A deeper look into the Private Hospitals

The stories published by Kenyan dailies in the recent past about healthcare in private hospitals have elicited various reactions from medics and other Kenyans, who have shared harrowing experiences at some of the facilities.

The reactions are evidence that there has been an erosion in the bond of trust between doctors and patients over the years given the strict guidelines set by hospital administrators to admit patients.

Norbert Wakisa, for example, says he lost his wife at Nairobi Women’s Hospital.

He came forward to describe how the hospital admitted his wife in July 2019 for three days despite his objection.

“When she died, I had a bill of Sh1.3 million and it took about a month-and-a-half to bury her, since the bill was high. Despite making a payment plan and leaving a title deed with them, they still asked me to make increments to clear it,” he said.

Another man, who lost his sister at the facility, said that it all pointed to negligence on the hospital’s part, and their insistence on a caesarean delivery, even when it was unnecessary.

DRIVEN BY PROFITS

The doctor-patient relationship ought to be sacred since patients rely on doctors to help them make life-saving decisions.

But, as the first two parts of this series showed, global finance trained its eyes on Kenya’s private healthcare system and went on an acquisition and expansion spree over the past decade and a half, deeply eroding the relationship in its wake.

While these investments have always been seen as a positive thing, the private equity firms that invested in private healthcare were driven purely by profits, and hospital management translated this to pushing medical staff to do unsavoury things.

These recent revelations show that there have been multiple instances of unnecessary admissions, and unethical acts to drive revenues up by private hospitals staff, who are pushed by hospital owners to make money from patients by any means necessary.

VICTIMS SILENT

Not many patients who feel and say they are aggrieved follow up to have their cases investigated, says Daniel Yumbya, the CEO of the Kenya Medical Practitioners and Dentists Council (KMPDC), the body that regulates all aspects of healthcare in Kenya.

For example, only 103 people have come forward to officially complain about being overcharged at health facilities.

This constitutes only 8.85 per cent of the total number of complaints received by KMPDC despite the numerous complaints forwarded through social media.

On billing, for example, the regulator is guided by the Medical Practitioners and Dentists (Professional Fees) Rules, 2016, and can determine whether there has been overbilling, no matter what the mode of payment was.

KMPDC is now urging patients who have been forced to undertake unnecessary procedures and feel they have been duped while seeking health services at Nairobi Women’s Hospital — and other hospitals — to come forward and help with investigations.

PATIENT AWARENESS

During an interview at his office on January 22, Mr Yumbya said that should no one come forward with a formal complaint, KMPDC’s legal department will act as the complainant.

“I requested the facility to respond and they did that on Friday. Our legal department will present the findings to the committee. The responses will be looked at by the legal team and, if there is a particular person of interest, we will have them fill a complaint form.

“If that does not happen, then our legal team will act as a complainant in the matter because it is a matter of public interest and we would like to make the hospital accountable to the public.”

He did not, however, divulge whether KMPDC would go after the facility for allegedly pushing employees to work harder and increase admissions.

“It is too soon to say and we do not want to give them the upper hand by saying this. Give us about a month to complete everything,” he said.

He said that patients should be aware of their rights as stipulated in the patients’ rights charter, which gives them the option of seeking a second opinion and giving consent before any procedure is done.

“A practitioner must explain to the patients the length of treatment as well as the costs and, while the patient should adhere to medical advice, they can also decline treatment in writing,” he said.

HIPPOCRATIC OATH

He added that doctors are supposed to ensure a patient’s best interest takes precedence no matter the situation.

“With this in mind, it is a doctor’s prerogative to determine whether a patient needs certain procedures or not. The council has handled cases where some patients have complained of not undergoing certain tests, while others complained that too many tests were done,” he said.

He said that while administrators should be worried about being penalised for inappropriate admissions, doctors should also be keen on how they admit patients as their priority should always be ensuring the patient receives quality treatment.

These conversations are at the heart of frustration at many hospitals with the boom in inpatient care in the country.

On January 23, Kenya Association of Private Hospitals chairman Abdi Mohamed told the reported that the buck stops with the doctor, who admits a patient for profit-making purposes and not clinical-related matters.