Zimbabwe: Doctors, Nurses Milking Patients Through Syndicates

7 August 2024

Senior Health Reporter

The Medical Laboratory and Clinical Scientists Practitioners Council of Zimbabwe is taking stern action against laboratory professionals who are working in cahoots with health workers in public institutions to coerce patients into seeking services from specific private sector laboratories.

This is despite the fact that most Government-run institutions provide similar services at a much lower cost.

Doctors and nurses often recommend a specific laboratory for blood, urine or stool sample tests and in most cases, provide a contact number for someone who can come and collect the samples on the laboratory's behalf.

The selected laboratories have bikers on standby at public health institutions waiting for the call to collect samples as well as return the results to the patient's bedside.

While for many this might seem convenient, the Medical Laboratory and Clinical Scientists Practitioners Council of Zimbabwe says medical practitioners doing this are exacerbating the financial burden on patients, particularly those from low-income backgrounds.

Speaking at a Health Professions Authority familiarisation meeting between councils under its purview and the media yesterday, the med lab council's registrar, Ms Agnes Chigora, said the unethical conduct of some medical practitioners was compromising the affordability and accessibility of healthcare.

"If you go to Government institutions, at times you see motorbikes stationed there. Does that mean the public lab which is there is not offering those tests? It seems they are working with other health practitioners, with nurses and doctors and they ensure that for any lab tests which are required, they demand that those tests come from specific laboratories," she said.

"As a client, if I send my parent to a public institution, it means that is what I can afford. But for someone to insist that they want a test done at a

particular lab, which is very expensive, it's not fair to our people."

Ms Chigora called on the public to report any instances of such malpractice to her offices or the Health Professions Authority and also warned medical practitioners involved in this practice that they could face disciplinary action.

She said the primary duty of medical practitioners was to provide quality care to their patients, and this included making informed decisions about laboratory services that are in the best interest of the patient, not their own financial gain.

The stance by the council is in line with the Government's efforts to improve the public healthcare system and make healthcare affordable for all.

The Ministry of Health and Child Care, through the Biomedical Research and Training Institution, is implementing the Integrated Specimen Transportation system with support from the Global Fund and United Nations Development Programme.

The programme seeks to improve disease diagnosis in all public health facilities, enhance the management of patients and improve health outcomes.

However, while the system seems to be working in rural facilities, health workers in urban institutions sometimes claim that their labs have no capacity to conduct certain tests. This forces patients to agree to send samples to private labs.

Ms Chigora said some of the labs that were involved in the scam were providing substandard services.

To curtail this, she said, the council working with the Ministry of Health and Child Care would soon carry out a certification exercise for all laboratories to ensure that only those who were operating above board remained.

"At the advent of Covid-19, everybody thought it was time to make money; labs were opened right, left, and centre. The Health Professions Authority does the routine inspection (of the labs), but we as a council, are going a step further. We are moving around these institutions, making sure that the laboratories meet the minimum standards required. The Ministry of Health and Child Care, in collaboration with the council, has come up with a national certification programme. We have trained auditors who are going around laboratories and we have a certain level, which the labs have to reach," she said.

Ms Chigora said labs, which scored below 55 percent, would be classified at level zero, which meant they would not be considered a lab and would lose their license.

Those classified at level 1 would be given time to correct all the non-conformities identified by the auditors.

The certification programme is targeting all laboratories in both the public and private sectors.

Malpractices have also been reported in pharmacies which sometimes also work with health workers in directing clients to their practices.

Pharmacists Council of Zimbabwe registrar Mr Alois Karonga said the council had received various reports of malpractices among pharmacists which they had dealt with over the years.

"Issues of malpractices that the council has dealt with which are on the rise, among others, include dispensing prescription medicines without prescription from medical doctors, selling expired and unregistered medicines and leaving pharmacies operating without registered pharmacists. These are some of the transgressions for which the council has brought pharmacists up for disciplinary inquiries," he said.

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