Hospital Detentions for Non-payment of Fees, A Denial of Rights and Dignity.

The hospital patients in Nigeria who are not allowed to leave when they cannot pay their medical bills.

One young mother who gave birth to her son via caesarean section was kept in a small room at the hospital with her baby for 16 months, when she and her family could not afford to pay doctors. Another family who lost their young son, were unable to collect the body until they paid up. And these are not isolated cases…

Hospital Detentions for Non-payment of Fees, A Denial of Rights and Dignity.

In some parts of the world it is common practice for patients to be detained in hospital
for non-payment of healthcare bills.

• Such detentions occur in public as well as private medical facilities, and there appears
to be wide societal acceptance in certain countries of the assumed right of health providers
to imprison vulnerable people in this way.

• The true scale of these hospital detention practices, or ‘medical detentions’, is unknown, but
the limited academic research to date suggests that hundreds of thousands of people are likely
to be affected every year, in several sub-Saharan African countries and parts of Asia. Women
requiring life-saving emergency caesarean sections, and their babies, are particularly vulnerable
to detention in medical facilities.

• Victims of medical detention tend to be the poorest members of society who have been admitted
to hospital for emergency treatment, and detention can push them and their families further
into poverty. They may also be subject to verbal and/or physical abuse while being detained
in health facilities.

• The practice of detaining people in hospital for non-payment of medical bills deters healthcare
use, increases medical impoverishment, and is a denial of international human rights standards,
including the right not to be imprisoned as a debtor, and the right to access to medical care.

• At the root of this problem are the persistence of health financing systems that require people
to make high out-of-pocket payments when they need healthcare, and inadequate governance
systems that allow facilities to detain patients.

• Universal health coverage (UHC) cannot be achieved while people are experiencing financial
hardship through their inability to pay for healthcare, so by definition any country that allows
medical detention is failing to achieve UHC.

• Health financing systems should be reformed by moving towards publicly financed UHC, based
on compulsory progressive pre-payment mechanisms. This would enable hospitals to become
financially sustainable without the need to charge significant user fees.

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