The Ministry of Health has issued unified regulations governing its hospitals, but controversy is right behind, Reem Leila reports A new unified regulation for hospitals will come into force at the beginning of January at 132 public hospitals. The new stipulation says all public hospitals are to operate for free for all patients from 9am-1pm instead of 9-11. The remaining 500 hospitals will join the system by the end of February 2011. "The 132 hospitals at which the regulations will be applied have reached healthcare quality standard so will be the first to apply the new regulation," Abdel-Rahman Shahin, official spokesman at the Health Ministry, stated. The unified regulation does not annul medication for patients from 3pm-5pm but patients will pay LE5 instead of LE1 to receive healthcare in the economy department. "Needy patients in critical condition who cannot afford subsidised medicine will be admitted to emergency wards operating 24 hours a day, for free," confirmed Shahin. Starting 5pm, public hospitals will be opened in return for LE20 and a maximum LE30 in fees. According to the new regulations a minimum 40 per cent of hospital beds are to be allocated for needy patients for free, whereas previous laws stipulated a maximum of 40 per cent of hospital beds to be dedicated to the poor for free. Despite what looks like a set of rules advantageous to the country's healthcare system, many experts object to the new regulations arguing it is unconstitutional. According to former MP Hamdi El-Sayed and current head of the Doctors' Syndicate, the minister of health does not have the right to change any of the regulations. "The minister should prepare a draft concerning the new regulation and present it to the People's Assembly for approval," argued El-Sayed. Health Minister Hatem El-Gabali did not consult any doctor or the syndicate. Thus it is unconstitutional and it will be illegal if applied, El-Sayed added. Shahin strongly denies the claims, saying the new regulation simply substituted the already existing one after modifications were made by the ministry's legal team. "Plurality of regulations is a legal problem which has existed since 1997. Rectifying it is not unconstitutional; on the contrary. Some governorates were applying the 120 regulations, others were enforcing the 239, whereas a few more were combining both. This is nonsense and must be corrected. There must be one regulation to be applied to all the ministry's hospitals," Shahin stressed. According to the new regulations, 40 per cent of the money going to public hospitals after the application of the unified regulations will be distributed among doctors, nurses, technicians and administrative staff and 25 per cent among technicians of laboratories and X-ray departments. "This will help in increasing the income of the health staff. The remaining number will be directed to the hospitals' treasury in an attempt to increase its overall budget," said Shahin. The medication market in Egypt is estimated at LE30 billion. "This amount is shouldered by ordinary citizens and the state budget," said Shahin. People spend LE20 billion in private clinics and hospitals, while the remaining LE10 billion is paid by the government. The new regulation is targeting the middle class who can afford paying LE50 for a private doctor in addition to at least LE150 paid for X- rays and blood tests. "The ministry's hospitals will be opened for this category of people to provide them the same health service they are looking for in the private sector but at half the price," stated Shahin. El-Sayed believes the regulation is a step towards privatising the health sector in Egypt. "In the beginning, the ministry will apply the system during the afternoon shift, but a few months later it will become noon and afternoon until the poor patient finds himself obliged to pay for what is supposedly free health service starting early in the morning," argued El-Sayed. Shahin denied the allegations, saying the ministry has spent billions to renovate its 500 hospitals during the past years. "We are not going to sell the hospitals now to a bunch of investors or put them into circulation in the stock market. "Rumours have been spreading about this since El-Gabali came to office but none of this has happened. Definitely it will not take place now, not after spending huge amounts of money on hospital renovation," explained Shahin. The deficit in the Health Ministry's budget has exceeded LE7 billion, whereas the deficit in the ministry's bonus budget is more than LE2 billion. Enforcement of the unified regulation is, accordingly, essential, said Shahin, to cover the deficit in order to improve the overall status of the health sector in Egypt. Shahin said there will be a medical council composed of the hospital's manager and heads of a hospital's various sections. Each hospital will have its own medical council. "The medical council will be responsible for identifying the doctors who will work in the after 5pm shift. For example, qualified, devoted doctors and those who work for free in the morning shift will have the right to work the 5pm shift," explained Shahin. The council will also be responsible for identifying the intervals of the 5pm shift and when it can be extended. "This has not yet been finalised, but starting in January everything will be ready," Shahin added.
