…Vesting hospital management in the hands of administrators’ll reverse trend – Akintayo, ex-president PSN
The National Association of Resident Doctors (NARD) has said the worrisome phenomenon of medical tourism would only become a thing of the past once the Federal Government exhibits the political will to revamp the nation’s health system, put the right policies in place and allow technocrats head sensitive political offices.
A former President of Pharmaceutical Society of Nigeria (PSN), Olumide Akintayo, however, differed on what is driving medical tourism in the country, as well as what can be done to halt the trend. Akintayo is emphatic that the nation’s tertiary health facilities, which are centres of excellence, have been mismanaged by the current leadership, resulting in the near collapse of quality care services and decayed infrastructure, which are factors driving medical tourism.
He said: “The starting point is to have the right people in charge of hospitals, a situation which the nation’s hospitals currently lack.” While highlighting his position, the Chairman, Committee on Communications, NARD, Dr. Julian Ojebo, who spoke to the Saturday Telegraph, also stressed the need for the FG to equip at least one hospital in each geo- political zone to handle specialised cases including kidney transplant and cardiac surgeries.
Ojebo, a specialist registrar anesthesia and critical care medicine, explained that besides creating an enabling environment for medical experts to thrive, there was need for the government to further explore the Public Private Partnership (PPP) arrangement to equip select hospitals for the specialised cases, saying: “Government can bring in about 60 per cent and the private sector brings 40 per cent. Medical tourism refers to people travelling abroad to obtain medical treatment. In the past, this usually referred to those who travelled from less developed countries to major medical centres in highly developed countries for treatment unavailable at home.
The Minister of Health, Dr. Osagie Ehanire, recently lamented that Nigeria loses about $2 billion in foreign exchange annually to medical tourism. However, speaking on the trend, a worrisome situation, Ojebo said: “We can overcome medical tourism but it is about policies. Nigeria has six geo-political zones; one hospital from each geo-political zone can be equipped for each specialty. “For instance, primary health care can be got from anywhere but the level of specialty that we need varies like cardiac surgeries; Abuja can be a centre for all cardiac related pathologies.
“It is just about the policies, the political will power and the push from both private investors and government to bring about these synergies. Policy planning and political will are interwoven, I can assure you that in the next two years there will be a total overhaul of the health system in the country.” Ojebo, who was the past first vice president of NARD, however, blamed the inability of some departments in the Federal Ministry of Health to identify the health needs of the country to ensure adequate policy planning that can curb the high rate of medical tourism in the country.
“The place we get it wrong is that the Department of Planning and Policy and Department of Hospital Services in the FMoH are actually not doing their job. The bureaucratic bottleneck in these offices actually hampers a lot of things; so, they really need to sit down with the stakeholders in the FMoH to actually know what the teeming population of Nigerians actually desire.” On his part, the past President, NARD, Federal Capital Territory (FCT), Dr. Michael Olarewaju, who insisted that doctors alone cannot drive the fight to end medical tourism in the country, said that the Federal Government must liberalise the health care sector by engaging private investors, in addition to increasing the funding and welfare package of professionals in the sector. He said: “Medical tourism is rather an unfortunate topic to discuss.
The government is paying lip service to ending medical tourism. If they are sincere, they could put an end to medical tourism. “Healthcare is capital intensive; so, the government needs to increase funding and maybe involve private investors in order to combat the dearth of modern equipment in our healthcare facilities.
“The healthcare workers need to be better remunerated in keeping with modern realities. The problem is not lack of skills, training or knowledge-base, but lack of modern equipment, with associated brain drain. “A government that wants to end medical tourism would do its best to stop the medical doctors from migrating to other countries.” “A country where the hazard allowance for medical doctors and other healthcare workers is pegged at N60, 000 per annum (N5, 000/month), compared to hardship allowance of over N1m per month for politicians, is not ready and doesn’t deserve to keep her medical doctors,” he added. Akintayo added: “What can be done to halt medical tourism should be a complete and total package; it should be about the proper management of human and material resources and the starting point is to have the right people in charge of hospitals administration.”
Akintayo reasoned that Nigeria must have a health minister who is a goal-getter. He said: “Although, the nation’s centres of excellence are supposed to be the tertiary health institutions, but do a random check about the persons managing our tertiary hospitals, they are those who do not have pedigree; they don’t understand anything about administration; and they don’t understand routine management.” According to Akintayo, the beginning of the trouble with the health system in Nigeria was the draconian Decree 10 of 1985, which removed the leadership of hospitals from the hands of hospital administrators and vested them in the hands of ‘medically qualified’ doctors. “That is why we always talk about those eras when hospitals in the country were managed by hospital administrators.
Those were the periods the University College Hospital (UCH) was rated as one of the best five in the whole of the Commonwealth. Even people from the Saudi Royal family once accessed health care from Nigeria. Then hospital administrators were the leaders and managers of tertiary hospitals.”
To this end, Akintayo disclosed that: “If you cannot manage resources, then of course, you cannot manage hospitals, then of course, the health system will fail; and that is what has been happening to us.” Speaking further, he pointed out that two years ago the Independent Corrupt Practices and Other Related Offences Commission (ICPC) carried out a survey of all the ministries, departments and agencies (MDAs) in Nigeria and in the damning report, the health sector was the most corrupt and stinking.