Audit exposes rot in Soroti Hospital private wing, management blames underfunding

________________

In the eyes of many Ugandans, private wing services in public hospitals are the holy grail of healthcare. And truth be told, a pocket of private wings at district or regional referral hospitals (RRHs) now rival top private establishments.

According to the 2010 Guidelines Manual, these are defined as “services which are paid for or paid higher rates than the general side, which are faster, have better ambience, private rooms, and privileged access to a higher cadre of medical staff, food and other personal care hotel services.”

Regulations

Such subdivisions in public health facilities are regulated by the health ministry (MOH), through its Directorate of Health Governance and Regulations. Under the two-tier system, direct out-of-pocket expenditure has long been touted as a game changer in improving the quality of services and the package of health care workers.

The finance ministry (MOFPED) documents showing that revenues generated from the private wing services increased from shillings 9.627 billion in the 2011/12 Financial Year (FY) to 1.774 trillion in FY 2014/15.

Over the years, the amount has significantly increased. With the Parliament health committee's report on the ministerial policy statement for 2025/26 citing Butabika Hospital as a case in point. The facility reportedly proposed raising its Non-Tax Revenue (NTR) target from 1.2 billion to 1.5 billion, having already collected 900 million by the half-year mark of FY 2024/25.

While the intent of setting up a private wing might be noble, who do you run to when this sub-division of a hospital falls ill itself?

AG report

One troubling example is Soroti Regional Referral Hospital (RRH), which was flagged by Auditor General (AG) Edward Akol for substandard private wing services.

In his report for the year ending 2024, Akol noted the facility’s private wing, comprising 26 ward beds and five intensive care unit (ICU/HDU) beds, was in a sorry state.

The AG observed that washrooms in the private wing had dilapidated plumbing, poor hygiene and insufficient cleaning detergents. Toilets didn’t flush, some lacked cistern covers, and others were completely unusable.

Prevailing challenges

Cognizant of the above, MPs on the Public Accounts Committee (Central), such as Silas Aogon (Kumi Municipality, Indep) on July 11, 2025, questioned the relevance of this sub-division in a facility overwhelmed with infrastructure challenges.

The facility run by Dr Ben Watmon serves a catchment population of 2.7 million from 10 districts and one city that make up Teso region. And yet, operate with only one mortuary fridge with a two-body capacity.

The facility started as a syphilis treatment centre in the 1940’s. It is one of the 13 regional referral hospitals, having been elevated to this level in 1996.

“There should always be a difference between private and public wings. Now, if the private wing also has dilapidated toilets, without running water, I guess now, even cockroaches are meandering around,” Aogon mused.

To him, the staff manning this facility deserve an award for accepting to work in sordid conditions.

“Why did you opt for a private wing?” Namugga probed.

“If you find someone working with MTN or Airtel in Soroti or a bank and they have insurance, they would be coming to you. But because of the state of your private wing, that’s why you see some private facilities have come and they are taking money from you. You will end up not generating money to help you sustain it,” Elijah Okupa (Kasilo County, Indep) said.

Hospital speaks out

Soroti RRH director Watmon attributed the poor state of the private wing to limited funding. He explained that the hospital receives just shillings 28 million annually to restock medicines which translates to shillings seven million per quarter.

He further explained that the hospital submits a planning figure to the finance ministry projecting expected revenue collections, an amount that should be reimbursed. However, for the past three years, despite an indicative figure of 200 million annually, they have only received 100 million.

“We collect even more….(in 2023/24 FY), we were given 100 million, we collected 150.6 million and we remitted all the money to Finance,” Watmon said.

Adding that they are also prohibited from spending the revenue at source.

Domestic arrears

During the year under review, the hospital accumulated domestic arrears worth shillings 625.35 million contrary to Section 21(2) PFMA, Cap 171, which provides that a vote shall not take any credit from any local company or body unless it can pay the expenditure from the approved estimates as appropriated by Parliament for that financial year.

These liabilities included shillings 548.2 million owed to National Water and Sewerage Corporation (NWSC), shillings 9.8 million to Uganda Telecom Limited, shillings 8.9 million in PAYE arrears to Uganda Revenue Authority (URA) and 28.98 million to Nile Energy for fuel supply, among others.

NWSC responds

NWSC spokesperson Samuel Apedel on Thursday revealed that negotiations are ongoing with the finance ministry to resolve the water arrears.  This was in a telephone interview with New Vision Online.

“We have been engaging with Ministry of Finance and in the current budget, there is a provision to clear some of the arrears. Unfortunately, one of the problems is that people underbudget for these utilities and sometimes the money for utilities is used for other activities,” Apedel disclosed. 

“Going forward, we encourage people to budget for what they consume,” he added.

Political clout

This left many lawmakers questioning how such dire conditions persist at a hospital in a region that is home to several prominent leaders, including Speaker Anita Annet Among and Vice-President Jessica Alupo.

However, Bugiri Municipality MP and JEEMA party representative Asuman Basalirwa argued that the root of the problem lies in the government’s failure to commit a substantial amount of funds from the national budget to the ailing health sector.

Controversial move

If possible, he suggested that Parliament should consider passing a resolution compelling all leaders, including MPs and ministers, to seek treatment at their local health centres. Arguing that this is the only way meaningful change at the base will happen.

He raised this point during the Soroti Hospital session and reiterated it in the subsequent meeting with officials from Moroto Hospital.

“One time, the late Prof. Apollo Nsibambi had a helicopter crash in Bugiri. He was brought to Bugiri Hospital, our hospital. He couldn't stay there for 10 minutes. He was complaining that the situation was unbearable. But we were saying, ‘but this is where we get treatment from and you’re the Prime Minister.’ So instead of working on the hospital, to be good for everybody, why do you want to create preferential treatment,” Basalirwa alluded.

“But the problem is that they will also refer them to Mulago or elsewhere,” he added.