In what must be the most bizarre fee structure the government-stipulated waste management company Wekaya, operating in the emirate of Sharjar, has announced a new approach to charges for clinical (medical) waste management services.

Though there are many variations in the approach to setting of charges, the fundamental approach begins with a charge per tonne of waste. That will vary depending upon the type of waste and the treatment required, the offset value of that waste from energy or materials recovery, perhaps the bulk (volume) of waste, and the required frequency and locations for collection.

But bizarrely, the charges in Sharjar are not to be calculated on the amount of waste generated by a medical facility but by the number of doctors and hospital beds it has — Dh1,000 per month for each doctor in clinics and Dh300 per month for each bed in hospitals, not counting registration and other charges! The new rules also apply to laboratories and school clinics though it is not clear how those fees will be calculated.

Medical facilities have no choice but to comply as the new rules are being implemented following a decision of the Executive Council of Sharjah. A fax, dated March 3, 2011, has been sent to health care establishments in the emirate by Wekaya warning them to register with the medical waste company within 30 days or face fines.

Fogging the issue, it appears that small producers – clinics no more than 3 or 4 doctors – enjoyed free collecton and disposal of clinical wastes. So the concept of charging by staff numbers is not entirely new and perhaps much of the problem stems from the charges that will be applied to the small producers, of which there are many.

Waste production maps closely to bed numbers, but with different volumes and types of waste generated in different specialties. So there will be informal mapping also between staff numbers and waste outputs.

This may be just another approach to charging, though not one that may find wide favour. It is certainly opposed in Sharjar where ts enforced implementation will be matched with massive increases in expenditure for almost everyone.

It must also be of concern that these effectively flat fee charges do not promote waste avoidance or minimisation, or even segregation of waste, since the charges for disposal will be fixed by bed numbers and staff numbers. So the inevitable endgame will be to dump it all in the clinical waste sacks!