The ban on private medical practice

It was George F.  Will writing for the Newsweek magazine some decades back that wrote, “What people learn from History is that people do not learn from History”. Circa 1984, during the military administration of Generals Buhari and Idiagbon, doctors were disgraced, humiliated and maligned.  They were accused of stealing hospital drugs, diverting government patients to their private clinics, not attending to patients in the government hospitals because they were busy in their private clinics etcetera.  All these were lies and spurious allegations “to give a dog a bad name so as to hang it!”  The allegations were also products of envy and jealousy.

From time immemorial, many students that read science in the secondary schools have aspired to be medical doctors.   I don’t have the exact statistics but my guess is that not more than about 10 percent achieve this aim.  So the ground is fertile for envy and jealousy among the unsuccessful ones.  That explains one of the reasons for the incessant industrial actions in government hospitals.   Two main reasons why there are incessant industrial actions in government hospitals are because the government always fails to fulfil its promises to the doctors and because  Joint Health Sector Union (JOHESU} members are always claiming to be what they are not.  As someone rightly pointed out, the paramedics that are not doctors want to enter “through the backdoor”.  My advice is that any paramedic who wants to be the Chief Medical Director (CMD) of a hospital should go to the medical school to qualify as a doctor, then do a residency training programme in a medical specialty to be a consultant, then write enough papers to be made a professor, and then apply to be CMD of a hospital.  On the other hand, however, since the hospital gardeners, gatemen and cleaners are also “paramedics” because they all work in a hospital, why can’t they also be made the CMD of a hospital?   Pardon the digression but this is one of the main reasons for incessant industrial actions in government hospitals.

During the period of the humiliation of doctors in the early 80’s, there was an exodus of highly trained world-renowned doctors from Nigeria to other countries.  In a way, the humiliation was a blessing in disguise for many doctors trying to make ends meet in Nigeria at the time.  An unspoken mantra among the doctors then was, “A nroju je eko obun, obun tun da eko re kere” meaning that we are condescending to work here and you are still making life difficult unnecessarily.  Many Nigerian doctors, therefore, emigrated from Nigeria to countries like Saudi Arabia, Qatar, Kuwait, UK, and the USA.  Here, they were accepted warmly and accorded their rights.  The doctors also had job fulfilment because they had modern equipment to work with.  But most importantly they were well remunerated.  One of such doctors in Saudi Arabia exclaimed, “From my first salary, I was able to buy a small brand new car and I still have money left to spend for the whole month!”

During this period, I knew of a Nigeria child who sustained a severe burn injury.  The child was sponsored by a Nigerian philanthropic NGO to Harlem in New York City, USA to be treated.  The treating doctor there was an American-trained Nigerian plastic surgeon who was frustrated out of UCH in Ibadan! Because of this exodus of doctors from Nigeria, the quality of the health delivery system in the country plummeted.  It is just now that it is starting to improve gradually.  And now, we want to set back the hand of the clock again!  How many of us can afford to seek health care in Saudi Arabia or the UK for months at the expense of the poor Nigerian taxpayers?

During the incessant industrial actions in the government hospitals, what will happen to those involved in road traffic accident, those attacked by armed robbers, those in pain and the pregnant women in labour if there are no private clinics to go to!!! And who are the best doctors to run these clinics? Of course, they are medical consultants and professors with university experience. Even when government hospitals are not shut down, patients prefer private hospitals because the patients are treated humanely and with respect.  Private hospitals cannot afford the “luxury” of barking orders at a sick patient or insulting a patient for shouting because he is in pain or makes it difficult for a sick patient to be quickly attended to by a doctor.

People should grow out of the puerile notion that doctors are minting money in their private clinics.  When one considers the cost of overhead in starting and maintaining a medical establishment, it is only a moron that will think that private medical establishments exist only to make money.  After all, it is easier to make money by getting a contract to cut grass in camps for displaced people.  In any case, if a doctor decides to spend his free time giving service to the sick instead of going about lobbying for contracts or running after women or hopping from bars to bars to enjoy himself, what is bad in that?

• Ajao is a retired Professor of Surgery at the University of Ibadan, Oyo State.