Viral Outcry: Eight Months After THISDAY Expose, Lagos Hospitals’ Payment Woes Persist

Omolabake Fasogbon

Eight months after THISDAY newspaper investigation uncovered the dangerous monopoly in the payment system across Lagos public health facilities, and the havoc this state-designed arrangement wreaks on helpless healthcare seekers, the situation has persisted unabated.

Patients continue to struggle at pay points, where decisions regarding their access to treatment ultimately lie.

The investigation, titled, “How Single-provider Payment System Deepens Healthcare Barriers, Endangers Lives,” detailed heartbreaking patient experiences, including delayed and denied treatment, missed appointments, exploitation and even avoidable death under an arrangement that entrusts bill payment across the state’s 36 public hospitals to a sole payment provider.

The provider also routes transactions primarily through one bank and sometimes two, a protocol that locks patients out of treatment when the sole provider inevitably suffers downtime, as
no alternative payment vendor to process payments.

European Merchant Services (EMS), a London-based payment consultancy, defines the single-provider model as a system in which “an organisation handles all its transactions through one payment provider.”

In healthcare, this means that when the provider fails, patients are trapped, unable to pay, and therefore unable to receive care.

A recent outburst by Mrs. Kafayat Oshodi in a viral video detailing her encounter at Randle General Hospital and subsequent public outrage echoing her claims, corroborated THISDAY report.

Oshodi’s experience attests to the continuity of monopolistic payment structure that remains a thorn in the flesh of healthcare seekers.

Mrs Oshodi narrated how she was stuck at the payment point during an emergency case when the hospital insisted on cash, rejecting the e-payment option she had prepared for, the very payment method government has consistently promoted.

Acoording to her, ​”Despite rushing to the hospital with four different debit cards, they rejected POS transfers and insisted on a cash deposit, even after I had queued for an hour,” she stated.

“When I asked to make a transfer from my phone, they claimed the network was bad and directed me to a POS operator who charged me far higher fees than usual.”

While the government reacted to her claim, its response was evasive, failing to address the main issue: the demand for cash in hospitals, which was the major bone of contention, as Nigerians continued to question the motive for cash demand amid multiple digital payment options and push for cashless transactions.

The investigation found that cash often becomes the last resort in Lagos hospitals when the sole provider faces downtime.

The outcome is understandably so given Nigeria’s connectivity challenge, which is precisely why experts submit that state administrators must adopt a multi-provider payment system to allow seamless switching when one network fails, while offering freedom of choice to healthcare seekers.

As an implication of embracing a single payment vendor, digital health advisor Emeka Chukwu cautioned that it could create structural bottlenecks where a single outage can freeze public health corridors, disrupt emergency care, and erode patient trust.

“No critical investment should centralise payment around one agent. It is simply dangerous,” he warned.

From THISDAY’s investigation, however, Kafayat’s struggle was among the least of the hurdles patients endure under the state’s rigid system. Experts believe a state-owned contingency would have averted these ordeals, should a vendor system fail or come under a cyberattack, as once happened in the US.

THISDAY found none, save for the provider’s manual backup – cash, an alternative found to cause delays often associated with increased mortality and readmission rates, worsening clinical outcomes, and, in extreme cases, leading to death.

CEO of Clearwater, a U.S.-based cybersecurity firm, Steve Cagle, argued that that health organisations must maintain an in-house contingency, different from the vendor’s.

His submission followed a disruption that hit a large part of the US health system, when Change Healthcare — the sole billing and payment provider for much of the country’s healthcare sector, much like the model Lagos has embraced, suffered a major cyberattack that put healthcare on hold for over a month.

“Hospitals should have a plan if a critical vendor goes down. What if you have a vendor that’s down for an extended period of time?” he asked.

The outcry following Mrs Oshodi’s viral video suggests the masses are indeed pushed to the wall and eager for reforms that will be expedited.

THISDAY captured some of the struggles Nigerians relayed via social media following Mrs Oshodi’s revelation, below:

Onefold Mission wrote:
“I have experienced it first-hand many times. Once I was told by 2am midnight to pay N100,000 cash.”

Olowoyan Benjamin also wrote:
“I understand this woman very well because it happened to me too at Massey Hospital. If not for God that kept my baby alive, they almost turned me into a mad person. Even some people beg for money just to settle some bills and some still lost baby and you will still pay if the baby die.”

Also expressing her grievance, Iyanuoluwa Olatunde wrote:
“You will wonder if stakeholders of government parastatals are in touch with government policies. How would the federal government implement cashless policies and a government hospital is still insisting on cash payment? Isn’t that counterintuitive?”

Joseph Omogbehin also recounted his experience, saying:
“She’s saying the truth, I experienced this. My wife was referred on emergency to Ikorodu General. We got there 11am; she didn’t get to the ward until 6:30pm. The main problem is their payment system. The government is still responsible for this kind of operations; our health systems are still far from being reliable.”

See video of an official at a Lagos government hospital insisting on cash as means of payment for health services