PHALALA FUND HAUNTED BY E40 MILLION DEBTS

MBABANE – The Phalala Fund is still being haunted by debts to the tune of nearly E40 million, the Ministry of Health has disclosed.

The debts, mainly unpaid remunerations to health service providers in and outside the kingdom, were accrued from the year 2008 to 2012. The Fund is part of the country’s national referral system for citizens needing specialised treatment.

According to the Ministry of Health’s Senate Portfolio Committee Report which was tabled in Parliament on Monday, the Fund has been faced with financial challenges for years.
In fact, patient referrals to South Africa (SA) were ceased in October 2013 unless a case was considered a serious emergency. 
Many health service providers in SA had taken a decision by that time to stop giving service to Swazi patients brought through the fund.
Their main gripe was the late payments.

The report clarified that this was prior to the engagement of a company called Health Share. Health Share is an intermediary that was hired to be responsible for patient case management and logistical operations, including selection of doctors, hospitals and lodging, where patients would receive treatment. In addition, the company audited and reviewed all transactions with service providers to prevent overcharging, over servicing and double payments.

“Health Share assisted in paying some of the arrears in addition to ensuring current balances were paid. But, payments were slowed and eventually halted in the fourth quarter of 2013. Rectifying this issue and resuming patient referrals must be government’s highest priority,” stated the report.
It went on that the centralised payment process contributed significantly to delays in payment of service providers. The processes required that invoices must go through multiple reviews within the Ministry of Health and then to the Treasury Department, which is a semi-autonomous function of the Ministry of Finance.

There was a recommendation though, that decentralising the current process and providing the ministry with the authority to autonomously review, approve, and pay medical bills can assist in preventing any further delays.
Strategies to bring efficiency were outlined as follows:

Similar to Health Share’s payment system with the government of Botswana, the Ministry of Health should establish a satellite office at its embassy in South Africa. The office will communicate with Health Share and review medical invoices and process payments.

On a monthly basis the office will be wired a lump sum from the Treasury Department for expected expenditures. This will eliminate the transport of invoices back into Swaziland for review by Phalala Fund office and other government departments.  Health service providers will get to be paid on time.

The Ministry of Health can establish an individual responsibility centre for the Phalala Fund. Currently, the Fund shares its budget with the Mbabane Government Hospital and other responsibility centres, which results in unrealiable and depleted funds.

Phalala Fund can open a commercial bank account or imprest account where it would have immediate access and have the ability to draw down funds.

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