CAIRO - Moawad Abbas, a driver, has had to travel 375km, all the way from Assiut (in Upper Egypt) to Cairo, to try and get his sick aunt treated at State expense. "To travel from Assiut to the capital several times for administrative procedures is very tiring and expensive, but what can we do?” he asks sadly. Although treatment at State expense is the only recourse for poor and low-income patients, the bureaucratic measures involved are so lengthy and tiring that some deserving patients are compelled to stop short halfway. The usual procedure is that hospitals send reports on the patients to the Specialised Medical Boards, which proceed very slowly. "My aunt needs minor heart surgery costing LE2,000. We can't afford it, so she has applied to be treated at State expense," Abass told the Egyptian Mail in an interview. "She needs a surgery to expand one of the valves in her heart. Because she is old and frail, she can't travel from Assiut to Cairo, so I've been making shuttle trips to follow up complicated procedures on her behalf," he said in a tired voice. "In order to make things easier for patients living in governorates [a long way from Cairo], a medical board has been established in every governorate, in order to e-mail the report on each patient, signed by the board, to the Specialised Medical Boards," says Dr Mohamed Osama, the director of the Specialised Medical Boards. According to the Central Agency for Public Mobilisation and Statistics (CAPMAS), the number of the patients treated at the State expense has dropped to 1.2 million in 2010 from 2.2 million in 2009, a decrease of 45.8 per cent. In 2010, 149 patients were treated abroad at State expense, costing LE20.8 million; in 2009, the number was 240, costing LE27.9 million. Dr Osama adds that, every day, the Specialised Medical Boards issue up to 5,000 decisions for patients to treated, at a monthly cost of LE200 million, while the total budget of the Specialised Medical Boards is LE2.5 billion per annum. He explains that treatment at State expense covers liver diseases, intensive care, respiratory complaints, chronic renal failure, cancer, blood diseases and complementary surgery for burns. The cost of the treatment at States expense fell in 2010 by 48.7 per cent to nearly LE2 billion from LE3.9 billion in 2009, according to CAPMAS. Many doctors and health experts say that the Health Ministry budget is one of the 'worst' and they demand it be increased by 15 per cent. Mohamed Khalil, the general co-coordinator of the National Committee for the Defence of the Right to Health, calls for the abolition of the treatment at State expense and the standardisation of health insurance in one large body, as well as boosting the budget of the Health Ministry by 10 per cent for now and then gradually increasing it until it reaches 15 per cent. Under the Egyptian public medical system there are three categories: treatment at the State expense, medical insurance covering civil servants and school children and free treatment available for the public at the Government-run hospitals. "A committee has been set up to study the whole issue of the treatment at State expense and certain diseases will be added to the list, such as backbone and eye problems, as well as some psychological disorders," Osama explains. Meanwhile, Health Minister Fouad el-Nawawi recently announced that LE250 million would be transferred to the free treatment budget from the budget for treatment at State expense, in order to boost medical treatment in hospitals. According to Osama, treatment at State expense does not extend to kidney failure patients in private hospitals, but only to such patients in governmental, university and military hospitals.Fouad has issued a decision for the formation of three committees to study Parliament's recommendations for the health sector and the development of dialysis in Egypt. The plan is to allot more money to dialysis within the health insurance system and to treatment at State expense. The three committees will make their recommendations within a month. Egypt has 44,000 kidney failure patients, of whom 30,000 are benefiting from treatment at State expense at a cost of LE650 million, while another 12,000 are being treated under the medical insurance system at a cost of LE250 million per annum. “This means that the total annual cost of kidney failure treatment comes to LE900 million," says Assistant Minister of Health Abdel-Hamid Abaza, the head of the Supreme Committee for Kidney Diseases. ($1 = LE6)
