The Egyptian Initiative for Personal Rights (EIPR) cautioned the government that mishandling the crisis in the state-funded treatment program will lead to its abandoning its responsibility to provide medical treatment for the poor. The EIPR added that the renewed interest in the issue, particularly after investigations by the Public Monies Intelligence and the Central Accounting Agency into allegations of squandering public funds, offers a golden opportunity to discuss and rectify the flaws in the system to permit the state to fulfill its obligation to provide health care to the poorest and neediest.

The EIPR also asked that the Ministry of Health and the chair of the Specialized Medical Councils – which administers the system - reconsider its governing criteria and institute a tight oversight regime that does not obstruct citizens’ access to the service. The EIPR called on the Ministry of Finance to supply the funds necessary to sustain the system of state-funded medical treatment, develop it, improve capacities and provide service to those most needing medical care. The EIPR pointed out that public health expenditure in Egypt is still less than in other countries with similar growth levels and income; it is also less than the spending percentage recommended by the World Health Organization, a reflection of how low health is on the government agenda.

“Resources for the state-funded treatment system are supposed to be directed to the poorest citizens, those without health insurance coverage and most in need of care for expensive, catastrophic illnesses,” said Dr. Alaa Ghannam, the director of EIPR’s Right to Health Program. “But mismanagement of the state-funded treatment program, neglect and the politicization of resource allocation have created the existing crisis. As such, the system should not be abolished, but rather must be reformed to operate in accordance with specific criteria.”

The current debate was sparked when several hospitals began demanding their past due payments from the Ministry of Health, which administers the state-funded treatment system, and it was reported that the ministry had accumulated a debt of over LE1 billion, which some sources attribute to a misuse of resources allocated to the program. The Ministry of Health also revealed in early January 2010 that it had information indicating that a handful of MPs acting on behalf of their constituents had received a majority of the approvals for state-funded treatment, thus highlighting the need for a strict, transparent, qualified and fair administration of the system.

While welcoming the start of the investigations into allegations of spending waste and fraud in the state-funded treatment system by the Public Monies Intelligence unit, as well as the investigative efforts of the Central Accounting Agency, the EIPR nonetheless also demands that any crimes exposed be referred to the Public Funds Prosecutor.

For its part, the Ministry of Health has taken the initiative to establish new conditions governing the way MPs can draw on state-funded treatment funds for their constituents, including a ceiling on the amount of funds that individual members of parliament can claim under the state-funded treatment program.

“Setting limits on MPs will not solve the problem; indeed, it will continue to fester if it is not treated at the root,” said Soha Abdelaty, the deputy director of the EIPR. “The long-awaited solution is the establishment of clear, specific criteria elaborating who may benefit from the system and what treatment interventions are covered by the system. When concluding a contract with university and private hospitals, the Ministry of Health should maintain an up-to-date list of the cost of various medical services offered by these facilities to avoid fraud and manipulation.”