Health Business: Unethical Practices in Private Hospitals

The social networks have in the recent past not been so friendly for doctors and health practitioners. Kenyan doctors have come under criticism for what the public terms malpractice, unethical practice and lack of empathy.

Yesterday, this debate took a new dimension as one twitter user (@Owaahh) did a thread on the unethical practice in private hospitals. In the thread, the user shared concerns from various Kenyans on how private hospitals operate as business entities and not health facilities. The thread revealed how the top management of popular private hospitals such as Nairobi women’s hospital are always pushing their staff to get as much money from patients as possible. The health practitioners are forced to authorize unnecessary hospital admissions, delay discharge of patients, order for expensive and unnecessary tests and prescribe loads of medicines.

In deed, you too must have experienced this at one point in time. It is not news that private hospitals in Kenya admit patients without any criteria and that after treatment, a patient leaves the hospital with many medicines most of which are branded (commonly referred to as original). A child with a flu would be put on strong painkillers, cough syrup, antihistamines like Cetrizine, an antibiotic and supplements like SevenSeas or Scott’s Emulsion. Just for a simple allergic rhinitis.

But where is the problem?

This problem is largely a systemic problem that has got everything to do with human resource for health.

Private hospitals do not want to employ adequate qualified health personnel. Most of the health professionals in these hospitals work on a locum basis. They are employed on contract to work for a specified number of hours. Their pay is based on the number of hours worked and the number of patients they see. Under such employment terms, the health professionals have to adhere to certain daily targets set upon them or else they risk losing their jobs. The lack of job security them pushes these health workers to adhere to such conditions and unethical practice. In order to protect their jobs, doctors spend less time with the patients and not adequate patient history and physical examination is conducted. They order for many tests, most of which are completely unnecessary. They also prescribe many drugs which aren’t necessary for the patient’s condition. All in this is done in the name of meeting daily targets set by the hospital management.

It is also common to see doctors, pharmacists and dentists employed in government go to other hospitals to work at certain times. This is on locum basis. They have to see many patients within a specified number of hours for them to earn more. This obviously comes with lower standards of health services offered.

If you have been keen, you must have noticed that these hospitals too have high turnover of employees. The person you meet in a given department this month is highly likely not to be there in three months time. The staff are hired and fired at will. Those who stay long are those who keep up with the unethical standards and expectations of the hospital management. Facilities like Bliss GVS Healthcare and Nairobi Women’s Hospital are well known for this high employee turnover.

The gullible members of the public have always bought this to mean better services. Little do they know that its all in the name of money.

So what is the solution?

Kenya Medical Practitioners, Pharmacists and Dentist Union (KMPDU) secretary general Dr Ouma Oluga says we need to invest in publicly-funded health facilities. The government need to employ adequate medical personnel at all levels and increase funding to the healthcare.

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