State-run hospitals in six provinces will soon receive new funding from the Ministry of Health to help provide free health care to the poor, a ministry official said Wednesday.
The new funding, provided through a so-called donor’s equity fund, will begin in May for the provinces of Prey Veng, Kompong Cham, Mondulkiri, Preah Vihear, Ratanakkiri and Koh Kong, said Mam Bun Heng, the ministry’s secretary of state.
“Through the equity fund, we will pay for transportation and the whole treatment fee for the poorest patients,” Mam Bun Heng said, though he did not disclose how much money is involved.
The equity fund has already provided free medical treatment for the poorest patients in Siem Reap, Pursat, Banteay Meanchey, Svay Rieng and Takeo since 2001.
A recent round of contributions from donors—including the UN Children’s Fund, Department for International Development and the Japanese government—will extend the equity fund’s reach to the six additional provinces, and will be meted out over five years, Mam Bun Heng said.
In provinces where the equity fund is not in place, hospitals have relied solely on a financial scheme established in 1997, which provides free treatment only for the poorest patients, and charges those who can afford it.
Under that scheme, 50 percent of fees go to the doctors; 49 percent for hospital renovations; and 1 percent to the state, according to Chen Chhear, the acting director for the Ministry of Health’s department of hospital services.
For an average state-run hospital like Kompong Speu Referral Hospital, a patient is generally charged $7.50 for a five-day stay, said Mihn Sovuthy, the hospital’s director. For longer stays, the hospital charges an additional $5 and the fee for surgery is $62.50.
But there have been problems determining who is rich and who is poor, Chen Chhear said.
Initially, hospitals asked the commune chiefs to write a letter for poor patients to give to the hospital to authorize free treatment. Then, she said, they found that commune chiefs were often writing letters for rich relatives.
Since 2002, she said, hospitals have a task force to evaluate patients.
“The task force…looks to see whether they wear gold or diamond jewelry,” she said, adding that if they “smell beautiful and have gold,” the hospital charges money for their treatment.
Regardless of problems in implementation, Sin Sumony, the executive director of Medicam, an umbrella group for health NGOs, said the financial scheme is good for Cambodia because the government simply cannot afford to provide free treatment to all.
Lack of assistance from such programs as the equity fund, however, has meant the standard of health care has suffered, Mam Bun Heng said.
“When we don’t have the equity fund to support the hospital, the hospitals cannot make enough money to sustain operations,” he said.
But an adviser to the ministry of health, who spoke on condition of anonymity, said the financial scheme does not address the fact that most people don’t go to the state hospitals.
“The people don’t have confidence in the state hospitals. They go to the private clinics, rather than the state,” the advisor said. “And besides paying [state hospitals] according to the financial scheme, they [still] have to pay the doctor directly to get more and better treatment,” the adviser added.
