Uganda legislators raise alarm over hospital extortion, staffing gaps and mental health neglect

KAMPALA - Members of Parliament on the Parliamentary Committee on Health have raised serious concerns over rising cases of extortion in public hospitals, chronic understaffing, and the apparent neglect of mental health services.

The concerns follow an oversight meeting with officials from several health facilities, including Butabika National Referral Hospital and Kiruddu National Referral Hospital, today, March 8, 2026.

During the meeting, legislators tasked hospital administrators to improve transparency in budgeting and service delivery, while also demanding urgent interventions to address systemic challenges affecting patient care.

Margaret Ayebare, the Woman Member of Parliament for Mbarara, criticised the practice of presenting lump-sum budgets, saying it obscures priority areas.

“When funds are bundled together, it becomes difficult to determine what the priorities are. However, if resources are allocated to specific priority areas, we can clearly identify what is most urgent and where to begin,” she said.

Ayebare also expressed concern over rampant extortion in hospitals, proposing the installation of surveillance cameras in high-risk areas to deter malpractice. She further urged Butabika Hospital to intensify public awareness campaigns.

“Many people do not understand the services offered at Butabika. The hospital should invest in radio airtime and community barazas to inform the public about which services are free and which are paid for. This will help curb extortion,” she added.

Committee Chairperson Joseph Ruyonga questioned the state of mental health services across the country, noting a gender imbalance in psychiatric facilities.

“When you visit Butabika and even prisons, you find more male patients than female. We need to know why this is so. Additionally, what is the operational status of our regional psychiatric hospitals? It appears mental health is a neglected area, as it is rarely addressed during presentations,” Ruyonga said.

He also challenged hospital administrators to provide evidence that anti-extortion measures are yielding results.

“All hospitals report measures to reduce extortion, but is it actually declining? We need clear answers,” he said, adding that the rising number of road accidents, often attributed to human error, also requires deeper investigation.

Meanwhile, Dr Elisa Rutahigwa, the Rukungiri Municipality legislator, raised concerns over spending priorities at Kiruddu Hospital, questioning whether certain procurements align with its core mandate.

“While I see areas of good performance, I am concerned about some priorities. For instance, is condom distribution central to your mandate? How do you set your targets?” he asked.

He further queried the rationale behind major equipment expenditures. “You are planning to procure dental autoclaves worth sh28.6 billion and a laparoscopy tower at sh259 billion. Are these critical investments for your hospital? Help us understand your priorities,” he added.

In response, Dr Charles Kabugo, Executive Director of Kiruddu Hospital, outlined the institution’s financial and operational constraints.

The hospital faces pension arrears amounting to sh55.35 million, which have not been provided for in the 2026/2027 financial year despite submissions to the Ministry of Finance.

Of the approved 830 staff positions, only 288 are filled, representing just 34.5 percent staffing, leaving a gap of 542 workers.

Kabugo noted that the hospital is grappling with an increasing patient load despite a stagnant budget. To address drug shortages, the hospital is seeking to increase its funding allocation from sh6.5 billion to sh11 billion.

He cited multiple challenges, including inadequate budgets, insufficient human resources, particularly in accounts to support Uganda Revenue Authority (URA) collections, congestion, and outdated equipment.

“We require sh20 billion to acquire additional land due to congestion, sh5 billion to replace ageing equipment, and another sh5 billion to support recurrent operations,” he said.

At Butabika Hospital, Executive Director Dr Juliet Nakku assured MPs that measures are being implemented to combat extortion.

“We have enforced the use of labelled staff uniforms and identification to ensure all personnel are easily recognisable to patients and attendants. We have also introduced toll-free and emergency lines for reporting extortion cases,” she said.

However, Nakku highlighted significant operational challenges, including staffing levels at just 49 percent and severe congestion, with bed occupancy standing at 234 percent.

“We are facing overcrowding in both wards and clinics, partly due to a dysfunctional referral system,” she explained.

She outlined several unfunded priorities, including sh30 billion for a 100-unit staff accommodation block, sh25 billion for a new complex housing a laboratory, pharmacy, training center, and storage facilities, as well as sh10.2 billion for additional beds across specialised wards.

The MPs emphasised the need for urgent government intervention to address the funding gaps, improve staffing levels, and restore public trust in the country’s health system.