Posted on: Sat 21-11-2015

The National Health Bill- A Personal Commentary

The Nigerian National health bill was signed into law by President Goodluck Jonathan in December 2014 after an unending dilly dallying between the legislature and the executive.
On paper, it looks pristine, all-encompassing and well thought out. That means 25% percent of the job has been done. The remaining 75%, I believe, depends on its effective and pragmatic implementation as the years roll by.
First, I believe a brief overview will be in order:
The National Health Bill is a 29 paged document which consists of 7 parts as follows:
 PART I – RESPONSIBILITY FOR HEALTH AND ELIGIBILITY FOR HEALTH SERVICES AND ESTABLISHMENT OF NATIONAL HEALTH SYSTEM
 PART II – HEALTH ESTABLISHMENTS AND TECHNOLOGIES
 PART III – RIGHTS AND DUTIES OF USERS AND HEALTH CARE PERSONNEL
 PART IV – NATIONAL HEALTH RESEARCH AND INFORMATION SYSTEM
 PART V – HUMAN RESOURCES FOR HEALTH
 PART VI – CONTROL OF USE OF BLOOD, BLOOD PRODUCTS, TISSUE AND GAMETES IN HUMANS
 PART VII – REGULATIONS AND MISCELLANEOUS PROVISIONS
I will go on to itemize the components of the different parts before beginning a discourse on selected subsections.

Part 1 :
1.Establishment of the National Health System
2.Functions of the Federal Ministry of Health
3.Eligibility for exemption from payment for health services in public health establishments
4.Establishment and Composition of the National Council on Health
5.Functions of the National Council
6.Establishment and Composition of the Technical Committee of the National Council
7.Functions of the Technical Committee
8.Establishment of the National Tertiary Hospitals Commission
9.Functions of the Commission
10.Establishment of Primary Healthcare Development Fund
11.Establishment, Composition and Tenure of the Federal Capital Territory Primary Health Care Board

Part II
12. Classification of Health Establishment and Technologies
13.Certificate of Standards
14.Offences and Penalties in respect of Certificate of Standards
15.Provision of Health Services at Public Health Establishments
16.Health Services at Non-Health Establishments and at Public Health Establishment other than Hospitals
17.Referral from one Public Health Establishment to another
18.Relationship between Public and Private Health Establishments
19.Evaluating Services of Health Establishments
Part III
20.Emergency treatment
21.Rights of Health Care Personnel
22.Indemnity of the HealthCare provider, Office or Employee of a HealthCare Establishment
23.User to have full knowledge
24.Duty to Disseminate Information
25.Obligation to Keep Record
26.Confidentiality
27.Access to Health Records
28.Access to Health Records Health Care by Provider
29.Protection of Health Records
30.Laying of Complaints
Part IV
31. Establishment, Composition and Tenure of National Health Research Committee
32.Research or Experimentation with Human subject
33.Establishment, Composition, Function and Tenure of National Health Research Ethics Committee
34.Establishment and functions of health research ethics committees
35.Coordination of National Health Information System
36.Duties of a FCT as regards Health Information
37.Duties of FCT Area Councils
38.Duties of Private HealthCare Providers
39.National Formulary Control of Safety of Drugs and Food Supply
40.National Health Insurance Scheme

Part V
41.Development and Provision of Human Resources in National Health System
42.Appropriate Distribution of Health Care Providers
43.Regulations relating to management of Human Resources in the Health System
44.Training Institutions
45.Industrial Health
46.Industrial Dispute
47.Medical Treatment Abroad

Part VI
48.Establishment of National Blood Transfusion Services
49.Removal of Tissue, Blood or Blood Products from Living persons
50.Use of Tissue, Blood or Blood Products removed or withdrawn from living persons
51.Prohibition of Reproductive, therapeutic Cloning of Human Kind
52.Removal and Transplantation of Human Tissue in Hospital
53.Removal, Use or Transplantation of Tissue and Administering of Blood and Blood Products by Medical Practitioner or Dentist
54.Payment in Connection with the Importation, Acquisition or Supply of Tissue, Blood or Blood Product
55.Allocation and Use of Human Organs
56.Donation of Human Bodies and Tissue of Deceased Persons
57.Purposes of Donation of body, tissue etc
58.Procedure for revocation of any donation

And finally, Part VI
Regulations
60.Powers of Minister to appoint Committees
61.Assignment of Duties and delegation of powers
62.Savings and transitional provisions
63.Interpretation
64.Short Title
I will now proceed to give my humble commentary on selected portions of the bill.
Part 1 1 (a) says the bill shall encompass public and private providers of health services;
I like that it recognizes the reality of private health providers being major health providers because sometimes I fear Government in Nigeria over estimate their reach as far as the collective welfare of Nigerians is concerned.
But then the next question arises, as it will in future sections: How will equality and fair play be ensured? This is because the government has deeper pockets than the majority of private institutions and thus policies of provision of compulsory emergency services in the absence of pay, for example, which can easily be provided by Government might drive private institutions under over time.

Part 1, 1(b) states that it shall promote a spirit of cooperation and shared responsibility among all providers of health services in the Federation and any part thereof.
I sincerely wish such things can simply be wished into existence by the eloquence of some poetic policy. Truth is, it can’t- nonetheless, it is one way to start. My pessimism gathers strength from the alleged comments of a high ranking JOHESU member who expressed bias that the health bill was written in such a way as to favor doctors.
I think part 1, 1(d) {Set out the rights and obligations of health care providers} health workers} health establishments and users} might help to strengthen this section as I believe one major flaw in our health system that encourages professional rivalry is that many people are not clear on what their rights and obligations really are. There are no clearly defined roles of each health care cadre with sometimes overlapping functions. If I had a dime for every time I’ve heard- “…after all, it is not my duty to do so and so…” among healthcare workers while in public service- I’d be rich enough to retire in opulence by now!

This commentary will be cut into several volumes so we can dissect and biopsy as many segments of this bill as possible. Every stakeholder needs to have a clear understanding of what it says if adequate implementation will ever be a reality. Till the next volume, keep on being awesome at what you do and remember – A people get the government they deserve. Ciao!

Author: Dr Adebola Seyi

National Health Bill- A Personal Commentary Volume II

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