Ban on medical workers moonlighting is uncalled for

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OPINION

By Dr Myers Lugemwa

For an immensely long time and until not long ago, one would see Uganda's gallant senior doctors-Prof. Ndugwa, Kyalwazi, Ssezi, Kakande, among others, now deceased and Freers, the Nzarubaras, the Kiryas, Zirembuzis, name them, and still living, go back to the hospital any time of the day or night to check on some seriously sick patients admitted on their wards.

This, they did not only out of professional responsibility but "Obuntu" and the "Call" from the noble medical profession. Officially, these were and many others, consultants whose main work is not only to treat very complicated cases, teach undergraduate and postgraduate doctors, conduct research and but also act as an advisory team to the running of their institution and government, for good patient outcomes and the health system.

Their routine of work, therefore, did not or does not entail the 8-hour schedule where handover after working for eight hours (Day, Evening and Night) because they can be consulted anytime of the day or night, Christmas or Idd to come and conduct a complicated manoeuvre, that a junior doctor is unable or has failed to do.  These highly professional gurus include others from many other disciplines in the medical field such as Radiology, Haematology, Cancerology, to name but a few.

Reading with consternation the article titled, " Medical Workers Banned from Private Facilities" that appeared in the New Vision of November 7, 2025 page 5, I felt it prudent, not only as a senior doctor in the profession, but   also as a Ugandan whose gut feelings tell me that banning medical workers from private facilities may be a tall order to implement let alone supervise.

With a probability of 100% of any health worker being a patient in any of our hospitals in the country, I certainly and without any reservation would not entertain any absenteeism of any health worker from a health facility when they are officially appearing on the duty roster for the day! I repeat, I wouldn't entertain absenteeism, be it by a porter whose work is to wheel the patient from reception to the ward or even the mortuary if one does not make it back home.

In submitting as quoted from the New Vision of the date in question, "Save for holding and managing appropriate personal or family investments not in health, HWs shall refrain from any financial or business dealings which may interfere....  " A health worker, whilst holder of a public office manage, may own property and may be a dormant partner or shareholder in a family or company, but shall not serve as an officer, or manager or employee of any business and shall, under no circumstances in be engaged in a private health facility or be active or dormant partner or associate in a private health facility," Reads the draft Health Service Standing Orders.....Those who go against the standing orders will be asked to quit". End of quote.

In my opinion, (If at all my opinion matters) I wish to submit that this pronouncement cam draft proposal can be likened to enslavement of the noble profession where the subjects are encaged with but only two options. Either to stay on and pretend to appease their employer at the expense of the life of the patient or quit at the expense of depleting the few senior colleagues (doctors, etc, etc) from government health facilities. This is not the first time such a thing is happening. 

Doctors like the late Bamundaga, Mivule who graduated way back in the 1930's and later Dr Ndugwa (Sr.) and the Rt. Hon. Dr Kisseka resigned from public service in the late 1950s and became a full-time private practitioner following similar orders from the then colonial government.  Likewise, young consultants have left Mulago Hospital following more or less similar unpalatable measures.

In Medicine, before treatment is prescribed, one has to take the history, examine the patient, investigate, make a diagnosis and prescribe treatment. In this regard, I am wondering whether, before the above proposed draft standing orders were brought forth, they were subjected to the same process in which the medical workers under discussion were engaged, at least to probe the reason d'être why they absent themselves even after the recent reasonable increase in their remuneration.

Ironically, other professionals, to wit: An Agricultural Officer, may own and run a farm without interference from the government. An Engineer may own and run a garage or construction company in Wandegeya without the Ministry of Works and Transport barring him from doing so. A veterinary doctor will certainly own and run an animal farm in spite of being an employee of the Ministry of Agriculture, Animal and Fisheries. An MP who has some private business is not prohibited from running the same as long as they attend Parliament session religiously. I am made to believe that even lawyers may have a clinic as long as its operation does not infringe on their schedule in court.

My submission therefore, is that the proposed standing orders be stayed and a deliberate effort to find out why the workers in question abscond from their work place with abandon to go and moonlight in other places despite the recent increase in their remuneration and a mechanism to ensure compliance to the fulfillment of duty as per duty roaster((critical patient management, teaching,  research, etc for consultants and other senior staff)  is employed and sanctions applied accordingly. Otherwise, public HFs are apt to suffer brain drain or brain in the drain with much meagre outputs than is currently on.

The writer is a medical doctor