister in September. In the letter written to Haufiku – and seen by The Patriot – the author, NAMPath Laboratories managing director, Esegiel !Gaeb detailed his frustrations over the mushrooming of health facilities owned by foreigners. He alleged that practices owned by foreign doctors are solely focused on “cashing in on our health funding while also being aware of Namibia’s apparent lack of resolve to prosecute unethical and illegal practices”. !Gaeb said the rising cost of private healthcare will result in the Government healthcare system being inundated with more patients. The letter was also forwarded to Attorney General Sacky Shanghala to probe all legal loopholes.
Areas of concern listed by the private doctors include private health service funding; regulation and private health services licensing; health service market industry protection for locals vs foreigners; protection of patients against poor treatment, over-servicing and unregulated tariffs; itinerant practice and working outside the scope of practice and registration of foreign nationals to practice health professions in Namibia. He called for the health ministry to limit the number of licences for all health facilities and practices in the country as well as ensuring that foreigners are banned from doing their internship in Namibia, regardless of whether they studied in Namibia or elsewhere. He also wants foreign health professionals to be compelled to work for State institutions.

Haufiku’s response to the letter
The minister said Government will not ban foreigners from opening practices in the country, but would rather focus on implementing stricter control measures to avoid any abuse of the medical aid system.  “Anyone who wants to setup business can do so. We will not restrict anyone, but what we are against is the abuse of system whether it is locals or foreigners,” he said. Haufiku, who acknowledged receiving the letter, said it seems to be targeting foreigners instead of abuse of the system. “My concern is about people abusing the medical aid system be it locals or foreigners, the letter seems to have undertones of an anti-foreign campaign and therefore it dilutes the objective,” he said. The minister said Government will not heed calls by local doctors to ban foreigners from doing their internship in Namibia.
He mentioned that he is aware of doctors overcharging patients and revealed that there are ongoing investigations to arrest the culprits. The minister noted that the sudden interest by foreigners to setup medical practices in Namibia is because the system is “lucrative”. “Namibia has been lucrative and our system is not tight. I did my internship in South Africa and I had to endure strict conditions. We [Namibia] are too lenient and anyone can do what they want, it shows that our checks and balances are very weak,” he said.




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