Hariri Public Hospital in Beirut and the failure of the national health care system

Since its inception in 2005, the Hariri Public Hospital in Beirut was designed to become a model of the hospitalization sector in Lebanon and the Middle East in view of its size and the diversity of its services. Yet, this model that is now in crisis is raising serious questions on the ways in which successive governments have approached health and hospitalization issues.
Recently, the media has widely covered the decript conditions of the Hariri hospital and the continuous protestations of its workers who have not been paid their salaries on a regular basis. The media has particularly highlighted the resignation of the director of the hospital, Faisal Shatila, a development which will jeopardize the fate of the hospital should the Cabinet accept it.
To be noted that the hospital, since its opening, has accrued continued deficits. According to several sources, these deficits have reached LBP 90 billion or $60 million in 2011. Until now, the government’s approach to the problem has been through cyclical infusions of emergency funds, taking the form of annual advances, which are estimated to have totaled LBP 80 billion between 2012 and 2014. Furthermore, the hospital’s debts to suppliers have continued to grow reaching LBP 35 billion in 2014. Salary payments to staff have been intermittent.
There are several interpretations of the origin of the current crisis. One major cause seems to be the poor vision and the absence of a strategic direction. The late PM Rafiq Hariri ambition was for the hospital to become a hub for regional hospitalization tourism, particularly for GCC nationals whereas most of the patients currently attending the hospital are destitute whose costs are being covered by the Ministry of Public Health.
On the other hand, and according to a recent report about the conditions prevailing at the Hospital, the latter is suffering from poor management, over staffing, and deterioration of equipments. According to that source, there are 500 extra staff members out of the 1200 that were largely recruited along confessional and political affiliations. The report also noted that the Cabinet financial advances are normally used to cover salaries which total LBP 2 billion a month as well as other urgent expenditures, in order to avoid the collapse of the institution.
Other reasons identified by observers relate to the sectarian approach to recruitment, a problem which is endemic in the public sector. A recent example was the refusal of the Ministry of Public Health and the Hospital Administration to contract 20 physicians affiliated to the Future Movement and Amal Party, as well as continuous tensions related to the Christian quota.
As a result, the Hospital now stands at the verge of collapse. Whereas, the Minister of Public Health, Wa2el Abou Fa3oor, announced that the hospital shall rise again, (maybe with more financial infusions and short term administrative measures), it is doubtful that officials can come up with real remedies in the absence of an overall vision to health and hospitalization.