Gov't insists on bonding policy for medical interns

PIC: Sarah Opendi(R), minister of state for health and Joyce Moriku (L) minister of state for primary health care appearing before the health committee of Parliament on September 20, 2016. Photo by Maria Wamala

It's a take it or leave it for medical interns as government out rightly rejects ‘pleas' for it to reconsider its contentious policy of bonding all medical interns for two years  before they can be allowed to engage in private practice.

"If you don't want to be bonded, please pay for your internship. Government cannot spend public resources training people who simply walk away after graduation without rendering services to the public for at least two years," Sarah Opendi, minister of state for health told lawmakers sitting on the health committee on Tuesday.

Opendi with minister of state for primary health care, Joyce Moriku, senior staff of Uganda Medical Association (UMA), Clara Odhiambo and leadership of 2016/17 medical interns, was at Parliament to respond to issues raised by the recent strike by medical interns over late payment of their allowances.

At the tail end of the ninth Parliament, the then chairperson of the health committee, Dr. Medard Bitekyerezo mooted the idea of government bonding all medical graduates for at least a year as a way of mitigating the perennial problem of inadequate key staff in public health facilities.

The proposal which has since been adopted by government means that fresh graduate medical doctors, pharmacists, nurses and anesthetists  mandatorily have to serve in government health facilities for some time before they can choose to seek employment in private health facilities or leave for greener pastures abroad.

UMA secretary general, Clara Odhiambo, and Fauz Kavuma, the chairperson of 2016/17 prospective medical interns questioned the rationale of the bonding policy, describing it as iniquitous and discriminatory.

"Why is bonding being designated only for medical profession alone? Why not bond lawyers and teachers too? That is why doctors feel targeted," Odhiambo said, urging government to consider dialogue with medical interns on the length of bonding.

Odhiambo said that bonding on its own cannot address the problem of scarcity of critical staff in government facilities if poor conditions of service are not urgently addressed.

Being the first batch of medical interns to be affected by the policy, Kavuma made a case for the bonding period to be reduced to one year with an option of increasing to two years later.

"In principle, it's a good idea. But when it was passed last year, we were never informed. It's like an ambush," Kavuma said.

Kavuma and his deputy Noah Emokol raised the issue of privately sponsored medical students whom they averred would be unfair to be bonded.

Opendi said medical students whose internship bills are picked by government but find bonding unacceptable can 'buy their freedom' by refunding allowances earned during internship.

Ministry of health officials told MPs that government expends sh1m gross per month on every medical intern during the one year mandatory practical training. But the allowance is subject to taxes.

Government, Opendi said, has earmarked sh9.3b for 752 medical interns over the next year.

Since government restructure public funding of education at tertiary and university level prioritizing science disciplines like medicine, a number of stakeholders have called for mandatory bonding of graduates to stem the tide of Ugandan doctors leaving for greener pastures immediately after graduation.