The General Manager of Health Services in Samoa is defending an increase in hospital fees by saying the move will help sustain the country's hospitals.
The fee has been increased from 50 cents to 5 tala or about 2 US dollars, and is the first increase in hospital charges in 10 years.
The nationwide increase would also prevent some patients being overcharged at district hospitals.
Low income earners and the unemployed have expressed concern about the increase, but the general manager of health services, Dr Stanley Dean, says it is necessary.
"In order to have a good sustainable health service in the future the community have to participate in the costing of these things, nothing is free these days."
Dr Dean says the need for a rise was reaffirmed by the Commission of Inquiry that looked into the doctor's strike last year.