By Chioma Obinna
Community pharmacists in Lagos have rejected the newly launched Lagos State Health Insurance Scheme, saying “the Scheme is shrouded in secrecy and not encompassing”.
The pharmacists under the auspices of Association of Community Pharmacists of Nigeria, ACPN, Lagos State Branch described the Scheme as discriminatory as it does not give room for other professionals apart from medical practitioners to participate actively.
Speaking in Lagos, the Chairman of Lagos ACPN, Pharm. Olabanji Benedict Obideyi, noted: “From our understanding, each family comprising mother and father, four children will pay N40, 000 per annum and it is compulsory, yet the entire health care professionals were not given a level playing ground to participate actively.” Olabanji who spoke during the Association’s Annual General Meeting in Lagos, State faulted the set up of the Scheme.
“What they have done is not in the best interest of the public by lumping everything about drugs, and in terms of remuneration to the doctors. That only makes them to pay if they need that service.
Stating that the situation would promote quackery, he said: “Some doctors will go and put up a kangoro dispensary unit claiming that they don’t need a pharmacist to be running it while some that are a bit ethical-minded will go and employ a Technician who in the first place should work with the supervision of a pharmacist. The technician will begin to prescribe drugs based on what they have and not what they need.
“For instance, if a patient comes to the hospital and needs antibiotics, the doctor, ordinarily, would have recommended Augmentin but because the funds have been warehoused to him and he pays himself, he will give Amoxil or Amoxicillin and which is just like 2nd class drug, when he should have given the 1st class drug and this can only happen because of the way the policy is queued towards them.
“But if it is done normally, when a patient sees a doctor, after diagnosis, the doctor will write the first choice drug for the patient,” he explained.
Obideyi argued that the present state of the Scheme would deny patients service of qualified pharmacists as the job of a pharmacist does not end at dispensing drugs but also ensure that the drugs prescribed are appropriate for the patient and in the right dosage. “You don’t want to solve one problem and create another. This is some of the benefits Lagosians are being denied of which they have actually paid for. These are some of the issues we are raising.”
Obideyi said the Association had on several occasions raised these issues with the State Commissioner for Health who is yet to address them. “The Commissioner kept giving all kinds of excuses. We have over 1,350 community pharmacists scattered all over the state.
“We have told our members that none of them should subscribe as a provider under the Lagos State health insurance until such a time our concerns will be addressed.
“We raised our concerns last year to alert the public but instead of addressing it they went ahead and launched the Scheme.”
He expressed worry that the scheme may end up like the National Health Insurance Scheme at the federal level, adding that it was the same issues that brought NHIS to its knees.
“It is unfortunate we don’t learn from experience. This is what they did at the national level and it failed. Everything has been shrouded in secrecy.
“We are supposed to act as a gatekeeper if doctors made mistake in prescription it is our responsibility to ensure that we detect that and ensure the patient is not injured. If I subscribe as a provider the chances that I will get a prescription will be very small. The money has been warehoused to the doctor. The same thing is applicable to the medical laboratory too.
Obideyi argued that for their members to participate, the government must recognize the role of the pharmacists, and as secondary providers, they must get a fee for service and not capitation as well as ensure that they removed payment for fees from the consultation.
“What we want is that when the doctor writes the prescription, he directs it to us, we do our own job, counsel the patient on how to take the drugs, get it labeled and ensure that the patient gets well.
“The payment should also be from the government agency handling the payment, not from professional colleagues that will short change us,” he added.