21 November 2012

Uganda: Doctor's Pay Rise Could Cause a Backlash

Photo: Jared Ferie/IPS
Ministry of Health to employ 10,000 health workers.


Recently the Government announced that it was doubling the salaries of certain categories of medical workers. Many people have discussed the benefits of this increment and I am not going to repeat them.

Whereas the benefits are real, this salary increment in government health facilities will lead to undesirable effects that are too significant to be ignored.

The Private-Not-For-Profit (PNFP) health facilities, known to most people as missionary hospitals, are bound to lose large numbers of skilled and experienced staff, who are likely to rush for the better pay in government hospitals.

These PNFP health facilities handle more patients than the Government hospitals do, and any setbacks they suffer will affect large numbers of patients.

In my academic research, I have studied how an increment in the salaries of government doctors affects PNFP under the Uganda Catholic Medical Bureau. What comes out clearly is that since the late 1990s PNFP health facilities have suffered greatly whenever the Government increased salaries.

I have every reason to believe that other PNFP facilities run by other Christian and Islamic medical bureaus have similar problems. These PNFP facilities do not have the financial muscle to match the salaries provided by the Government hospitals. Market forces, therefore, place PNFP facilities at a disadvantage. Certainly, loss of skilled and experienced health workers has a negative impact on service delivery.

Moreover, my research has demonstrated that loss of staff increases the operational costs of hospitals. Others who fail to get into Government service will get demoralised.

Unfortunately, government hospitals do not have a good reputation, to the extent that even when they have better qualified staff and facilities, most patients prefer to go to PNFP health facilities.

The Health ministry should, therefore, be conscious of the fact that every major operational or policy decision in the sector has a bearing on PNFP facilities, which treat the majority of the population.

Such decisions should, therefore, be made in consultation with the parent organisations of PNFP health facilities, rather than surprise them with an announcement in the mass media.

The writer is a PhD candidate at Makerere University.

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