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Covid-19 will end poor budgeting in Nigeria – Obi, Reps Committee on Health Chair

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By Nnamdi Ojiego

Chairman, House of Representatives Committee on Health Institutions, Dr. Paschal Obi, in this interview, calls for improved welfare package and good working conditions for health professionals fighting against coronavirus pandemic.

Obi also speaks on the decayed state of Nigeria’s healthcare system. He represents Ideato North/ Ideato South Federal Constituency, Imo State.

Do you agree that the outbreak of coronavirus pandemic has exposed the deplorable state of Nigeria’s healthcare system?

I will partly agree. I became the Chairman, House Committee on Health Institutions last year. Before the index case of Covid-19 was recorded in Nigeria, I had almost concluded facility tour of about 50 percent of tertiary health institutions we have in the country. From my observations so far, Nigeria’s health institutions especially at the tertiary level, have very qualified and adequate manpower. However, the greatest problem we have in health institutions is lack of equipment, facilities and environment under which doctors and other healthcare professionals operate.

Following this discovery, I made recommendations to the Federal Government through the Federal Ministry of Health. I recommended that government should sit up and start making adequate provisions for the funding of these health institutions. If you visit some of our health institutions, you may not find basic things like stethoscopes and thermometers to check blood pressure. Government has so much to do in ensuring that healthcare institutions are well equipped to deliver quality healthcare services to Nigerians.

Fighting Covid-19

Fighting the coronavirus has been very challenging for the entire world not only Nigeria. Nevertheless, we are doing well. The truth is nobody knew there would be an outbreak of disease. We had concluded and passed into law, the 2020 budget before the outbreak.

There was no provision for funding to fight the pandemic in the 2020 budget. Even at that, institutions like the Nigeria Center for Disease Control, NCDC, are still doing well. NCDC has procured a reasonable quantity of equipment needed to combat this pandemic. Also, if you go to some of our health institutions across the country, you have places that are properly equipped to handle this pandemic. We are not doing badly. The recovery rate in Nigeria is higher than what it is in some other countries.

Blessing in disguise

This pandemic should be an eye opener to Nigerians. Now that there is lockdown everywhere, if the President is sick, he might not have the option of going abroad for treatment. He may be forced to be treated at the National Hospital, Abuja, or Aso Rock Clinic. And when he gets there, he would see the level of decay in the hospital. With this, when we talk about adequate budgetary provisions, he would know that it is true.

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Same applies to the states. If any governor gets sick now, he would be taken to the abandoned general hospitals. They would now see the level of decay that obtains there. It is a blessing in disguise and I believe by the time we will be talking about the 2021 budget, at least, there will be a paradigm shift from envelope budgeting to actual budgeting.

Envelope budgeting

I have written the Minister of Health on why envelope budgeting must stop. Envelope budgeting is what they just did in this 2020 budget as regards the health institutions. For example, government can allocate N100 million to Federal Medical Centers, FMCs, and allocate N200 million to teaching hospitals for capital projects irrespective of what the institution had budgeted for the year.

And each of the institutions might have budgeted for themselves about 1billion or 2billion for capital projects. That is what we call envelope budgeting. It has no bearing on what your actual needs are. Budgeting done at the institutional level is geared towards tackling the actual problems they (health institutions) have at hand. It is pertinent that before we budget for these institutions, we take a facility tour of them, and ascertain their needs.

This is because, what the FMC, Owerri, needs may not be what that of FMC Umuahia or Sokoto needs. And what may be the needs of UNTH Enugu may be at variance to what LUTH in Lagos needs. Therefore, we can’t sit down and say that this year, we are giving each teaching hospital 200m for capital projects when we have not gone there to find out what they really need.

Legislative interventions

When I became Chairman of this committee in July last year, there was only one Linear Accelerator, the equipment used in carrying out radiotherapy in cancer patients. There was only one functional machine in Sokoto . There is none in the south. It was my intervention by way of a motion that compelled the federal government to do the needful. Federal government is providing these linear accelerators in each of the six geo-political zones.

I moved the motion and it was passed and provisions have been made for that in this 2020 budget. Before now, most cancer patients have to wait for more than six months before it could get to their date of appointment for radiotherapy. As a result of this, so many have lost their lives while waiting for radiotherapy, and that makes those who could afford it, go to countries like India, and Ghana among others for ordinary radiotherapy. It is a different story today because we now have them in six political zones.

Hospitals

Again, we have three national orthopedic hospitals in Nigeria. One each in Enugu, Kaduna and Lagos. If you visit the orthopedic hospital in Enugu now and take photographs of structures and equipment there, and then juxtapose it with that of Kano and Lagos, you will pity people that use the facility.

It is an eyesore. I have also made a serious move to correct that and provision for it was made in 2020 budget for the National Orthopedic Hospital, Enugu, to now look like its counterparts in the north and west.

Also, we have National Eye Hospital and National Ear Hospital both in Kaduna, northern Nigeria. There is none in the south. I have also succeeded in getting approval for us to have one national Eye Hospital in the South-East and National Ear Hospital in the South-West instead of having two of them together in one area. That of the South-East would be located in Owerri.

In my constituency, I have been able to attract several projects. Right now, there are about seven boreholes that are being provided in different areas in Ideato North and South. I have also, secured jobs for a lot of unemployed youths from my constituency in the federal civil service. There are about 10 health centres I’m going to transform. As a medical doctor, I would use them to show an example of what a primary health centre should look like.

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