The government is not getting value for money despite increasing doctors’ salaries, the deputy head of Public Service in charge of performance and service delivery, Jane Kyarisima Mwesiga, has said.
Kyarisima raised concern over rampant dual employment among government health workers, saying that despite the enhanced salaries following a series of strikes and complaints, there has been little improvement in service delivery.
Doctors’ salaries were revised in the 2018/19 financial year, raising pay for medical consultants to about Shs 12.7 million per month and senior consultants or specialists to Shs 17.4 million.
However, Kyarisima noted that there is still widespread concern that senior specialists, who are among the highest-paid health workers, are often absent from public hospitals. She was speaking at the launch of the ministry of Health Client Charter and Health Service Delivery Standards, which will guide service delivery in the health sector until 2030.
The standards outline the minimum level and quality of services expected at each level of care from the village level handled by Village Health Teams (VHTs) to the highest level at national referral hospitals.
They also describe how services should be delivered and the timelines within which they should be provided. The Client Charter, on the other hand, details the rights and obligations of patients seeking health services, as well as feedback mechanisms through which citizens can lodge complaints or make inquiries about healthcare services.
Commenting on the development, ministry of Health permanent secretary Dr Diana Atwine said that while the ministry has developed a universal charter, individual hospitals will be required to develop their own versions outlining how they relate with patients.
Atwine said the launch of the service delivery standards and charter comes at a time when the ministry is intensifying a crackdown on consultants who continue to receive government salaries while spending most of their time working in private health facilities.
The standards come in the wake of the latest Auditor General’s report, which highlighted significant gaps in health service delivery. The report indicated that facilities such as Mulago national referral hospital are operating with only 34 per cent of the staff required to handle the workload, with some specialities, including critical care, facing staffing gaps of up to 90 per cent.
However, Atwine noted that recruitment alone will not solve the problem. She said without mechanisms to measure the output of specialists and ensure accountability for the time they spend on duty, access to quality and timely healthcare services will remain limited.
Meanwhile, Kyarisima said the new standards will also be used to measure the performance of permanent secretaries, alongside plans to conduct citizen satisfaction assessments on services received at public health facilities.
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