Government Debt Puts Health Sector on the Brink of Collapse

Exclusive to "SadaNews": Many citizens are complaining about the lack of health services in government hospitals, whether in terms of transferring patients to private hospitals or in terms of the availability of medications for many diseases. Is the suffocating financial crisis facing the Palestinian Authority threatening its ability to provide health services?

The Executive Director of the Union of Pharmaceutical and Medical Supplies Suppliers in Palestine, Mohannad Habash, confirms to "SadaNews" that the health sector currently relies on a "matchstick" and could soon witness a complete collapse.

He states, "Day by day, we hear hospitals issuing distress calls," pointing out that the suppliers' union has tried with the Ministries of Health and Finance to keep the health sector resilient amid the severe financial crisis the Palestinian Authority is undergoing. He noted that, while other sectors like education have collapsed, the health sector continued to provide public services until recently.

He explains that the current problems in the health sector are manifold, including the cessation of medical transfers from the government sector to private hospitals, as cases that do not have treatment and medications available in the government sector are referred to the private sector, which in turn issues invoices to add to the debt. He states, "But we have reached a point where we cannot continue with this mechanism and accumulate debt upon debt."

He indicates that pharmaceutical companies no longer have the capacity to continue supplying medications to government hospitals due to the rising debt and the lack of means to purchase additional quantities, noting that companies need to ensure liquidity to allow them to operate at a minimum level.

He adds, "Companies have almost stopped supplying medications to the government and have lost capacity," noting that the supply is scant and does not exceed 5% of the normal supply.

He points out that what keeps companies going is the availability of cash flow from private hospitals, but private hospitals can no longer maintain their level of services to the government sector in this regard.

He adds, "The types of medications available at the warehouses of the Ministry of Health and government hospitals are very scarce; more than half of the medication types have a zero balance," noting that a month and a half ago, there were about a thousand types of medication not available at the government, and certainly, the situation is worsening over time.

Regarding the size of the health sector's debts owed by the government, Habash noted that the debt is divided into several categories: the price of medications supplied to the Ministry of Health, medical transfer costs to private hospitals, and costs of medications supplied to private hospitals for cases referred from the public sector.
 
He clarifies in his conversation with "SadaNews" that the direct debt owed to the companies for the price of supplying medications and medical supplies to the government reaches about 1.3 billion shekels, in addition to debts to private hospitals amounting to 2.3 billion shekels, meaning that the debts of the health sector owed by the government to private hospitals and pharmaceutical companies reach 3.6 billion shekels.

Habash points out that the debt figures are increasing month by month, having reached historic levels, noting that the last payment received by the companies was five months ago and amounted to only 15 million shekels.

It is noted that the available figures from the Ministry of Finance and Planning show that the size of public debt reached about 47.7 billion shekels by the end of January, distributed among 10.7 billion shekels in domestic borrowing, 4.2 billion shekels in foreign borrowing, 7.9 billion shekels in dues to employees, 8.2 billion shekels in dues to the private sector, and 16.7 billion shekels in debts to the pension fund and other entities.

For his part, Shaddad Abdullah, a healthcare expert, states, "We have only weeks left, not months, before the healthcare system in the West Bank comes to a real working halt."

He points out that the last payment transferred by the Ministry of Finance to the private and community hospitals or to the pharmaceutical suppliers was over six months ago, explaining that the original agreement for scheduling the Ministry of Health's debts to suppliers and service providers stated that 3% of the total debts of the Ministry of Health would be transferred monthly, but the amount disbursed monthly has declined to 1.5% of the total debt, until the Ministry of Finance stopped payments altogether months ago.

He illustrates that the debt size of some hospitals receiving medical transfers has exceeded 700 million shekels, while the debt size of pharmaceutical suppliers for some companies has exceeded 100 million shekels.

He states, "The total accumulated debt of the Ministry of Health to suppliers and service providers has exceeded 3 billion shekels at a minimum."

He clarifies that the most affected patient categories are cancer patients, and their biggest threat currently is the inability of private hospitals to admit new cases, accompanied by the complete lack of all the resources of government hospitals for medications and treatments.

He calls for the preparation of emergency budgets and stringent governmental restrictions on unnecessary expenses outside the health, education, and local governance sectors, as well as restructuring the categories of beneficiaries from government health insurance according to the economic condition. He concludes by saying, "This is a very late early warning."