National hospitals in Egypt shut down despite COVID-19 pandemic

The Central Agency for Public Mobilisation and Statistics recorded a decrease in the number of national hospitals in 2019 compared with 2018 due to a hospital lockdown because of the lack of doctors. Such a decrease affected thousands of Egyptians who are struggling to get proper medical care under the pandemic accompanied by high costs of treatment. The poverty rate in Egypt is 32.5 per cent.

Shortage of doctors

Two days ago, the Central Agency for Public Mobilisation and Statistics issued the annual publication of the health service in 2019. The publication indicated that the number of national hospitals (public and university hospitals) dropped from 691 to 652 in 2018, while private hospitals also decreased from 1,157 to 1,130 hospitals in the same period of time.

Despite the decline in the number of hospitals in the two sectors, private hospitals witnessed an increase in bed numbers in 2019 from 35,320 to 35,745 in the last year. On the contrary, the number of beds in national hospitals decreased from 95,683 to 92,599, besides 2,761 beds in the hospitals affiliated to the ministries and public sector, which is a fixed number that hasn’t changed within the last two years.

Alaa Ghannam, the health officer for the Egyptian Initiative for Personal Rights, explained that the decrease in national hospitals and bed numbers is due to the continuity of the lockdown of what is called the integration hospitals – small village hospitals containing 20 beds on average. Integration hospitals were established at the beginning of the 2000s, “but the state failed to operate them because of the lack of doctors and so gave up on the idea, and since then the hospitals have been closed sequentially.”

In return, Ghannam considered the decrease in the number of private hospitals as an expression of the successive operations of merging and possession in a way potentially getting close to a monopoly. He also indicated that such merger operations mean, statistically, fewer hospitals that hold the same name.  The published information recorded an increase in the doctors’ numbers in the governmental sector at 2.7 per cent and 2.2 per cent in the private sector. However, Egypt suffers a huge lack of doctors when compared with the population. Such a ratio didn’t increase to more than 0.45 per thousand inhabitants in 2018, which is the lowest ratio since 1970, and it’s a little bit more than the average ratio and half of the lowest category of the middle-income countries according to the The World Bank.

The story behind national hospital numbers

According to publications issued by the Central Agency for Public Mobilisation and Statistics, from 2006 to 2019, the percentage declined to be 54.9 per cent after the numbers dropped from 1,187 to 652 hospitals only. While there is an increase in the number of private hospitals from 664 up to 1,130, as the percentage became 70.1 per cent.

This is mainly due to a successive decision issued by the Egyptian government to shut down 535 national hospitals in addition to 60 fever hospitals, which are widely known as the hospitals of the poor, which went out of service after being transferred into just an attached department to central hospitals since the beginning of the health reform plan implementation at the end of the 1990s. Such a decrease in hospitals affected thousands of Egyptians. According to CEOWORLD, Egypt comes 84th out of 89 countries in the Health Care Index in 2019, which monitors the health care level provided to citizens.

Doctor Mohamed Hassan Khalil, the general coordinator of the programme of the right to health (a health rights organisation), attributed the tragic decline of national hospitals to a privatisation plan accomplished by the government; as the health reform programme initiated by the Ministry of Health in cooperation with the World Bank in 1998 to transform the health services to be profitable instead of providing it only at cost.

Doctor Tarek Kamel, the former secretary-treasurer of The Medical Syndicate, added another reason for this decrease which is the lack of finance, as he said: “80 per cent of the health service is finance, and the other 20 per cent depends on good management and employment.” Kamel mentioned that the budget allocated to the Ministry of Health never reached the percentage of three per cent stipulated by the constitution of 2014. The budgets of the last four years didn’t exceed 1.6 per cent of the GDP.