Why Nigeria health sector and indices are very poor — MHWUN President
AT the just concluded 10th National Quadrennial DelegatesConference of the Medical and Health Workers Union of Nigeria (MHWUN) in Abuja, the President of the Unon, Comrade Biobelemoye Josiah, lamented the poor health indices and the deteriorating health care system in the country. He highlighted the factors responsible for the bad state of the health sector; and also proferred solutions to the problems.
Medical Tourism and Brain Drain
The nose-diving healthcare delivery system has deteriorated to the extent that it is embarrassing to look with nostalgia how Nigeria was once the hub of healthcare where neighbouring countries once considered the Mecca for health pilgrimage. What obtains at the moment is a massive health tourism of those who can afford better healthcare delivery outside the shores of this country.
This embarrassing state of the once celebrated health sector has been bedevilled by poor management that the country is witnessing high level of brain drain of personnel to other countries where the environment of operation is attractive.
Privatization/Public Private Partnership (PPP)
Many factors have conspired to cast a very gloomy and dark cloud on the horizon in the Nigerian health care delivery system, prominent among which is the attempt by government to lean towards the policy of the capitalist west to privatize health institutions, especially Tertiary Health Institutions. The privatisation train has made efforts to justify its implementation by insisting that privatisation, Public Private Partnership (PPP) and all its corollaries in commercialisation and concessioning as well as outsourcing are necessary in order to curb incessant strikes in the health sector which they erroneously believe remains the bane of good health care delivery in Nigeria.
If the business of government is to provide for security and the welfare and well being of its citizenry, then privatisation of the health industry as being saliently canvassed by the managers of the health systems in Nigeria would not provide the answer.
Management of Health Institutions
What has destroyed the whole health system in Nigeria is the government’s mistake of handing over the management of the health system to an opportunistic and ill equipped powerful minority of the health team who have completely destroyed the team spirit and arrogated to itself the sole ownership of the system to the exclusion of the large majority of the team members.
Under this guise, the focus is no longer patient oriented but self serving motives leading to not only corruption in the system but a management of the sector by a very ilI-equiped, professionistic professionals that have abandoned their duties in the clinics and theatres for management assignments.
Appointment of Ministers/Permanent Secretaries
When a Minister of health, a Minister of State for Health and, until recently, a Permanent Secretary of health and almost all departments are managed by one profession whose sole purpose is to exclude other professions in the healthcare delivery system for self serving reasons, there can be no harmony in the sector.
If Nigeria must return to our hey days of exemplary healthcare where the common man would have access to efficent and affordable healthcare delivery; corruption, which has become the enfant terrible in the Federal Ministry of Health must first be confronted and defeated. And this can majorly be achieved through a very conscious method of divesting the management of the health care system from a tiny powerful health professional group whose main objective is to commercialize the health system for their benefit rather than to benefit Nigerians, particularly the poor and vulnerable who cannot afford the cost of privatised health systems.
Call on President Buhari
As long as the appointment of Ministers of Health, Directors in the Ministry of Health and the Chief Executives of Health institutions remain the birth right of one profession, the Medical doctors, to the exclusion of other health professionals in the team, turbulence and inefficiency shall continue to thrive as they are only not trained for such duties. Their discriminatory approach would continue to invite protestations from other members of the health team who are in the majority. As long as government does not make conscious efforts to break this monopoly by the Medical Doctors, a monopoly that is self serving, Nigerians would continue to suffer for it and not even privatization that is presently heating up in the Federal Ministry of Health would halt this destructive nose-diving of the health ‘indices of Nigerians. We therefore call on President Muhamadu Buhari to take a special interest in the Health industry in Nigeria with the hope of reversing the trend.
Expected Actions Required
As an immediate action to put confidence into Nigerians, the appointment of Ministers in the Ministry must not necessarily be to only health professionals in order to halt politics of exclusion that has taken tap roots in the Ministry. We believe the appointment of non-health professionals as Ministers, or the mixing of appointments of both Doctors and other health professionals as ministers in the Ministry of Health would go a long way in boosting the conhdence of the operators/stakeholders in the Ministry that this present administration has come to terms with the problems and is determined to proffer solutions to them. In the long run, we advise the revitalization of the healthcare delivery by returning the management of health institutions to Hospital Administrators who have not only been trained for such functions but also possess the professional attitude to manage these institutions without fear or favour of any professional group.
This would reduce incidences of friction in the system and would provide untinted and unbiased advice and information to government on the way forward in our healthcare delivery system.
A situation where all health institutions and hospitals are managed by Medical Doctors to the exclusion of other very qualified health professionals has always been a basis for invitation of contestations and thus acting as a major bane on good healthcare delivery.
The search for Local Government autonomy has always been supported by our union because it is at that tier of government that the impact of government would be better felt. Our union, under the auspices of the Nigeria Labour Congress, just like the Nigeria Union of Teachers, has always thrown our weight behind Local Government autonomy as long as the funding of Primary education and the unfettered establishment and funding of Primary Healthcare Boards/Agencies are not going to be affected adversely.
Under this arrangement, we call on government both at Federal and State levels. to accede to this autonomy with laws that ensure the adequate operations and funding of Primary Healthcare through the unfettered establishment of Primary HealthcareAgencies.