TO LEASE OR PURCHASE?

Three crucial factors ignored in Medical Equipment Scheme deal

MES was a good idea but poorly executed.

In Summary
  • Leasing is a good option if you have equipment that requires high and regular maintenance but you don’t have the capacity for that maintenance.
  • No needs assessment was carried out.
Abraham Rugo, Country Manager International Budget Partnership - Kenya. /COURTESY
Abraham Rugo, Country Manager International Budget Partnership - Kenya. /COURTESY

The Medical Equipment Scheme has turned out to be another big scandal.

Through the scheme, we were trying as a country to address the problem of availability and cost of specialised medical attention.

Save for the level 6 hospitals, there are few hospitals with proper facilities like dialysis and chemotherapy equipment.

 

Previously one needed to find a private facility and pay huge sums. The other option was to travel to Kenyatta National Hospital where sometimes people had to wait for dialysis for a week or two.

There was and still is need for specialised treatment, which one should be able to get within an area that is reachable, accessible and the services must also be affordable.

That is the problem that the government was trying to solve. Following devolution, the health function was handed over to counties. This means from former provincial hospitals downwards, all are under the counties.

Therefore, whatever decision that was being taken about the equipment needed to have considered three factors.

First, who is going to operate the equipment? Are there people who are trained? Second, is the capacity of the facility to host that equipment and the third is the cost.

The national government went ahead and effected the scheme with little consideration for the three factors and started deducting money from the counties.

Leasing is a good option if you have equipment that requires high and regular maintenance but you don’t have the capacity for that maintenance.

 

It is that you want something whose initial cost is very high as well as the cost of maintaining them so you lease for some time, but there is also a system where you lease to own.

Because of that initial error of not matching the infrastructure, human resource and budget, we ended up with a situation where national government is making a decision that is technically a county government’s decision.

I personally don’t have the verdict of whether buying or leasing is the best option if the above three factors are not considered.

The International Budget Partnership country manager spoke to the Star