By Louis Okoroma
It is always difficult to disabuse the minds of people of the lies they are told. The members of the press and non-medical doctors in the health sector have portrayed medical doctors as the problems of the Nigerian health sector. While Dr. Angela Uwakwem superintended over the affairs of FMC Owerri, there was crisis and the workers presented her as the only problem of the centre. Now that she has finished her tenure, FMC Owerri has not shown any massive improvement as one would expect. It is still the same old story: arrears yet to be paid; not paying 100% salary et cetera. In Nigeria, it is easier to allege that a leader is corrupt, the same way an innocent girl can be labelled as a prostitute or a boy called an armed robber, cultist or internet fraudster, for no other reason than that we have decided to give the dog a bad name in order to hang it. The fight against her was a national fight but people thought the fight was by workers in the centre. One may ask: what was her offence?
It was nothing but the introduction of Public-Private Partnership (PPP) in the hospital. Like the biblical Deborah, she had the courage to toe where other heads of government hospitals considered a no-go-area. She introduced PPP in some ancillary services in the centre and that was against the inordinate principles of the cabal there. Heaven, of course, was let loose. The non-medical doctors knew that once that programme was allowed to triumph in the centre, their end was near and the crisis in the health sector would be nipped in the bud. Why are they afraid of PPP? The answer is simple: they knew that with PPP, the end of imperiousness and unnecessary unionism in the health sector was near. This happened despite the fact that the Federal Ministry of Health has a department/directorate for PPP. There is one question I always ask people: the hospital that President Buhari went to in the UK, was it a government hospital or a private hospital? Although the identity of the hospital was shrouded in secrecy, I can state without mincing words that the hospital must either be privately owned or under a PPP arrangement.
The primitive type of hospital system we run in Nigeria is outdated and should be scrapped. Same is applicable to our university system. World class institutions like Harvard, Massachusetts Institute of Technology, Johns Hopkins; universities and their hospitals, and Apollo Hospital in India, just to mention but a few: are they owned by the government? Why are non-doctors in Nigeria afraid of PPP or totally privatising the health sector? They are aware that such programmes will automatically define each profession in the health sector. Why don’t we have JOHESU (Joint Health Sector Unions) among health workers in multinational companies, or in our private health sector? These two places are no nonsense places. How can a worker leave his place of work for the purpose of unionism and expect his payment at month end? Each person’s job is well defined in these two areas. In these two areas, no entrepreneur will employ and pay a non-doctor as a consultant but in our government hospitals,we are ready to cut our national cake, after all, the proceeds of the oil in Niger Delta are everlasting. How many owners of private pharmacy shops, medical laboratories, physiotherapy homes, radiography scan centres et cetera have appointed their colleagues as consultants to man or consult in their centres? But, I have lost count of private hospitals where medical consultants consult on daily basis. They cannot use their private centres to show us how non-medical-doctor consultants work, but they want to do it in our public hospitals.
The argument against PPP and privatisation in our health sector is specious. Nigeria is a place where an unconfirmed rumour is taken to be true. The argument that those who feel threatened by the proposed introduction of PPP or fully privatising our health sector sell to the public is that such a policy would increase the cost of medical care. From a layman’s point of view, that argument is reasonable but technically speaking, PPP or full privatization of the health sector will not only reduce the cost of medical care in Nigeria but will also raise the quality of health services rendered . Consider NITEL of those days, the corporation was the lord of our communication industry. It had the proverbial sauce and yam, and Nigerians were at its mercy. For its services to be installed in your place, you had to kowtow to it, and to fix any fault thereafter, you had to pay obeisance to the organisation. It was a painful experience but when Chief Olusegun Obasanjo government came on board, he said enough was enough. The doors were opened for private investors to come in and, today, SIM cards of many GSM providers are free not to talk of their competitive packages. Thereafter, internet/data bundle packages were introduced. Nigerians are currently no longer queuing up in cyber cafes to check their e-mails, or to surf the internet, as it used to be. What brought that tremendous change that nowadays, even a beggar on the street has a cell-phone with a SIM card? The secret is privatisation and the opening up of the doors to private investors in the telecommunications sector. That move automatically striped NITEL of its monopoly power. Telephone that was then an exclusive preserve of the rich and the highly-placed in the society can now be owned and used by an average Nigerian.
Coming to our so-called federal tertiary hospitals, collection of laboratory samples end on or before 2pm on Mondays through Fridays, and only a few emergency laboratory tests can be done beyond this time and during weekends.What is the reason? Whether tests are done or not, the ministry of finance will share the national cake at month end. In other climes I have visited, all laboratory tests can be done anytime in tertiary hospitals. That means, currently in Nigeria, if a patient does not get to the laboratory section before 2pm during the week days for the collection of his blood sample, he will be asked to come back the next day, without recourse to the inconvenience that will cause to the patient or the distance involved if the patient is an out-patient. The same is applicable during the weekends. If the CMD/MD of the government hospital talks, JOHESU will shut down the centre, lock up the hospital and leave with the keys. If you want to talk, lawyers will tell you as citizens they have right to freedom of association and to embark on strike, but no lawyer has ever told me that JOHESU members have right to lock up all units of government hospitals and go with the keys when they are on strike or even beat up a CMD, as it happened in UCH Ibadan during their last national strike.
I throw it as a challenge to all Nigerians who have travelled outside this country for medical tourism to come and tell me if it was a government-owned hospital they went to? In our private businesses, we look for the best brains to man the business but in government-owned businesses, we remember federal character as contained in Section 14(3) of the Constitution of the Federal Republic of Nigeria (CFRN) which is a mockery of America’s Affirmative Action. That section of our constitution currently sets aside meritocracy for mediocrity. I leave the amendment to the National Assembly. For those arguing that privatisation will increase the cost of medical care in Nigeria, I ask whether anybody can be treated free in our government hospitals. Any day you see an accident victim with no relative, just rush the victim to the nearest government hospital and know if the victim will be treated free of charge. My personal observation is that the cost of treatment at many private hospitals and centres are cheaper than what obtains at the so-called government-owned hospitals and centres. Consider, for an instance, that a government hospital may fix the price for a particular scan at N1500 while private centres are collecting N2000 for the same procedure.
If you go to a government hospital today, they will book you to come in two weeks’ time. Let us assume you used N500 as your transport fare.
John writes from [email protected]