Some States Lack Consultants In General Hospitals

Posted on: Thu 18-07-2013

Many Nigerians blame government for the health care problems in the country. How true is this ?

This is an unfair assertion. Much as we all agree that there is a problem with the health sector, i think the government has tried, over the years, to address the issues. The most recent is the National Health Bill, which is an organisational framework to address the issues relating to health. But you will understand that some of these things require input from other stakeholders and it's been bedsviled by politics ofintra-professional rivalry. That is the major thing that is hampering its implementation. I think where the government should hacve acted promptly was to learn from other countries' experiences.In any case, a committee has been inaugurated to study what is happening around the world and recommend concrete solutions for the intra-professional problems that are hampering the implementation of well-thought-out government programmes. As for the National Health Bill, if it eventually becomes an Act, it will benefit the masses. So, it is not correct totally to say that the problem of the Nigeria health care system starts with government and ends with the people. Again, I think the problems hampering the National Health Insurance Scheme should be examined and modified to serve the people better.

Members of the public accuse teaching hospitals of negligence. If you agree, how can it be addressed?

What people term negligence- is not negligence in the real sense. It is something that has to do with the fact that the teaching hospitals, which were originally designed as tertiary hospitals are overwhelmed with basic problems of health. There are at least three basic levels of health care. These are the primary, secondary and tertiary. Teaching hospitals belong to the tertiary level and they are supposed to be centres of excellence for clinical research and others. Before you go to a teaching hospital, it should be by referral, so that those who get to the teaching hospital are those who require expert services. The primary and secondary health care needs should be taken care of at the local and state levels, but because they are not working, the top tier is now over burdened.

What can be done to address this problem?

We need to upscale the system, which is some form of strengthening, starting from the primary health care to secondary and then the tertiary levels. When this is done, it will remove the burden on the tertiary centres, which people now perceive as being negligent. There should not be an overwhelming outpouring of patients to a centre that is supposed to take care of specialist diseases. To reduce the burden; there is a role for the local government, which, by the way, should be autonomous. They can strengthen their own primary health care system such that there

would be health posts in the various communities, from where complicated cases could be referred to the primary health centre, which will, in turn, refer complicated- cases to the general hospitals at the local government level. It is only the more serious cases that will then be referred to the teaching hospitals .

Do not forget that tertiary health centres are basically for, training, research and clinical services. Again, if the National Health Bill is signed into law, it will address most of these challenges.

Meanwhile, state governments should realise that it is not enough to just build giant structures as hospitals; you need requisite manpower because health care - professionals, generally, can take care of these patients with minimum physical structures and this will meet the needs of the people. Again, they should strengthen community health workers who do most of the work at the primary level. In a secondary health care facility-you need consultants; but it is a shame that in some states, there are no consultants in the employ of the state governments. So, the issue is not

that of negligence but that of an overwhelmed system.

The governing boards of various tertiary hospitals were i naugurated recently. What difference will this make in the health sector?

These boards are made up of people who have expertise in various backgrounds, and their appointments should help in making the system functional. Note, too, that the boards are saddled with the responsibility of ensuring that government policies are implemented faithfully. However, there is always room for improvement. The new boards have new impetus and new leaderships and I believe they will perform if given the liberty to operate.

One of the major challenges facing teaching hospitals, especially the new ones, is the issue of infrastructure and the UUTH is not left out. How is this being addressed?

First, I cornmend'the former medical directors of the institution because the UUTH metamorphosed from the Sani Abacha Specialist Teaching Hospital to a Federal Medical Centre, before it was upgraded to a teaching hospital. If you visit the school, you will notice many ongoing projects, confirming the vision to expand the scope of services being rendered. However, funding has

been very poor. Now, part of what the board intends to do is to see how we can source for alternative funding to execute these development initiatives. Recall that some of the members of these boards are captains of industries; that will help us to see how we can diversify the income generation of the hospital. Again, most teaching hospitals have not received more than 20 per cent of their budgets, even now that we have passed the first half of the year. When the funds are eventually released, most of the hospitals will thrive.

How can we solve the problems in the health sector in order to meet the MDGs?

As a medical practitioner, I'd say it is not possible to meet the Millennium Development Goals. Everybody around knows this, except something miraculous happens. Year 2015 is around the corner and our indices ire still very abysmal. We need to look at areas where we have fallen short and redesign programmes to address those specific challenges. Health is a continuum; so, the setting of targets and dates, to me, does not make much sense. The point is to consistently address these problems without putting tags on them.

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