DEFENDING his ministry’s 2020 budget before the Joint Senate and House of Representatives Committee on Health last week, Minister of Health, Dr. Osagie Ehanire, mooted the idea of importing medical experts from Europe and North America as a way of making up for the shortfall in the number of doctors working in Nigerian hospitals. In addition, the minister wanted to address the persisting imbalance in the country’s patient-doctor ratio, which currently stands at a dismal 1:5,000, contrary to the World Health Organization’s (WHO) recommended 1:600. For Dr. Osagie, the idea is a win-win, since importation of medical personnel would allow the Health ministry to staff teaching hospitals with experts exposed to the most advanced and sophisticated medical ideas and practices, and such experts, being volunteers, would cost the Ministry of Health next to nothing.
Under pressure from the media and stakeholders, including the Nigerian Medical Association (NMA), the Pharmaceutical Society of Nigeria (PSN) and the Lagos Medical Guild, the Health ministry provided clarification to the effect that the initiative is “not about recruitment of people, but about volunteers willing to visit Nigeria for limited periods without pay, to share skills and expertise on cutting-edge practices, to raise the capacity of Nigerian practitioners.” Furthermore, “the steps are to improve the quality of service delivery in our hospitals. No mention was made of ‘import’ of people. If anything, the ‘import’ is only of knowledge and latest skills from abroad.” Whether or not the honourable minister means to import experts or their knowledge (an academic point, given the deep imbrication of both, especially in the most specialised aspects of medicine), he is at least to be praised for openly acknowledging that the Nigerian health sector is, well, sick, and that urgent remedies are needed in order to avoid total collapse.
Nevertheless, while the minister deserves kudos for admitting the severity of the situation in the health sector, his diagnosis of what is wrong with the sector, and his plans for amelioration, leave a lot to be desired. For example, even as he admitted the lugubrious scenario in the sector, Dr. Ehanire was still insisting that “the country’s teaching hospitals were adequately equipped and manned by experienced and qualified doctors” and “that more work needed to be done to build the confidence of Nigerians in the facilities.” If the hospitals are well equipped and manned, why bring up the idea of importing experts/expertise from abroad? If the problem is that Nigerians lack confidence in the country’s medical infrastructure, why not focus on restoring their confidence? At any rate, why would Nigerians choose to spend millions of Naira in search of medical solutions in disparate countries (what the minister insensitively refers to as “medical tourism”, a process participated in by only a few with very deep pockets) if such solutions are available in the country? It would seem as if the honourable minister is trying to have his cake and eat it at the same time.
As it happens, the most accurate diagnosis of the situation in most Nigerian hospitals (including the structure of incentives), and easily the most vigorous rebuttal of the Health minister’s plans, is the reaction of the president of the Nigerian Medical Association (NMA), Dr. Francis Adedayo, as follows: “Is it the four per cent budgetary allocation to health? Is it the equipment that is not there and is not working? Where will they (imported medical experts) work, with empty seats and chairs at most hospitals? The health minister needs to tell himself some truth. No doctor in the Diaspora will want to come back under the present circumstances. The health system is not functioning optimally and we have to fix it and prevent brain drain before thinking of attracting doctors practising abroad.”
We fully endorse the NMA president’s statement. If Dr. Ehanire is serious about restoring the Nigerian health system to its former glory, the golden days when medical experts came to Nigeria’s teaching hospitals to immerse themselves in the latest skills and knowledge, he has to start by asking why Nigeria is h
emorrhaging medical talent and why, after all these years, the country’s hospitals remain “mere consulting clinics.” The Nigerian health sector is in a deep crisis, and it is difficult to see how it can import its way out of it.