HUNDREDS of millions of pounds of UK development spend is going to expensive and exploitative private healthcare providers, according to a new investigation.
The report from Oxfam found that the UK – as well as the EU and the World Bank – are allowing their development finance institutions (DFIs) to fund fee-charging providers in low and middle-income countries that block patients from getting care, bankrupt them, with some even imprisoning those who can’t afford their bills.
British International Investment (BII), a DFI whose sole shareholder is the Foreign, Commonwealth and Development Office (FCDO), has channelled hundreds of millions of pounds in this way, according to the report.
It also found that over 90% of their health investments are out-of-sight, made via private equity funds mostly domiciled in tax havens.
An International Development Select Committee inquiry into the UK’s use of DFIs is due to publish its findings in the coming weeks.
Oxfam’s senior health policy advisor, Anna Marriott, said: “This is far more than just a case of a few bad apples; wherever we looked we found cases of exclusion or exploitation and some appalling human rights violations.
“It’s sickening that the Development Finance Institutions, including British International Investment, are being allowed to use taxpayers’ money to help boost the profits of powerful healthcare corporations in the Global South, while turning a blind eye to the harm and impoverishment they are causing.
“Woeful levels of scrutiny mean BII even invested in a Kenyan hospital chain a year after its director had publicly confirmed that patients who don’t pay their bills would be detained.”
Franciska Wanjiru is one of dozens of such cases, as her mother’s body was detained for non-payment of a bill at a BII-funded hospital in Nairobi, Kenya.
Two years later, she made a public plea to the hospital to release her remains as a Christmas present, as she couldn’t afford the nearly £34,000 hospital bill.
After four visits, she stopped going to the morgue to visit her mother as she was charged for that too and could no longer afford it.
She said: “I feel very sad seeing her. It is not easy for me because her body has changed. It does not look like a body anymore; it’s more like a stone. We plead with the hospital to give us the body. We will never be able to pay the money no matter how long they keep it.”
Wanjiru is one of dozens of similar cases cited by Oxfam. Those detained include a secondary school student who was held hostage in hospital for 11 months, a newborn baby whose twin had died and a refugee who was involved in a car accident whose son had been killed.
In India, private hospitals funded by BII have also been denying people treatment according to the report, even though they had government health insurance cards entitling them to free care.
Oxfam spoke to people who had been pushed into poverty by health fees of up to $36,000 (almost £29,000). There were also cases of emergency patients, including a stab victim, not being treated until relatives turned up with cash.
The numbers of women dying in pregnancy and childbirth is rising across the world, yet the charity also claims BII-funded private hospitals are charging astronomical fees for maternity care.
In one hospital in Nigeria, the lowest price for an uncomplicated birth is the equivalent of 12 years’ wages for the poorest 10% of the population, and the price for a caesarean is the equivalent of 24 years’ wages.
Oxfam warned the risks to patient rights and health and to public healthcare systems are too high to allow this stream of funding to continue, and called for a stop to all future DFI funding to private healthcare providers as well as an urgent independent investigation into existing investments.
Marriott added: “Every second, 60 more people are pushed into poverty by catastrophic health costs and instead of helping to tackle the problem, this way of spending UK aid is fuelling it.
“At a time of spiralling need and decimated aid budgets, it’s more crucial than ever that any development funding for health is spent as effectively as possible to reach those without access to healthcare.
“Aid should be used to support governments to strengthen public health care systems that can reach everyone, not channelled through these huge money-making corporations that are clearly doing harm.
“The Government has said reducing maternal deaths is a priority for the UK’s development strategy so I think British people would be shocked to learn that it is supporting for-profit hospitals where childbirth can cost the equivalent of a year’s salary for some of the poorest. The abysmally unaccountable way this is happening risks undermining support for UK aid.”
A spokesperson for BII, said: “Over two billion people globally can’t access the medicines they need, causing preventable illness, disease and death. BII supports universal healthcare coverage - a fundamental part of the United Nations’ Sustainable Development Goals.
"We invest to help strengthen the quality and accessibility of healthcare in ways which improve the lives of millions. Our healthcare investees have directly treated over 12 million people.
“Every healthcare system in the world – be they public or private - have isolated incidences of shortfalls in care. We take the Oxfam allegations extremely seriously. We investigate all such incidents whenever they come to light and have an established complaints mechanism for anyone to raise matters of concern.
"We continue to encourage Oxfam to share any evidence they hold of these alleged cases so that we can accelerate our investigations.”
An FCDO spokesperson said: “The FCDO works closely with BII’s Board to ensure the investment’s portfolio is in line with our objectives, including reducing poverty and supporting a just and fair green transition.
“We take these allegations seriously and will support BII in their investigations.”
