The Hieroglyphs of Health

The Medical Syndicate Urges the President of Egypt Not to Sign the "Hospital Leasing" Law

Civil Society Develops Argument for Rejection

In recent days, Egypt’s Medical Syndicate has urgently appealed to the President not to sign the controversial law regulating the leasing of public health facilities to private sector companies, commonly referred to as the "hospital leasing" law. This appeal follows the House of Representatives' approval of the bill last week.

Initially returned for review on May 9, the law underwent amendments to reduce the allowed percentage of foreign workers and ensure service provision to state-funded healthcare beneficiaries. Despite these changes, which were perceived as favoring investor control, the law was approved by Parliament a few days later.

The Syndicate argues that the law jeopardizes the safety and health of citizens, destabilizes the health system, and lacks guarantees for the continued provision of services, particularly to low-income individuals. Concerns have been raised about the investor's commitment to treating social health insurance patients at the state's expense and the absence of clear criteria for selecting hospitals to be leased.

While the Syndicate supports private sector participation in creating and establishing new hospitals to enhance healthcare services, it opposes leasing existing government hospitals that primarily serve low-income Egyptians. The union warns that the law could jeopardize the jobs of 75% of workers in these facilities, including doctors, nurses, and administrators, as investors may choose to replace them or relocate them through the Ministry of Health. Additionally, there is apprehension about the possibility of investors hiring doctors from unrecognized universities, whom the union's general assembly has decided not to register.

Despite submitting their concerns to the Health Committee of the House of Representatives, the law was passed, sparking objections from doctors, representatives, and human rights organizations. They view the law as the state relinquishing its constitutional duty to provide health services, allowing private sector management that could compromise service fairness.

Key Objections from Civil Society

The Right to Health civil society organizations have further developed their arguments against the concession law, stating key objections:

1. Contracting Methods: The government can choose between public tender or direct agreement without needing parliamentary approval after presidential licensing.

2. Profit Limits: The law exempts investors from profit limits mandated by the "Public Utility Obligations" Law, potentially leading to high profits at the expense of public health.

3. Worker Job Security: The law threatens the stability of 75% of current health facility workers by allowing investors to replace them.

4. Quality and Access: Concerns exist about maintaining the proportion of beds allocated for government-funded treatment.

5. Regulatory Loopholes: The law allows significant flexibility for investors without ensuring necessary service quality and fairness.

Concerns About Implementation

Civil society raised additional concerns based on previous and practical experiences with private sector involvement in hospitals. This experience indicates a preference for well-equipped facilities in prime locations, often leading to higher costs without proportional quality improvements. The General Investment Authority had previously proposed numerous opportunities for private sector management of government health facilities.

Doctors criticize the law for making healthcare for the poor susceptible to profit motives. Before the law's official enactment, the government had already proposed leasing several hospitals to investors, raising further objections and fears.

Defense and Objectives of the Law

Proponents, including the Minister of Health and the Health Committee, claim the law benefits patients by not imposing additional financial burdens and enhancing service quality. The law aims to reduce government spending on healthcare, aligning with the state's policy of allowing private sector investment while maintaining public sector funding for essential services.

Call to Action

The Medical Syndicate calls on the President to reject the law, emphasizing its potential to harm public health and destabilize the health system. They stress the need for a more balanced approach that safeguards public health interests and worker security while encouraging private sector contributions to new healthcare infrastructure.