…Stakeholders champion resistance, call for review of project
RECENTLY, the Infrastructure Concession Regulatory Commission, ICRC gave the Federal Ministry of Health the nod to concession 22 Federal Teaching Hospitals. The selected teaching hospitals are to be run on a Public-Private Partnership, PPP, basis.
The ICRC Director-General Mr. Chidi Izuwah, the goal is to bring private investment to upgrade these facilities, in expectation that the project would transform the institutions, improve access to healthcare, reduce medical tourism and create direct and indirect employment for Nigerians.
Series of criticisms and outright rejection have ensued. A cross section of stakeholders says the concession plan would severely compromise quality of life of the average Nigerian.
They say attempts to commercialise the pharmacy facility of the University College Hospital, UCH, Ibadan collapsed and that at the Garki Hospital; Abuja where such took place, things have never been the same. Consensus is that the project will widen the gap in healthcare access by taking it out of the reach of the common man. Sola Ogundipe, Chioma Obinna, Gabriel Olawale and Chinelo Azike spoke to major stakeholders in the health sector on their concerns and recommendations. Excerpts:
It is unacceptable—Comrade Ayuba Wabba, President, Nigeria Labour Congress
“At inception of the present administration, President Muhammadu Buhari publicly expressed opposition to privatisation of healthcare in the country. But you can see that whereas they cannot pass through the door as the door is locked, they are coming through the backdoor that is unacceptable. The major roles of tertiary hospitals are teaching, research and provision of tertiary health services at affordable cost.
“So I wonder what would be achieved if the tertiary health institutions are privatised or concessioned, because the two important components of research and teaching will suffer. “Healthcare delivery should not be for profit, even in the developed world, healthcare still remains a priority. In a country where the inequality gap is so wide between the rich and the poor, if healthcare is made essentially for profit generation, many poor citizens will not be able to access it. Government should instead invite the private sector to invest by establishing new hospitals and not take over existing public hospitals”
It’s a ploy to rob Nigerians of access to health services — Dr Casmir Ifeanyi, National Publicity Secretary, Association of Medical Laboratory Scientists of Nigeria
“The move is nothing but a ploy to rob Nigerians access to healthcare. Nigerians also need to resist concession of our health system into private hands. That PPP template in health sector amounts to robbing Peter to pay Paul.
It’s robbing Nigerians’ access to health services to enrich a few. In other parts of the world, private sector is contributing to healthcare provision and does not go to take over public health institutions. If things continue this way, very soon public health institutions will be shut down so that the private institutions can thrive. Nigerians need to wake up. I believethe President was not properly guided in this matter. So we hereby demand upward review.”
A review is necessary —Dr. Osahon Enabulele, President, Commonwealth Association of Nigeria
“The planned concession of public hospitals needs to be reviewed with involvement of all stakeholders, including members of the public. Similarly, there is need to learn from previous experiences. This is to ensure that the plan aligns with the primary objectives of setting up public hospitals in Nigeria, particularly with regards to advancement of social justice, equity and fairness.
Whereas the objective of the concept developers may be that of improving availability and quality of services, it must be understood that whereas private sector involvement in healthcare delivery is critical, government cannot hands off ownership of these hospitals. Rather, government should exercise greater responsibility by way of increasing her financial and material investments in health care, with institution of better governance mechanisms at all levels.
The private sector should be supported with soft single digit interest loans and grants through the establishment of a Health and Hospital Development Intervention Fund (HHDIF).
Ceded public facilities have not yielded result —Dr Saliu Oseni, Chairman, Lagos NMA
“Sincerely, I don’t believe in it (concession) because the reality is that, all we need in our public hospitals is discipline. Again, governments do more of politicking by going in the wrong direction. If you cede the public facilities in healthcare, tell me how it improves the services?
A lot of hospitals that we have ceded have not given us any result so what we have done is that we end up selling a project or a facility that gulped billions then we will now say we are doing privatisation, No.
The truth of the matter today is our government knows things that are not functional but they have not done anything to make it functional and they keep saying we don’t have funds, so where do our taxes that we pay go to? Is it to service the Senators or Ministers or what? So, the people should rise and demand that they divert the monies to the proper place and we will have results. Even the so- called five percent or less that is dedicated to health, who is monitoring it? How is it audited? Is it really used for what it is supposed to be used for? Those are questions that not answered.
Government should concession only 40% —Dr Anthony Omolola former President, AGPMPN
“”My take is that concessioning can be done for 40 percent of the facilities and 60 percent should still be run by the government. With concession, these facilities are expected to be more efficient and better equipped. However the issue of affordability has to be dealt with.
Only better remuneration will stem the tide of brain drain. It is expected that concessioned facilities will be under pressure to provide optimal conditions for staff and clients. Government should still leave a good number of facilities under its management to ensure access for the less privileged. The fact remains that Universal Health Coverage is the way to go.”
Concession at all levels will reduce medical tourism —Mr Balogun Ajiboye, President, Association of Private Nurses Practitioners of Nigeria
“The implication of the decision to concession 22 health facilities is that the selected teaching hospitals will be run on a public -private partnership for improving access to quality healthcare services. Let’s view it from the angle of indicators for provision of Health care which are available health care services and sanitation, accessibility and utilisation, quality of care.
It is a notorious fact that none of the public hospitals, be it primary, secondary or tertiary can boast of any of the indicators.
What is lacking in healthcare delivery system in Nigeria is access to quality care and not the shortage of health facilities, so If we can use the facilities on ground optimally the health status indicators will definitely improve in Nigeria.
Looking at other variables, if concession is encouraged and it is properly done, it will reduce waiting time, reduce health workers incessant strikes , reduce redundancy in health care work force and promote efficiency and high productivity in health sector in general.
Healthcare will be inaccessible —Comrade Olurotimi Awotunde, State Auditor, NLC Lagos State Council; erstwhile Chairman, Lagos NANNM
“The Federal government should be careful privatising public health institutions because health services are social services. The Labour Unions are not in support of privatisation of the healthcare sector. It will make healthcare inaccessible to the common man whose wellbeing is our interest.
It is also going to create unemployment because the new occupant will set new terms and conditions. It is another attempt by the federal government to get people out of job and increase the unemployment rate.
What government should do is increase budgetary allocation to health sector in line with Abuja Declaration. That should be the focus of government to make healthcare services accessible and reduce medical tourism. We need to discourage it and invest in training of workers and replace obsolete equipment.
Concession will kill remains of health service—Pharm Bola Adeniran, Chairman, Lagos PSN
“Whatever remains of the health services is about to be sent a death knell because of the concessioning of 22 Federal health institutions in Nigeria. President Buhari is especially encouraged to evaluate the motive of the ICRC which, in conjunction with the immediate past leadership of the Federal Ministry of health has been championing an agenda of privatization/concessioning of Pharmacy and Laboratory, Radiography, Physiotherapy and related facilities.
The Federal Government is once again advised to assess the benefit/risk ratio of this policy especially against the background of poor result turned in facilities like Garki Hospital, Abuja which was concessioned to private profiteers but has not improved in efficiency or competencies since the tragic concessioning exercise some years ago.
For the records, services at Garki Hospital, Abuja are no longer affordable to the common man, implying that safe and effective medicines for all cannot be attained in such facilities. This completely jeopardizes the National Drug Policy 2005 of the Federal Republic of Nigeria.