Public hospitals, partial privatisation

Gamal Essam El-Din , Tuesday 21 May 2024

A new law aimed at privatising public hospitals was approved amid sharp criticism from some MPs, reports Gamal Essam El-Din

Public hospitals, partial privatisation


On Monday, MPs approved legislation allowing the private sector to manage, operate, and develop public hospitals and other healthcare facilities. Medical facilities offering health services considered central to national security, birth control units, and those that collect blood and plasma are exempt from the provisions of the new law.

A report by the House of Representative’s Health Committee said allowing the private sector to manage and operate public hospitals will improve the services offered.

Following pressure from MPs, the government-drafted law was amended to limit foreign medical staff to 15 per cent of total staff members in partially privatised healthcare facilities, and 25 per cent in hospitals fully owned by the private sector.

The committee report noted that under the law private investors will be able to secure concessions “to manage and operate public hospitals for a period of no less than three years and no more than 15 years at the end of which the hospitals will be transferred back to state ownership.”

The legislation was met with criticism from a handful of MPs affiliated with both opposition and pro-regime political parties.

The left leaning Al-Tagammu and the Egyptian Socialist Democratic parties opposed the draft on the grounds that it will push the cost of healthcare out of reach for ordinary citizens.

Tagammu Spokesperson Atef Al-Maghawri said that while the party had no objection to the private sector building hospitals and investing in the healthcare sector it opposed “allowing the private sector to manage and operate public hospitals because poorer citizens will be unable to afford the fees charged by private investors”.

His criticism was echoed by Egyptian Socialist Democratic Party Spokesperson Ihab Mansour who claimed that public hospitals which now offer basic healthcare services to citizens at reasonable prices will begin to discriminate among citizens depending on who can pay and who cannot once they are managed by private sector investors.

Mansour also noted that the legislation is being put forward at a time when roll out of the government’s Universal Healthe Insurance system is progressing at a snail’s pace. “Instead of allowing private investors to operate public hospitals, the government should focus on implementing universal healthcare,” said Mansour. “Six years since implementation began, just 3.5 per cent of the population is covered. At this rate we’ll have to wait 160 years for full coverage.”

MP Diaaeddin Dawoud said the law signalled that the government is no longer interested in fulfilling its social obligations towards the poor but was instead “pursuing aggressive liberalisation and privatisation policies at the expense of the unprivileged”, while MP Maha Abdel-Nasser called it a black day when MPs discuss and approve a law that will end affordable health services for those on low incomes.

The Doctors Syndicate weighed in against the law. In a written message to House Speaker Hanafi Gebali, syndicate head Osama Abdel-Hay said that while the syndicate had no objection to local and foreign investors building new private hospitals in Egypt, allowing them to manage or operate existing public hospitals that offer services to low-income citizens would introduce a profit motive and make basic treatment unaffordable for ordinary citizens.

Abdel-Hay also expressed concerns about how the changes will affect the 75 per cent of doctors and nurses who work in Health Ministry-affiliated hospitals and noted that the draft legislation offered no guarantees that private investors will be required to provide healthcare services to citizens covered by the Universal Health Insurance system.

Defending the new law, Abdel-Hadi Al-Qasabi, spokesperson of the majority Mostaqbal Watan Party, insisted private sector involvement in managing and operating public hospitals will improve health service provision, while Gebali stressed that the changes do not represent the privatisation of public hospitals since they will return to public ownership once the concessions expire. What the law does, continued Gebali, is open the door to experienced private investors to improve the performance of public hospitals through modern management techniques.

Health Minister Khaled Abdel-Ghaffar defended the bill as part of government plans to attract the private sector into more areas of the economy and said that safeguards would be in place to ensure investors do not raise healthcare prices.

The law will allow investors to manage and operate as many as 526 public hospitals, according to Abdel-Ghaffar, and the terms of the concessions allow the government to terminate agreements should hospitals begin charging excessive fees or offer low-quality services.

* A version of this article appears in print in the 23 May, 2024 edition of Al-Ahram Weekly

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