PHALALA FUND SUSPENSION: ONLY CHILDREN WITH CANCER WILL BENEFIT

MANZINI – While Phalala Referral Fund remains suspended, only children with cancer will be assisted through the fund.

The suspension of Phalala Medical Referral Fund to scrutinise its expenditure and allocation to emaSwati in need of specialised treatment follows the Forensic Audit on the Acquisition and Distribution of Medicines to Public Health Facilities in Eswatini, which started last year. The suspension of Phalala Medical Referral Fund, just like the audit of the medical drugs, came after years of this publication reporting on the anomalies in the public health sector, which included the abuse of the fund. According to sources, the suspension of the fund is set to establish the ballooning bills to specialised entities, which are used for patients in need of their service.

Objective

The fund, whose objective is to assist deserving emaSwati, who would, otherwise, not have access to specialised medical care, cannot perform its mandate, due to financial constraints.
Some of the specialised treatments are done locally by private doctors and or private hospitals; however, in most instances, locals are transferred to neighbouring countries, in particular from South Africa. The suspension has led to hundreds of emaSwati, who require the specialists’ services being left to die or rather find alternative means to pay for their medical procedures. The non-performing fund affects the poor of the poorest, who cannot afford medical aid. However, this is done to ensure that when the resources are availed, due diligence shall be applied when allocating the resources. The suspension of the fund follows that government is still in arrears with a majority of the healthcare facilities both locally and in South Africa. Government reportedly owes in excess of E220 million and despite an annual allocation towards assisting emaSwati, the arrears have not been declining. Sources claimed that government was still paying bills dating back to 2022.

Suspension

The financial constraints which led to the suspension of the fund at the beginning of the year are said to have led to the auditing of its (Phalala Medical Referral Fund) financial resources in order to find the leaks and bring to book those who may have misused the fund. In previous instances, it was reported that some people were abusing the fund by using it to pay for their holidays in the lodges, which are allocated to local patients in South Africa. Director of Health Services Dr Velephi Okello confirmed that the fund remained suspended and financial assistance would only be availed to children diagnosed with cancer. She said this was caused by financial constraints emanating from the fact that unlike in yesterday years, where Phalala Medical Referral Fund had an open budget, it was now restricted to E170 million. Dr Okello said due to the need by emaSwati for specialized treatment, the Ministry of Health had been failing to settle all debts and its arrears had accrued.

Facilities

She said this resulted in many specialised healthcare facilities in South Africa rejecting local patients. As such, she said it was still the case and the ministry anticipated clearing its debts when the finances allocated for the 2024/25 financial year were available. It is worth noting that government’s financial year starts on April 1. “We’ve been waiting for the new allocation so that we can pay them (specialised healthcare institutions) and then review new patients other than children,” she said. She said the biggest challenge was that the ministry had a limited budget for the specialised treatment; yet it was one of the most expensive in the healthcare sector. Dr Okello also emphasised that due to the constrained budget, the fund was now scrutinising vigorously the lists of patients who shall be funded through Phalala Medical Referral Fund.

As this is happening, some people supporting those with chronic illnesses are relying on donations from good Samaritans to make trips to South Africa in order for their loved ones to access specialised healthcare. Victoria Sikhondze, a grandmother to a minor who was diagnosed with leukaemia, cancer of the blood cells, said since 2018, government had not paid at the health facility where her granddaughter was admitted. “We’ve been seeking assistance but at the hospital we were referred to, we were not assisted as government has not been paying. I received a donation of about E3 000, which I then used to pay at Steve Biko Academic Hospital,” she said. Sikhondze said the donations were what assisted them in various instances as the condition of her granddaughter was not improving.

She said at some point, to deal with the medical needs of her granddaughter, she resorted to selling her livestock in order to cover some of the costs of medical supplies. Sikhondze said she now only relied on her elderly grant to afford her granddaughter a decent meal, at least once a month. Meanwhile, at the end of October last year, a monthly management report of the fund showed that the debt owed to the South African health facilities had shot up to over E220 million.

Stuck

In August last year, 23 Phalala patients were stuck in South African hospitals without assistance, as government owed E181 million. The facilities included the Chris Hani Baragwanath Academy Hospital and Charlotte Maxeke Johannesburg Academy Hospital. It was said both hospitals, including Concordia Lodge, where they were accommodated during the course of their treatment, were owed monies dating back to 2018. In 2019, the fund owed SA hospitals medical bills estimated to be around E66 million. It is stated that some of the outstanding bills dated back to 2013. These millions owed by the fund combined all six referral hospitals and clinics, which accept local cancer patients to be treated in SA. In 2014, the same occurred as the Phalala Medical Referral Fund was haunted by debts to the tune of nearly E40 million.

The debts, mainly unpaid remunerations to health service providers, in and outside the kingdom, were accrued from the year 2008 to 2012. In the same year, about 128 patients could not benefit from the Phalala Medical Referral Fund, as the State was defrauded E9 million due to multiple payments in the past three years. It was once discovered by government that the State lost money due to multiple payments. It was approximated that the money lost due to this could have assisted about 128 patients (E8 990 882.92) when using the average service charge of E70 000 per patient. This was when 297 invoices were reportedly double paid or even paid three times.

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