Published on 19/07/2025
Management of Lira Regional Referral Hospital has defended its decision to pay private wing medical doctors a monthly salary of just Ugx. 1 million, arguing that the arrangement is based on mutual agreement and provides a lifeline for many unemployed doctors in the country.
Dr. Nathan Onyachi, Hospital Director, made the defence while appearing before Parliament’s Public Accounts Committee (PAC) on July 10, 2025. The session was convened to address audit queries raised in the Auditor General’s December 2024 report.
According to Onyachi, the hospital hires private wing doctors on local contracts due to staffing gaps and resource constraints. He noted that although the pay is meagre, the doctors accept it willingly. “It’s not ideal, of course,” Dr. Onyachi admitted. “A doctor should earn more, but we offer what is available. There are many doctors on the streets without jobs. They take up the offer by mutual consent.”
However, PAC Chairperson Muwanga Kivumbi challenged the logic behind the recruitment and remuneration process, especially for full-time work. “Are you seriously telling us a graduate doctor accepts to work full-time for UGX1 million in a hard-to-reach area?” he questioned. “Does that stretch your normal imagination?”
Onyachi acknowledged the pay was “abnormal,” but insisted that the contracts were a stop-gap measure while awaiting validation from the Health Service Commission (HSC). “We advertise locally, conduct interviews, and select the best candidates. We then invite the Health Service Commission to validate them,” he explained, though he conceded that not all the doctors had been validated.
Pressed further, Onyachi revealed that the doctors work in shifts of about eight hours per day, depending on their schedule. Committee member Asuman Basalirwa (Bugiri Municipality) sought clarity on whether the contract terms explicitly stated whether the jobs were full-time or part-time.
“Let the accounting officer clarify whether the contracts indicate the nature of employment. Do you have copies of the contracts?” Basalirwa asked.
“Yes, they can be made available,” Onyachi responded.
Victoria Nekesa (UPDF Representative) asked how long these doctors remain on local contracts before being absorbed into mainstream government service.
Onyachi responded that the local contracts were temporary and that once validated and if a government position became available, the doctors could be absorbed into the formal system. “It’s a starting point. Many of them begin volunteering for nothing. This arrangement gives them a foot in the door.”
However, Mawogola South MP Gorreth Namugga raised concerns about the ethical implications of such employment practices. “This approach exploits vulnerable, unemployed doctors,” she said. “You’re using their desperation to justify low pay and bypass standard procedures. There’s room for compromise—and that puts government at risk.”
Namugga further called for a broader review into how private wings operate across all regional referral hospitals. “Government has standards. You cannot reduce them to informal negotiations just because doctors are desperate,” she added.
Basalirwa questioned whether the contracts had the involvement or clearance of the Solicitor General, while Nekesa inquired if the practice was unique to Lira or standard across other hospitals.
Onyachi clarified that private wings are a formal policy of the Ministry of Health and not a local innovation.“Private wings are officially recognized. All regional referral hospitals operate them. What we’re doing is not new,” he said.
Still, the Committee remained concerned about the sustainability and legality of hiring doctors under such loosely regulated terms, especially when the pay is below acceptable professional standards.
