Kampala- The appointment of inexperienced junior officers to influential positions in the Health ministry has undermined the quality of services delivered by the sector, a senior doctor has claimed in a newly published book.
Prof Anthony K. Mbonye details a litany of in-fighting and power struggles that led to his resignation as director general of health services in charge of clinical and community health in January 2018.
“The immediate effect has been on the demoralisation of staff who feel that the institutional mechanism to advance their professional careers are no longer relevant,” Prof Mbonye writes in the self-published book, Uganda’s Health Sector – Through Turbulent Politics (1958-2018).
“The second way is because staff occupying senior political and management positions lack the requisite knowledge and the experience to apply standard rules, regulations and procedures, with a negative impact on service delivery,” he adds.
The 156-page book details the origins of the modern health sector in Uganda from the colonial times and the ground-breaking work of Dr Albert Cook and other missionary doctors, running through the decades as the country’s turbulent politics and economy affected the quality of services, including healthcare.
Most of it is based on historical facts and is detailed and interesting without being remarkable.
Prof Mbonye’s recollection of recent appointments to the ministry, on the other hand, is an insider-account of tales of intrigue and power struggles as political appointees to leadership positions in the ministry clashed with technocrats for almost a decade.
“A case in point is the recently appointed Permanent Secretary in the Ministry of Health, Dr Diana Atwine, who possessed little knowledge of the health sector and no experience in management and accounting procedures,” Dr Mbonye writes.
“Similarly, the appointment of Dr Christine Ondoa as a minister when she had failed in her management of Jinja and Mbarara hospitals, proved problematic. In another case, Dr Jane Aceng from Lira Hospital, after failing in her application for the post of medical superintendent, was accelerated to the post of Director General of Health Services and later Minister of Health. She engaged in infighting with staff and fellow ministers,” he further states.
Dr Atwine, however, laughed off the claims, saying she had no time responding to a book written out of frustration.
“I am chairing a meeting and not able to talk, but what is in the book is sour grape and sheer malice that is not worth responding to,” she said.
In response, Dr Ondoa said: “I don’t know the criteria he (Prof Mbonye)used to come up with assessment, but he is entitled to his opinion. I didn’t forge any qualification...At the time I was appointed minister, I held the highest qualification in the medical field and that is a senior consultant.”
“To get that qualification, you are recommended by the Health Services Commission and the director general of health services. So I don’t know how he came to that conclusion. My records in Jinja, Mbarara and Arua regional referral hospitals speak for themselves...By saying I am incompetent means he is doubting the appointing authority,” she added.
Dr Aceng was reported to be in a Cabinet meeting by press time.
Reports of clashes between top officials in government ministries and agencies are not new and they sometimes spill over into the public as seen most recently in the Uganda Investment Authority, the Uganda Police Force and the central bank.
Prof Mbonye claims that some of the officials appointed to the ministry had poor academic grades, lacked management and leadership experience, had been previously accused of improper conduct, or were appointed due to their connections to powerful individuals.
Dr Atwine has previously worked as a personal physician to President Museveni and the head of the State House-based Health Monitoring Unit.
In June 2016, Prof Mbonye was appointed acting Director General of Health Services. The Inspector General of Government later investigated claims that he had rewritten the job description to benefit him when interviews were conducted to fill the position substantially.
The IGG’s report noted a conflict of interest in Prof Mbonye not informing the Permanent Secretary of his application for the job and he was removed from his position in September 2017 then reinstated as he challenged the decision in the High Court.
On January 31, 2018, Justice Henrietta Wolayo dismissed the IGG’s findings and ruled that there had been no conflict of interest and that Prof Mbonye had not been given a fair hearing. The ruling came two days after Prof Mbonye had resigned.
“I no longer had confidence in their capacity to lead; and felt that I could no longer work alongside officers who leveraged the power of their undeserved positions and conducted themselves in such an unprofessional way,” he notes in his book.