Economy

880 doctors under probe in referral-for-bribe scandal

muraguri

Health PS Nicholas Muraguri: “If a doctor is reported to the medical services board, they will be deregistered for that is a criminal offence.” PHOTO | FILE

Summary

  • Up to 880 doctors in public and private hospitals could lose their practising licences and face criminal charges if investigations confirm that they intentionally misadvised patients to seek treatment abroad in exchange for kickbacks.
  • Health Principal Secretary Nicholas Muraguri told the Business Daily that the investigation seeks to identify rogue doctors who have been colluding with specialists in countries such as India to fleece patients of millions of shillings while draining Kenya’s hard currency reserves.
  • Dr Muraguri said any doctor found guilty of the alleged malpractices will be stripped of their practising licences and face the risk of criminal prosecution.

Up to 880 doctors in public and private hospitals could lose their practising licences and face criminal charges if investigations confirm that they intentionally misadvised patients to seek treatment abroad in exchange for kickbacks.

It has emerged that the Ministry of Health received reports on the unethical practice last year and launched investigations whose outcome will be released next month.

Health Principal Secretary Nicholas Muraguri told the Business Daily that the investigation seeks to identify rogue doctors who have been colluding with specialists in countries such as India to fleece patients of millions of shillings while draining Kenya’s hard currency reserves.

Dr Muraguri said any doctor found guilty of the alleged malpractices will be stripped of their practising licences and face the risk of criminal prosecution.

“It is really messy. If a doctor of whatever calibre is reported to the medical services board, they will not only be named and shamed but be deregistered for that is a criminal offence,” Dr Muraguri told the Business Daily.

Kenyan doctors are said to have established a network of illicit dealing with foreign hospitals that ensures a regular flow of patients to the facilities even for ailments that can be treated locally in order to pocket the kick-backs.

The doctors are known to pocket up to Sh200,000 for every referral – mainly of cancer, kidney and cosmetic surgery patients. This adds a huge financial burden on patients because the kickback due to the referring doctor is included in medical bills accruing abroad.

More than 10,000 Kenyans travel abroad each year in search of treatment for various ailments, especially cancer and kidney transplants. The State has narrowed its focus on 880 cases.

READ: Lobby claims doctors bribed to refer cancer patients abroad

Official statistics show that the overseas treatments cost Kenya about Sh10 billion annually. Kenyans are increasingly turning to India, in particular, for treatment of chronic diseases in the belief that the Asian country has better doctors, advanced medical equipment and charges lower, a position Kenyan officials discount.

The PS said Kenya is well-equipped and staffed to conduct cancer treatment, kidney transplants and beauty surgeries, defeating the need for unnecessary travels abroad.

“Kenyatta National Hospital (KNH) conducts about 30 kidney transplants a month and some of our private hospitals have capacity for heart transplants, meaning these issues can be managed here,” said Dr Muraguri.

Dr Muraguri said only delicate conditions that local experts cannot treat would warrant overseas care. Kenya has more recently expressed the ambition to become East Africa’s medical tourism hub, a desire that is being undermined by the continuous outflow of patients.

The situation is made even more difficult by the fact that top government officials have ignored the official policy in favour of local healthcare, opting instead for treatment in Europe and the US.

Dr Muraguri said some local practitioners have become money-hungry while overlooking the medical profession’s Hippocratic Oath, which gives top priority to life and welfare of patients.

The PS said it had become common practice for medical workers to push the sales of a given line of medicines for their own gain by influencing patients on what and where to buy.

Lobby groups like the Kenya Network of Cancer Organisations have recently raised the red flag over rising cases of suspect referrals abroad.
Medical care in India costs higher than in Kenya, contrary to popular belief that charges are lower in the Asian nation.

“A kidney transplant in India is more expensive than it is locally but it seems Kenyans feel more secure in the hands of foreign specialists,” said Antony Were, the head of Renal Department at KNH.

Indian hospitals charge about Sh2 million, excluding travel and accommodation that might push the costs above Sh2.5 million, he said.

Kenyan private hospitals charge about Sh1.8 million for kidney transplants while KNH asks for Sh500,000.

Only two public hospitals — KNH and Moi Teaching and Referral Hospital in Eldoret — have the capacity to conduct kidney transplants at subsidised rates.

Patients, however, have to wait for at least two months at KNH for kidney transplants due to the huge backlog. Kenya has over the years grappled with a shortage of doctors and medical equipment that has only added to the push for foreign medical attention.

For instance, there are only 12 oncologists (cancer specialists) and 23 nephrologists (kidney specialists) in the public sector, against a population of about 44 million people. Private hospitals are better equipped and staffed.

Cancer is the third leading killer disease in Kenya after malaria and pneumonia, according to the 2015 Economic Survey. Official data shows that reported deaths from cancer rose from 11,995 in 2010 to 14,175 in 2014.

The World Health Organisation reckons that of the approximately 41,000 Kenyans diagnosed with cancer annually, about 28,000 die.

Deaths from malaria, HIV/Aids and tuberculosis have been declining over the same period, reflecting the public health crisis brought home by cancer at a time when the country is reeling from a shortage of doctors and equipment that can handle the deadly disease.

But sector players say there are genuine cases where local doctors refer patients to foreign specialists due to lack of certain medical equipment and expertise.

“We don’t have the capacity to do liver transplant and rare brain surgeries like brain stem,” said Kanyenje Gakombe, the chairman of the Kenya Association of Hospitals (KAH) — which represents top private hospitals like Aga Khan and Nairobi Hospital.

Local facilities are also limited in the treatment of rare cancers such as rhabdomyosarcoma, which attacks muscle tissues. Local doctors are mostly skilled in dealing with breast and prostate cancer, according to Dr Gakombe.

Some Kenyans also turn to foreign hospitals when diagnosed with late-stage cancer while others fly out in the quest for multiple opinions because of concerns over possible misdiagnosis in local hospitals.

Health secretary Cleopa Mailu said Kenya will hold a medical tourism conference “in the next one month”, a forum that stakeholders will use to promote increased use of local facilities.

“Sometimes from where we sit one can wonder why patients are being referred abroad for the same standard treatment that we have the capacity to handle but the matter is under investigation,” said Dr Mailu.

The Kenya Medical Practitioners and Dentists Board, which registers medical workers, promised to form a tribunal to hear and determine cases of the alleged malpractices.

“The 880 cases have been lodged with the board. Seven hundred and thirty-five (735) have been determined at Preliminary Inquiry Committee (PIC) level,” said the board’s chief executive, Daniel Yumbya.

“Out of these, 15 cases have been determined by the Full Tribunal and 13 cases have been determined by the Professional Conduct Committee (PCC).”

The National Hospital Insurance Fund (NHIF) plans to start paying up to Sh5 million in hospital bills for members with chronic illnesses seeking treatment abroad.

Only sicknesses that cannot be treated locally due to lack of equipment or specialised doctors will qualify for treatment abroad.

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