Wednesday, 26 October 2011

Outsourcing healthcare in Lesotho

Lesotho has a new hospital. A new hospital which is, apparently, about the revolutionise healthcare in the country. This according the World Bank, who are proclaiming this as a unique (and apparently revolutionary) public private partnership model that could be replicated all over Africa. Apart from being a public private partnership (PPP) - which, frankly, is anything but unique  by this stage - it appears that a private consortium has been hired to run the hospital. The consortium is headed (only headed?) by SA's Netcare, a healthcare provider that operates many private hospitals in South Africa. Also, the consortium will be held to account with performance contracts. So, PPP with performance contracts for the private-sector implementing organisation. An "innovative partnership with the private sector and one of the first of its kind in Africa", they say.

The hospital is great and if this keeps people alive and makes it easier to manage the crippling weight of HIV/AIDS, that's great, too. I'm not holding my breath. What it is not, is innovative, revolutionary or unique. It's outsourcing. Healthcare in Maseru has been outsourced. Granted, Netcare is probably quite good at what they do - private hospitals in South Africa tend to work pretty well - but their bottom line is not the people of Lesotho.  They are a large, profit-driven, foreign corporation. If this was happening anywhere else, with a company not from South Africa, there would be an outcry.

Of course, it is possible that it will work. For a few years, a quarter of Lesotho's population will have access to private-quality healthcare in their own country. Netcare knows how to run hospitals. Healthcare will probably improve. Given that this one hospital does serve a quarter of the population, health stats will probably be significantly improved. At which point the World Bank and friends will pat Lesotho on the back for achieving the MDGs and take their money elsewhere. And this tiny, mountain kingdom with limited options in terms of growing its economy will be faced with trying to find the money for hugely costly private hospital bills from public healthcare funds.

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