By Johnbosco Agbakwuru
Recently, the State House Clinic was in the news for the negative reason. The wife of the President, Aisha Buhari, had lamented that the place was a shadow of itself and could not render the services expected of it due to lack of drugs and absence of vital equipment.
The clinic has the mandate to cater for the health needs of the President, the Vice President, other top government officials and their families.
Designed as a world class hospital, with the right equipment and qualified personnel, everyone gravitated towards the State House for the treatment of any ailment, no matter how complex. As at the last count, the facility had catered for over 10,000 patients for free! Meanwhile, this comes with a price: High maintenance cost which currently flies in the face of poor budgetary allocations. And the poor allocations degenerated of late to the point of lack of adequate drugs and equipment to handle the medical needs of the people who patronize the State House Clinic.
No wonder, the President’s wife, who visited the clinic for medical attention, was disappointed because there were no drugs and equipment to handle critical cases.
But the Permanent Secretary of the State House, Jalal Arabi, blamed the situation on poor allocations in the face of the high cost of running the place. According to him, it costs the clinic N2 million monthly to maintain its Magnetic Resonance Imaging (MRI) and other scan machines amongst others. The implication is that the high cost of maintenance could only be sustained with adequate budgetary allocations and timely releases which unfortunately are lacking.
As a wholly government owned facility, the State House Clinics depends solely on budgetary allocations from the federal government. But with the advent of economic recession in the country, the facility, like other government institutions, suffered dire consequences.
While defending the proposed N3.219 billion allocation to the State House Clinic in the 2017 budget at the National Assembly, the State House Permanent Secretary, Arabi, told lawmakers that the government intended to upgrade the facility to reduce the incidence of medical tourism and save foreign exchange for the country.
He faulted the claim that the State House Clinic received N11.01 billion from 2015 to 2017, adding that the facility received zero allocation for capital project sin 2017, while only 33 percent of the entire budgetary allocation to the clinic was released since 2015.
Speaking through a statement by the Deputy Director, Information, State House, Attah Esa, the Permanent Secretary stated that out of the total capital appropriation of N2,941,062,044 billion for the period, only N969,681,821.53, representing 32.97 percent, was released, while of the N465,935,358 billion earmarked for recurrent, only N225,575,200.60, representing 48.41 percent, was released.
The statement read: “The attention of the Presidency has been drawn to recent media reports suggesting that the State House Medical Centre had received N11.01billion as appropriation for the period 2015-2017.
“According to the Permanent Secretary, State House, Jalal A. Arabi, contrary to the above claims, out of the total Capital Appropriation of N2,941,062,044.00 and Recurrent Appropriation of N465,935,358.00 for the period under reference, only the sum of N969,681,821.53 (representing 32.97%) for Capital and N225,575,200.60 (representing 48.41%) for Recurrent was actually released.
“Arabi also said it may interest the public to know that there was zero capital allocation for the Medical Centre in 2017, while out of the N331,730,211.00 being recurrent appropriation for 2017, the actual amount released up to September was N91,370,053.60 (representing only 27.54%).
“The Permanent Secretary emphasised that the above figures are verifiable from the Ministries of Finance, Budget and National Planning.
“He observed that during the three-year period under review (indeed two years since no capital allocation for 2017), and despite the shortfalls between budgetary provisions and actual releases, the Medical Centre continued to provide free services to the over 10,000 registered patients annually. In addition, the Centre has continued to execute on-going projects.
The foregoing suggests that with adequate funding, the clinic can return to its path of excellence.
Besides, the Permanent Secretary while speaking with the lawmakers said that the State House Clinic takes care of Resident Doctors working there.
He also said that 80 percent of the State House workers and their spouses enjoy free medical services, despite their failure to enlist on the State House Clinic’s National Health Insurance Scheme, NHIS.
“The State House reached an agreement with HMOs with regard to the remittance of all NHIS payments in respect of State House staff whose NHIS point is the State House Medical Centre”, Arabi said.
‘’It is instructive, however, to note that whereas almost 80% of the personnel serving in the State House access medical services at the State House Medical Centre, only about 20% of them selected the medical centre as their NHIS point.
“The implication of the foregoing is that, whereas they access free medical services at the centre, their respective NHIS contributions go to those medical facilities they selected as their providers, even though they do not go there for any medical service.
‘’This explains the quick depletion of the drugs and other consumables due to the very high number of patients being attached”.
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Consequent upon the myriads of challenges facing the clinic, the Ad-hoc Committee of the House of Representatives probing allocations to the clinic, declared that the life of the President and his family members should not be put at risk, saying there was need to have an effective health management in place in case of an emergency.
From these submissions, it is clear that the major constraint facing the State House Clinic is insufficient funds. In a situation where its budget could not be increased with assurances of releases to match, chances are that the facility cannot deliver on its mandate. The litany of complaints will therefore continue.
This calls for government to think out-of-box in order to prevent further rot in the facility. The Permanent Secretary, having studied the situation, has suggested that the facility be commercialized to ensure greater efficiency.
This suggestion means that those patronizing the clinic would pay fees for the services they enjoy. Some other stakeholders want the fees subsidized.
Considering the class of people patronizing this facility, charging them a token should not be a big deal. This is against the backdrop of the fact that most of them can afford to pay for the best of treatments both at home and abroad. The funds so generated from the fees should be used to upgrade the clinic and elevate its status to one of the best in the world.
When the facilities are upgraded and its members of staff are world class, patronage is likely to increase and the goal of discouraging medical tourism would be realized.
Again, since majority of those patronizing the State House Clinic are government officials and civil servants, they should be made to domicile their National Health Insurance Scheme (NHIS) in the facility. Substantial percentage of their medical bills could be settled through the insurance scheme while the patient pay the remainder.
With these, coupled with a well focused and disciplined management, the dust raised by non-availability of drugs and inability to maintain the clinic’s equipment would become a tale told in the moonlight meant only to entertain toddlers.