Hospitals incur heavy losses from ‘defaulting’ patients

King Faisal Hospital in Kigali.Hospitals have called for support to tackle losses that they have been incurring . Photo by Sam Ngendahimana

Hospitals have called for support to tackle losses that they have been incurring as some patients do not pay for the health services they provide them.

They exposed the issue on Monday, September 28, 2020 as the Parliament’s Public Accounts Committee (PAC) was listening to their responses to issues in public finance management that were identified by the 2018/2019 report by the Auditor General.


PAC heard that most of the patients are economically disadvantaged people including the retailers of a handful of commodities for survival in Nyabugogo taxi park and its surroundings.


Some escape hospitals, while others provide wrong identification and do not have identity cards such that it is difficult to follow up on them so that they may pay in the future.


In the 2018/19 financial year, Masaka Hospital had a target to generate over Rwf3 billion revenue, but made only Rwf1.4 billion.  

MP Mediatrice Izabiliza wanted to know factors that might have caused the hospital to make less than half of the targeted revenue, pointing out that such low performance has a negative effect on their financial plans.

Masaka District Hospital Director-General, Dr. Marcel Uwizeye said that there are many arrears, including those owed by the community-based health insurance scheme – Mutuelle de Santé – and the outstanding medical bills for services offered to economically vulnerable patients.

“There are unpaid health services that we provide to patients who do not have means to afford them, which have grown to Rwf350 million,” he said.

“All that is money that we should plan for, expand our activities, buy medicines and generate more revenues through provision of more medical services,” he said.

The Auditor General’s report showed that Muhima Hospital was faced with the issue of increasing number of patients who do not pay after receiving health services, pointing to Rwf41 million arrears.

Muhima Hospital Director-General, Dr. Pascal Nkubito said that those arrears stem from patients who leave the hospital without paying the fees for the health services they were provided – because of lack of means.

“We treat the patients, and when they lack means to pay for the health services, they leave the hospital... We need guidance on how to follow up on such arrears in the community,” he said, indicating that the hospital submits regular reports to the Ministry of Health and the District (Nyarugenge) about such issues.

MP Annonciata Mukarugwiza, vice-chairperson of PAC said that although some patients are not able to cover the medical bills immediately, such money could be recovered if the hospitals put in place effective follow-up mechanisms.

“They are people who are unable to pay immediately, but are able to manage later. Such money is meant to help buy other medical equipment and medicines to enable the hospital to treat other Rwandans,” she said.

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