What you need to know:
- The facts of the matter were straight forward; on July 23, 2022 Robert Ssentongo, a person of humble means, was informed that his son, Raymond Mugerwa, was involved in an accident
On February 15, 2023, the civil division of the High Court of Uganda in Kampala made a decision on a matter in which a patient was allegedly detained in a hospital for failure to pay the medical bills.
The facts of the matter were straight forward; on July 23, 2022 Robert Ssentongo, a person of humble means, was informed that his son, Raymond Mugerwa, was involved in an accident.
Mugerwa had initially been admitted at Ggwatiro Hospital but was later transferred to Jaro hospital because of his worrying condition. A lifesaving operation was undertaken only for Ssentongo to default on the undertaking to pay the medical bills.
Incensed by his conduct, Jaro hospital decided to detain his son, hence the petition to court challenging the detention.
To court the cardinal issue was the legality of the detention of a defaulting patient in the hospital after treatment.
Courts usually rely for guidance on similar cases that had previously been decided. In this particular case, court looked at a case in Nairobi, Kenya in which a judge ruled that it is a violation of patients’ rights when hospitals refuse to release them over accrued medical bills.
In the Kenyan case, a one Gideon Kilundo caused the admission of a patient to the Nairobi Women Hospital with the full knowledge the hospital was a private one and that he would be required to settle the hospital bills. The hospital treated the patient until she fully recovered. Gideon then failed to honor his promise to pay the bill and the patient was detained and the case went to court. Court, in this matter, noted that there were many other public hospitals within Nairobi, including the biggest referral hospital in East and Central Africa, where Gideon’s patient could have been admitted and treated cheaply. Gideon, on his own volition, chose the private hospital but defaulted to pay the bills upon discharge without offering any plausible explanation.
The approach of the Kenyan court was first to highlight the primacy of the contractual obligations between the patient and the hospital.
The court emphasised that hospitals should always pursue other lawful debt recovery means other than detaining patients. Court was not convinced that an illegal detention of a patient is one of the avenues for the recovery of a debt within the legal system. To court the question that would arise would be for how long the hospital would be expected to hold the patient. And this would lead to a classic example of a scenario where two wrongs will not make a right. Court ruled that in as much as the hospital was aggrieved by the failure of Gideon to pay the hospital bills, detaining the patient was not one of the acceptable avenues of debt recovery.
Court, in the Ugandan case, applauded the medical team of Jaro hospital who saved the life of the young boy. From the evidence on record, there was no doubt that a more serious consequence could have resulted had Jaro hospital declined to treat the patient, whose condition was a medical emergency. The irony, to court, was that with all the medical interventions made by Jaro Hospital, Mr Sentongo had the courage to tell lies about the events leading to the treatment of his son and the post operation discussions that took place between him and the hospital management.
Court was particularly concerned that Ssentongo had the audacity to hide the identity of the persons responsible for his son’s accident. Further, Ssentongo hid the fact that he had probably been paid by the insurance company linked to the car that had in fact caused the accident.
The judge failed to understand how a person whose son had been saved by Jaro hospital could so blatantly lie to court by denying how his son had been brought to the very hospital that had saved his son’s life. There was evidence that Ssentongo accompanied the group of persons that had brought his son to Jaro Hospital and had, in fact, made an undertaking to clear the hospital bills. The evidence that he signed the consent forms before the child was taken to theatre for the surgery was so clear and glaring.
To the judge, courts of law should strongly frown at people such as Ssentongo for expressing the kind of ingratitude so deep to the medical profession that their behavior could easily undermine the entire health sector. The fact that Ssentongo chose to have his son operated in a private hospital in Kampala when one of the country’s biggest referral hospitals was probably a few kilometers away could not be ignored.
Just like the decision of the Kenyan case in the case cited, the Kampala court equally condemned the behavior of patients who walk into private hospitals for treatment and expect to walk out without paying a single cent under the guise of constitutional protection of liberty and freedom of movement.
The main issue for court to determine was whether a hospital can lawfully detain a patient who has defaulted to clear the hospital bills. And in the alternative, court was to determine if the detention of such a patient amounted to the violation of his or her rights to personal liberty under the constitution.