Uganda Cancer Institute ED Orem Defends Patient Charges

Dr. Jackson Orem, Executive Director of the Uganda Cancer Institute, has defended the institute’s decision to charge patients seeking services at its private wing, citing the necessity to maintain essential equipment due to insufficient government funding.

During a session with MPs on Parliament’s Public Accounts Committee, Dr. Orem addressed concerns over revenue collection discrepancies highlighted in the December 2023 Auditor General’s report. The institute aimed to collect Shs4.5 billion but only gathered Shs3.37 billion in the 2022/23 fiscal year. Dr. Orem explained, “Even if Government gives us that Shs4.5 billion, there is still going to be a need because cancer treatment is uniform internationally.”

Dr. Orem emphasized the financial challenges posed by cancer treatment, noting that patients, regardless of economic status, often struggle financially. He highlighted the universal standard of care for cancer patients, regardless of their ability to pay.

“Cancer is a very impoverishing condition, majority of the people who come to the institute actually, they come when they don’t have money. Even the rich and people of middle class, initially when they come, they want to be in the private services, but they can’t even last three months in the private services. They revert to general wing.” He said

Muwanga Kivumbi, the chairperson of the committee questioned the necessity of the private wing given the revenue shortfall. Kivumbi expressed concerns that the poor might be subsidizing services for the wealthy who can afford the private wing.

He pointed out, “You generate Shs4.5 billion, and your budget is Shs48 billion, and the services offered are a public good because my understanding is that the poor are subsidizing for the rich who go in the private wing.”

Responding to inquiries about the private wing’s operation, Dr. Orem clarified, “All cancer patients are equal, and despite the few who seek exclusive services, we subsidize them,”  He stressed that private wing patients primarily benefit from enhanced ambiance rather than significantly different medical services.

Dr. Nixon Niyonzima, Head of Research and Training at the Uganda Cancer Institute, detailed the costs associated with private wing services, including admission fees, consultation fees, and diagnostic tests. He explained that revenue from patient charges supports equipment maintenance, an area with limited government funding.

Dr. Niyonzima defended the need for patient charges by highlighting the importance of equipment maintenance, particularly for radiotherapy services. He emphasized the institute’s reliance on patient revenues to bridge funding gaps for critical maintenance needs.

“Part of the reason we collect NTR is to ensure that our equipment is maintained, we have a very small budget for maintenance of equipment and most of the money we get from NTR is for maintenance of equipment. We actually need more support from Government, we still have many gaps that are unfunded.” he stated

He explained that Admission fees- Shs100,000 is charged per night, consultation fees-Shs50,000 per visit, laboratory blood tests-Shs10,000, ultra sound-Shs10,000, X-ray-Shs30,000, CTScan-Shs200,000 to Shs300,000 and this is charged depending on the organ the patient wants, but patients in both general and private wing receive free drugs.

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