Parliament, key ministries to interface over healthcare gaps in regional hospitals

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Parliament is at a yet to be designated date next week set to meet with three ministries to address critical gaps in health care service delivery.

The engagement, expected to feature the ministers and permanent secretaries (PS) of public service, health and finance, will also be graced by the Speaker of Parliament.

Public Accounts Committee (Central) vice-chairperson Gorett Namugga disclosed this on Wednesday, July 30, 2025, during an engagement with officials from Mbarara Regional Referral Hospital, led by director Dr Deus Tumwesigye.

“We wanted to finish all the referral hospitals such that we can know those that are too ill…. Some of these things will not wait for the Treasury Memoranda. We are not going to be in the house, mentioning procedure or order,” Namugga stated.

Understaffing

According to Auditor General (AG) Edward Akol’s report on Mbarara Regional Referral Hospital for the year ended December 2024, out of the approved structure of 1,269, only 301 (23.7 per cent) were filled.

Leaving several critical positions unfilled, including senior consultant medicine, consultant (anaesthesia), consultant (orthopaedic), consultant (pathology), consultant (surgeon), MOSG (psychiatry), MOSG (anaesthesia), MOSG (pathology) and ophthalmic clinical officer.

A Medical Officer Special Grade (MOSG) is a senior medical doctor who has a master's degree or equivalent in a clinical speciality and has more experience than a general Medical Officer (MO). But still below a Consultant in the professional hierarchy.

While 18 new cadres have since been recruited and 32 others promoted to plug the gaping hole, Members of Parliament contend that this is not a matter to be taken lightly.

“Under internal medicine, according to the structure, you’re supposed to have 186 staff under the approved structure. You have 56 and 130 vacant positions…. When you go to paediatrics and child health, you are supposed to have 91. You have five staff,” Namugga said.

“If you look at surgery, you need 67 staff, you have seven. It’s not about this being a query time and again, we are dealing with lives and just remember we have just started the financial year, as PAC, we can move the Government to ensure that these regional referral hospitals are given sufficient funding under the wage. Your basic mandate is to treat the people, so if you can’t have the staff to handle this assignment, then what are you there for?” she wondered.  



Death in hospitals

In light of these revelations, former health state minister and Tororo District Woman Sarah Opendi (NRM) contended that staffing shortages could be a key reason why many Ugandans die prematurely in hospitals. Deaths that she says could have been averted if there was adequate care.

“Imagine someone comes to the hospital, but there's no one to attend to them. For instance, in ENT, the staffing is zero, none of 21 positions filled. In orthopaedics, only seven out of 45 are available. Assuming these orthopaedic doctors are engaged, maybe one is busy in theatre or two, the others may be away, we are human beings, what happens?” Opendi said.

Regrettably, Isaac Modoi (Lutseshe, NRM) said many of the doctors who would have filled these ranks are roaming the streets jobless.

“There is a ceiling (recruitment), and yet we have manpower which graduates every year in these relevant sectors. So it is parliament, I believe, that should come out with the policy,” Modoi said.

Space crisis

The facility serves eleven districts and one city. In 1989, it was designated as the teaching hospital for Mbarara University of Science and Technology (MUST) and, as a result, was placed under the Ministry of Education, where it remained until 2005.

Currently, the hospital operates 42 units. However, due to the highly specialised services it now offers, Tumwesigye says the hospital, originally designed for a 370-bed capacity, is overwhelmed.

“We've actually come to 450 beds. Unfortunately, there is no physical expansion. We've been forced now to narrow the spaces between patients' beds. Occasionally, we admit under these same beds. You find a patient is on a certain bed, and now another patient comes, gets forced to go on the floor, or even sometimes under the colleague's bed. We've had patients in tents,” Tumwesigye admitted.

To make it worse, sister facilities like Kabale, Fort Portal, Masaka still refer to them because of specialists they have and high standard labs they possess, which are accredited internationally.

Looming water crisis

In his report, Auditor General Edward Akol noted that Mbarara Regional Referral Hospital had accumulated domestic arrears amounting to shillings 716 million as of June 30, 2024. This included Sh695 million in unpaid utilities and shillings 20 million for goods and services consumed.

Of the sh648 million carried forward from the previous financial year, only shillings 320 million (five per cent) was settled. Additionally, new arrears totalling shillings 100 million were incurred during the year.

According to Tumwesigye, the bulk of these arrears stems from unpaid water bills. He explained that while settling them remains a priority, the costs have continued to rise, partly due to insufficient budget allocations and partly due to wastage caused by the hospital’s ageing plumbing system, which dates back to 1952.

Despite efforts to mitigate the problem, including harvesting rainwater from hospital rooftops and installing automatic taps, the hospital remains overwhelmed by the sheer size of the population it serves.

“I am actually very scared. Very soon, we shall commission a call and dispatch centre. It is coming up. And this call and dispatch centre has a horse pipe. All these ambulances are going to be now cleaned and washed from the hospital compound. We have a 100-bed capacity neonatal intensive care unit that is coming up. We don’t see any increment in funds we are receiving,” Tumwesigye warned.

In the year under review, the budget for water was sh560m. This year, the facility was allocated Sh660m but officials contend that that they need around sh800million.