Gaza-the Coalition for Integrity and Accountability-AMAN conducted a workshop where medical referrals to hospitals and clinics outside the Palestinian Ministry of Health institutions. Prior to holding the workshop AMAN had prepared a report entitled “Problems and Challenges in Medical Treatment Referrals to Institutions outside the Ministry of Health in the Gaza Strip”. Recommendations of the report included those that would help decision-makers to promote integrity in the environment of medical referrals; define services that can be developed to reduce or limit referrals to other institutions; and rationalization of public spending.
During the workshop, the researcher who prepared the report pointed out the main results of the report; one of which is the absence of a specific and clear standard that governs the selection of the country of treatment. As it stands, the country of treatment is determined by the specialization department, the minister of health, or the president’s office. This in turn has led to lack of justice in providing medical services to citizens. As a matter of fact, there are times when the patient is sent for treatment abroad at a high financial cost, when the same treatment is available at local medical centers for a much lower cost. This is an example indicating that there are many interventions by other parties that pressure to define and or change the location of the t. transfer.
Other issues highlighted by the report included weakness of control over hospitals that patients are transferred to especially Israeli hospitals, hence resulting in waste of public funds; lack of assigning professionals to monitor patients in hospitals that are transferred to and especially Israeli hospitals, hence providing opportunities for some hospitals to loot public funds by issuing unrealistic medical bills unprecedented for such treatments. Moreover, some hospitals prescribe medications and treatments that were neither requested nor are the reason for the patient’s transfer. In addition, the report revealed other serious abuses which led to the waste of public funds.
The researcher, Hassan Duhan pointed out that there is no specialized unit for receiving complaints. This issue is left limited to the director of the treatment department abroad. He also added that there are no powers given to professional employees to solve the patients’ problems.
Mr. Wae’l Ba’lousheh, Director of Gaza’s AMAN office was the one to open the workshop and also to point out that AMAN targeted the Ministry of Health due to the important role it plays in people’s lives symbolized by the services it provides to citizens, who by the way expect semi-perfect services from it. However, Mr. Ba’lousheh said that the Ministry has been affected negatively due to the Israeli occupation and the internal political division hence increasing its burden.
Dr. Bassam Budairy, Director of the Department for Treatment Abroad in the Gaza Strip, presented procedures, followed by the Ministry, that ensure transparency and integrity in medical referrals abroad. He also added that the department works around the clock to ensure better service for the citizen. Moreover, he pointed out that the department recently scrutinized several doctors’ reports when realizing that they are inaccurate. It also refused to transfer several cases abroad when it became clear that there is no need to do so. When asked about measures taken against those who present false reports, he said that the department refuses to accept their reports. With respect to exceptions made regarding medical referrals, Dr. Bassam clarified that he receives requests from the office of the Minister to examine the validity of need to transfer the case. At the same time, the Ministry tries to limit medical exceptions in line with with the many mechanisms at hand. Dr. Bassam made it clear that the department is always ready to cooperate with AMAN with the aim of improving services for the citizens, especially in regard to disseminating information and regulating the complaint unit at the department.
On the other hand, participants emphasized the need to make all information concerning treatment abroad available and accessible to the citizens, especially procedures to obtain treatment abroad.
Participants put forth recommendations which included: forming specialized medical committees to be appointed by the Supreme Medical Committee in regard to medical transfers abroad, conditional upon meeting weekly and that members rotate regularly in order to handle emergency cases; importance of increasing the number of employees in the specialized treatment department as well as in the higher administration for transfers abroad and to ensure that they are trained and qualified to deal with the public; establishing specialized complaint units in hospitals that are available around the clock and function as communicators between heads of divisions and physicians to solve problems received through complaints by patients and their relatives.
Other recommendations included forming medical committees for monitoring and control over hospitals that receive referred cases. These committees should also be tasked with follow-up duties with the patients and their cases to prevent waste of public funds; prepare a qualified cadre to make periodic control on patients’ files in hospitals housing referred cases; develop a survey/questionnaire to be included with the transfer papers in order to study the extent of satisfaction of referred patients of the purchased services.
Finally, participants stressed the need to put an end to all exceptional cases received by the Department of Treatment Abroad, and to subject all cases to examination in-line with procedures normally followed except in very rare cases.
This project funded by EU