•‘There was a year we didn’t work for eight months and we got salaries. That has to stop’

By Chioma Obinna

Recently, the Chief Medical Director, Lagos University Teaching Hospital, Prof. Chris Bode, was reappointed for the next four years by President Muhammadu Buhari.   Last week, the CMD unveiled his plans to improve the 57-year-old health institution. At the occasion, he said one of his plans is to ensure that the hospital achieves 100 per cent proficiency.

Excerpts:-

Chris Bode

Challenges of the past

When I came on board four years ago, the system was suffering. The greatest challenge was lack of confidence in the system, both among workers and the people who come here. Our various clients stopped believing in the system. Now, with the co-operation and collaboration of others, that narrative has changed. It’s humbling to know that the same environment that was so hostile has gradually embraced change. We had stormy relationships, stormy reception from trainees, from workers group, but I guess, through appealing to their good side and showing by example from the leadership of the institution in the past four years, the situation has improved appreciably. We have been able to change the mindset so that all workers at LUTH now appreciate what we were established to do – render services to people. That is what matters; any other thing will be excused. People are not interested in that, no matter what you do, if you do it very well, people will come to you and if you don’t they will go elsewhere. And we don’t want them to go elsewhere for many reasons because even our own livelihood depends on it and the mandate given to us would be a failed mandate if we don’t fulfil it.

Repositioning hospital

There has been enormous support in the last four years from the top management team, the nurses, the head of nurses and all heads of department; they have been marvellous as they embraced the experiment. The change we tried to implement has yielded very good results, with all modesty. We must thank the Minister of Health and his team. They have really risen to the challenge, done very well for us and also the workers in LUTH have been marvellous. I must say that our people know good things when they see it. I think that is what has been driving us. The entire workforce is eager to reflect the new order. The changes are manifest. For instance, our dental school that was decertified last year because we didn’t have dented chairs has now been re-certified. Through a joint effort between the university, alumni and management, we have been able to put LUTH back on the path to its former glory. Good things are happening, that’s my message and we must do more.   The greatest enemy of progress is to be complacent, there is no resting here. We must commend the management board led by Alhaji Isa Sali Bello and his team for astutely leading the hospital at this time; we have been able to accomplish a lot.

Changes

There is calm in the system now. I can recall that there was a year we didn’t work for eight months; our salaries were paid by government. At another time, we went on strike for five months. All that had to stop. The healthcare sector can no longer afford such disruption. So we had to start whittling that down with support from members of the public, members of our staff and even government. With time, the government started listening to what the agitations were and the government was fulfilling them, promising and fulfilling; coupled with delivering on low hanging, deliverables, intermediate term and long term plans. All these have now started bearing fruitful results and I like to add that it has really brought LUTH to the fore again. A lot has been done during the past four years. We now have a reliable power supply through our gas-fired electricity, we now have a very good blood bank, good water supply; our wards are beginning to be rehabilitated and other facilities as well including the acute stroke care centre. We are repositioning our radiology department. We are putting up a new structure for the care of over 8,000 HIV patients and our advanced facility centre has been up and running and is doing very well. Workers are going through further training and we have crowned it with the $11 million NSIA-LUTH cancer centre which the President commissioned in February.

Plans for the next four years

A lot more needs to be done, looking ahead. The reward for hard work is more work and, because our facilities have been there for 57 years now, we need to carry out complete rehabilitation of our wards, our out-patients department and many other structures. The out-patients facility is inadequate; we want to build an extension so that patients can be seen more promptly rather than being given long appointments. We are going to do the same thing for our operation theatre facilities and other facilities that need to be upgraded and expanded.

We are appealing to all like-minded bodies to assist LUTH. The late Chief Isaac Olusola Dada promised to build a renal dialysis centre for us before he passed away suddenly. It is going to cost more than N200 million. It will have 36 dialysis machines and will be one of the largest in the country for modern renal dialysis. The Lions Club and the family of Chief Dada will build and furnish it on a PPP basis, experts in dialysis, institutions that supply equipment and consumables can come and use it, we will make the services affordable to ensure that Nigerians come here rather than go abroad. We are still going cap in hand. Already, we have immense support from the Sovereign Wealth Fund; they have promised to sustain the cancer centre, so it will be a modern cancer centre that render services and give meaningful returns to investors. It will serve as a beacon for public-private collaboration in health care delivery. If they don’t see us as valuable, they won’t bring their money to tie down. We are planning a hospital-wide information management system to reduce the paperwork, improve efficiency and reduce the stress faced by patients. Another plan is to expand operation theatres, intensive care unit and eye treatment unit. The ultimate goal is to make LUTH a comprehensive and reliable hospital in one structure so that we don’t refer any patient. We want to achieve 100% proficiency. If LUTH refers somebody to any other place, it’s like telling them to go and die because we ought to have everything. Even if our accident and emergency ward are full, I would rather you move patients straight to the ward and begin emergency care at the ward rather than tell them there’s no bed. We would do all that we can to increase bed space. Even while doing this we must appeal to all Nigerians, services in LUTH are highly subsidized between 30 and 80 per cent. Depending on the services, for an average operation, you may pay a million naira outside; here you might pay just N200, 000.

Appeal

We are a government institution, but we must agree that services are not free. We need to review the concept of health care financing so that there will be universal coverage. There should be a safety net provided by the national institutional scheme for those who may easily fall through the cracks. The elderly, children, pregnant women and accident victims should be taken care of under a solid health insurance scheme.   Public health institutions must continue to treat patients they are not able to pay and we cannot reject anybody brought as an emergency. We found out that such obligations are a big drain on the finance of tertiary institutions, not only at LUTH, it happens everywhere. Maybe because this is a large hospital, we feel it a lot.