adminVusumuzi Dube Municipal Reporter
GOVERNMENT has ordered all councils to provide 24-hour outpatient services manned by a medical officer at their clinics, in a bid to increase the scope of health care centres and offer comprehensive services at primary care levels. However, the move is likely to face resistance from some local authorities, with the Bulawayo City Council (BCC) expressing reservations over the implementation of the order. The council is instead suggesting that the Government applies for land to establish a district hospital.
The order was made during a meeting between officials from Ministry of Health and Child Care and directors of health services from the cities of Bulawayo, Harare, Gweru, Masvingo, Mutare and Chitungwiza.
Harare City Council has already implemented the order.
According to the latest council report, the Ministry had convened the meeting with the main aim of developing strategies to use every opportunity and available health facility to offer a level of appropriate comprehensive health care, particularly at primary care levels. The thrust is to use urban and rural facilities in a more efficient manner and as part of a well-defined referral system.
“Central government wishes to see services ordinarily provided at secondary level care brought to the primary care without clarifying the source of funds. Harare City appears ready to move forward with this. The other cities invited were not expected to take this up in the short term as they have no resident doctors but the city of Bulawayo was expected to be next in line after Harare city.
“The Secretary for Health and Child Care indicated that increasing the scope of services offered by local authorities had been discussed at cabinet level and Government was anxious to see it implemented,” read the Bulawayo City Council minutes in part.
The health ministry is going to second doctors to local authorities for rotation as is done at district hospitals with an emergency service (casualty) being availed.
“This would be the first port of call for emergencies like road traffic accidents where minor procedures like Plaster of Paris (POP) application, suturing would be done, major accident cases would be referred directly to the hospital.
“In an effort to reduce maternal mortality, emergency obstetric services for example a theatre to conduct caesarean section (CS) and other like procedures, would be availed,” read the minutes.
The Ministry also ordered BCC to go ahead with their authorised engagement of nurses with the view being this should be implemented as a matter of urgency despite the Government not pledging to honour the public health financing agreement of 1974 and regardless of council management’s stated view of inability to meet salary obligations.
However, BCC has further put themselves on a collision course with the ministry after rejecting the move, arguing that Government had previously reneged on funding the sector.
“Council was beset with problems of severe staff shortage and faces the problem of; markedly reduced revenue inflows, a Government that has reneged on funding the delegated health services provision despite an agreement signed by the two parties.
“Council being compelled to reduce the salary portion of its revenue expenditure to maintain a 30 percent salaries is to 70 percent service delivery ratio. Increasing the scope of services offered would surely entail increasing the staff establishment and consequently the staff costs. This was therefore not an opportune time to take this on. This opinion could be reviewed as fortunes of the country take a turn for the better,” read part of the submissions made by the city’s director of health services, Dr Zanele Hwalima.
The local authority also suggested that the Government would better apply for land for a district hospital in the city if they wanted to increase the scope of operations.
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