What Parirenyatwa said about the doctors and medical aid societies debacle- Full debate in Parliament

 Hon. Mlilo, what is the interim measure?  I think I have already touched on the doctors and medical insurers.  Then you say how are you decongesting hospitals?  What is the Ministry doing?  What we are doing, and I have said this before – that if you look at Harare, Bulawayo, Gweru, Mutare and all the provincial hospitals are congested.  A lot of them do not have district hospitals like Parirenyatwa and Harare Central hospitals.  So a patient is seen at Budiriro Clinic and if it is a challenge they are immediately referred to Harare Central hospital because there is no interim or middle hospital where they can be treated.

So what we have done is, and we have already started in Mabvuku Polyclinic, to say look at all our Polyclinics in the country, whether it is Ascot in Midlands or Pelandaba in Bulawayo all those Polyclinics or Kuwadzana Clinic.  When you go to that clinic now as I speak, if you walk into that clinic, you will find that the services that they are providing are very and I am saying this word with a lot of respect, are very basic, I will say basic because they could do a lot more.  Those Polyclinics could do a lot more.  Instead of mwana anenge awonekwa paHighfield Clinic akaminyuka ruwoko pane kuti mumutumire kuHarare hospital for an X-ray, because that is the only other place where they can go.  Ondosvikoita queue up for just a fracture, “onoita queue up kuti aitwe x-ray paHarare Central Hospital.”  We are saying no, no, no, Budiriro Clinic should have X-ray machines, laboratory and a Doctor who stays there full time. That is how we are de-congesting and trying to assist.  This we will do in the rural areas as well so that we are able then to say we have built up capacity.  We cannot just say we cannot do it because there is no capacity.

In the rural areas, the same thing should happen.  We have got district hospitals that are surrounded by clinics or health centres.  We are now saying from the health centre, we must go to the villages and build up village health posts.

Hon. Chidhakwa I must apologise, I did not quite catch your question.  You said something about disregarding of tariffs.

HON. S. CHIDHAKWA:  You talked about some doctors disregarding the set out tariffs.  My question is, is that not a criminal offence?  Why are those people not being arrested?

HON. DR. PARIRENYATWA:  If you ignore what we gazette, for example if what we gazetted was $35, and is not being honoured, that is a problem that should be addressed.  Yes, it is a big challenge.  Hon. Maridadi, you talked about the cost structure in the country.  It is true that our health services in the private sector are extremely high, even the drugs here are much more expensive than in other countries and this is reflective of our whole economy.  So I think you are right.  It is very painful for us and particularly for some of us in the Ministry to send a patient to India to get a prostatectomy done when it can be done here. We can remove a prostate here but we are sending people to have a prostate removed in India, which is much more expensive.

Therefore we are saying to ourselves let us just resource our health services a bit more, get personnel who can work in those institutions and are adequately remunerated.  We can then be able to say to ourselves we can do more services to our people.  You are right, the cost structure in the country is very high.  The anti-trust laws and the Competition Commission – this is all being looked at.  I think you are right about actuarial assessment of tariffs.  This is what we have agreed on with doctors and the service providers that we cannot come up with a tariff from nowhere.  We have agreed that there should be an actuarial determination of tariffs.  However, that is long term, we wanted an immediate solution and the actuarial assessment of tariffs is coming in.

Hon. Munengami talked about the relationship between doctors and medical aid societies.  We have said it is not right for medical aid societies to channel payments to preferred doctors.  That is one of the things that the doctors mentioned.

Hon. Chimanikire, I have already said I am not sure how to manage the issue of remedying the issue of auctioned houses.  You finally asked about the issue of Cuthbert Dube.  This is part of the audit report that has come up and I think it would be a follow-up from the audit report.  Thank you.

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