“Special Services” May Return to Public Hospitals

5 June 2011

Maputo — Mozambican hospitals may reopen the fee-paying “special clinics” that the country’s previous health minister, Ivo Garrido, tried to ban in 2007.

Speaking at a Friday press conference, the administrator of Maputo Central Hospital (HCM), the largest health unit in the country, Zacarias Zindoga, said that the current Minister, Alexandre Manguele, “is very concerned to reactivate the special clinics”.

Garrido had ordered the closure of these clinics because he found it morally indefensible to have two levels of treatment in the same hospital, based on ability to pay. The “special clinics” allow people who can pay to jump the queue that less fortunate patients have to face.

In a March 2007 interview, Garrido declared “You cannot defend, from a religious, moral or ethical point of view that two people go to a hospital and are treated in different ways because one is rich and the other is poor. As doctors, we have taken the Hippocratic Oath, and we cannot discriminate against poor people”.

The counter-argument has always been that the “special clinics” bring much needed money into the public health system.

Garrido’s measure met with stiff opposition. “Special consultations” were eliminated in the public hospitals, but in Maputo Central Hospital the “special clinic” still exists. It was to have been closed last November – but with the appointment of Manguele as Minister the closure was halted.

Zindoga said a study is under way to analyse the viability of the “special services”. He said he did not know when the commission charged with this study will complete its research, but he believed it would be this year.

He told the reporters that the special clinics were important not only for hospital revenue, but also for providing a VIP service for diplomats, visiting foreign dignitaries and the like (though in reality, these can always use the private health sector – Maputo has no shortage of private clinics).

“The special services contribute a lot to our budget, but I think what is of more weight for the Ministry’s decision is the request from the users”, said Zindoga.

The “special services” certainly provide a very significant supplement to the money that the HCM receives from the state budget. In the first four months of this year, the revenue from the special clinic was slightly higher than 91 million meticais (about three million US dollars).

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