Prof. Adebayo Faduyile was elected the President, Nigerian Medical Association (NMA) last year. In this interview with FRED EZEH in Abuja, he lamented the activities of unqualified foreign trained doctors seeking professional opportunity in Nigeria.
What is your assessment of the health sector in Nigeria ?
We have obviously not done enough in the health sector in the last three years. Our minimum expectation from government has not been met. They have tried though, but there are lots of gaps to be filled. There are lots of things that we ought to have improved on. First on the list is the liberalization of health insurance scheme. That would greatly improve access to health care delivery. The National Health Insurance Scheme (NHIS) Act was signed in 2004, and since then, government has funded the National Health Act, which was supposed to have 1 percent of consolidated revenue fund to support basic healthcare provision and National Primary Health Care Development Agency (NPHCDA). Government has been paying lip service to the issue of the health insurance. But we are happy that some money was voted for that purpose in 2018 even though it was released late in the year. Howbeit, the NHIS has performed poorly because coverage has been abysmally low. I’m happy that states are establishing their own health insurance programmes to complement NHIS. We also encourage private organisations to establish same to boost health care delivery to Nigerians. We appreciate government for the return of Global Alliance for Vaccine and Immunization (GAVI) to Nigeria. Their brief exit from Nigeria significantly affected the immunization coverage in Nigeria. Immunization coverage dropped to 20 percent from 70 to 80 percent on the wake of their brief exit. It was a lesson to us that we should not rely on foreign interventions to immunize our children. Immunization and treatment of children ailments, ideally, must be territorial and not based on foreign interventions. As regard cancer treatment, we are happy with the recent procurement of two new state-of-the-art cancer machine which was installed in Lagos State University Teaching Hospital and the National Hospital, Abuja.
What are your suggestions to improve the services of NHIS?
Poor records at NHIS is a function of the society we have found ourselves. It cannot be taken away from the Nigerian society where corruption has become way of life. In addition to that, we have foundational default that must be corrected urgently, and it must start by proper planning. Previous NHIS Executive Secretaries failed to lay solid foundation for the success of the agency. They probably assumed office, dropped previous plans and began implementation of theirs. There was no succession plan and that affected smooth running and development of the agency. Most annoying part was that the people in government borrow billions of Naira deposited as premium and use it for something else. No one could dispute the fact that NHIS is a great and laudable policy. But it must improve in its services and accommodate more people and include more ailments in its coverage. Its establishment Act should also be reviewed so that more responsibilities could be added to them.
How cordial is your relationship with other hospital workers, against the back drop of periodic strikes and other industrial disharmony?
Well, our collective responsibility is to provide health care services to Nigerians that visit hospitals in search of healthcare. The perceived fights and displeasure in the health sector does no one any good. Few weeks ago, we had series of meetings with members of the nurses’ union to find common ground to perceived acrimony and bitterness amongst us. We observed that some hospital workers believed that doctors are responsible for their career stagnation. But after several interactions, we both realized that miscommunication was our major problem. We equally realized that we are working for same purpose but with different methodology. And all that was required was to sit down with each other and sincerely discuss the issues and resolve them amongst us. That was all that was required to bring peace and unity among hospital workers. That would definitely enhance health care service delivery especially to Nigerians who could not afford the services of private health care providers or foreign health services.
What about the issue of perceived superiority battle between NMA and JOHESU?
No one is superior in hospital services. Each profession is very important and complement each other in health care delivery to Nigerians. Nurses, pharmacists, laboratory scientists and several others, are heads of their own section. But when it comes to the overall headship of the hospital, doctors are rightful persons that head the hospital. It’s global practice and Nigeria is not an exception. It has been scientifically proven that health institutions that are led by medical doctors have better result in terms of medical care and other related services. It’s also on record that NMA has never, openly or otherwise worked against interest of any professional group either for pay rise or career progression, and we would not attempt to do that. Relativity should be the watch word in hospital services.
What is your relationship with the recently constituted Medical and Dental Council of Nigeria (MDCN) governing council?
We are happy with the reconstitution of the governing council. That has been our prayers over the three years that it was disbanded. We have met once and we would hold another meeting very soon to extensively discuss issues that affect us. However, we have chosen to move on speedily to catch up with the lost time and events. We really lost a lot of things to that prolonged delay in constituting MDCN governing council. The council has reactivated and strengthened its organs to swiftly check on excesses of medical doctors and quickly stop the activities of charlatans who might have taken the advantage of the previous events, to engage in professional misconduct. In addition to that, the council has commenced its role of curriculum review of institutions that are offering health education.
What about the fate of foreign trained doctors who desire opportunities in Nigeria health sector?
We have no problem with foreign trained doctors, except the ones that might have acquired substandard knowledge from unrecognized/unaccredited schools. No fewer than 500 new medical doctors who passed professional exam conducted by MDCN were inducted into the system few weeks ago. The council has ensured that standard and credibility of the exam is maintained. This was because, the council found that many Nigerians enroll in some unrecognized and unaccredited institutions in one remote part of the world, spend three to four years there, and return with an unrecognized certificate and substandard knowledge. Such people are serious threat to the health of Nigerians, and that was why the MDCN has put a serious check on these set of people. MDCN ensures they prove and defend whatever knowledge they claimed to have acquired and that could only be done through a standardized exam. Interestingly, the professional exam is CBT and each person’s questions is different from another, in addition to practical. Some of the foreign doctors are denied opportunities to practice in the country where they were trained.
There are indications that many Nigerian doctors don’t have NMA stamp. Do you still enforce usage of the stamp by doctors?
Every genuine member of NMA is entitled to NMA stamp. We have insisted that it should be used in all official activities of the doctors that is one way that we have used to checkmate quacks. Some doctors have been reluctant in acquiring theirs but they have recently seen the reasons and they are rushing to get it. Process of acquisition must pass through the state chapters. We have resolved that in no distant time, we would make it compulsory that all medical report and other referrals must carry NMA stamp. That will help us greatly.
Aside that, do you take other measures to ensure the sanctity of your profession?
We adopted several measures that had yielded significant result. But they are within the law. We have seen several other professionals in health sector going about sealing people’s businesses. That is not what the law recommends. They don’t have the powers to do that. It’s strictly the responsibility of the law enforcement agencies to do that. Our worry is that they go beyond their scope. As a pathologist, I have the right to open a laboratory. But in many cases, you see officials of Medical Laboratory Science Council of Nigeria (MLSCN) harassing such establishments. We don’t have problem with that, just that it’s illegal. Aside other measures that we have taken to cleanse our profession, we set committee working at different states, monitoring the activities of medical doctors. Any doctor suspected to be fake is promptly reported to security agencies for proper action. We have equally appealed to Nigerians to join the fight against fake medical professionals. This they could easily do by reporting any suspected case to the relevant authorities.