JOHESU/AHPA Advise Tinubu against Privatising Public Health Institutions

Health workers under the umbrella of Joint Health Sector Unions (JOHESU) and Assembly of Healthcare Professionals Association (AHPA) have advised President Bola Ahmed Tinubu against plans to privatise public health institutions in the country.

Reacting to a recent call on the federal government to privatise all Federal Health Institutions (FHIs) for effective healthcare delivery and as a panacea to reduce brain drain by the Nigeria Medical Association (NMA), JOHESU/AHPA warned that adopting such idea would jeopardise the cardinal objective of the National Health Policy.

In a letter addressed to President Tinubu, the National Secretary of JOHESU, Mathew Ajurotu, argued that the idea of concession, privatisation and commercialisation of the country’s health facilities “bothers more on the pecuniary gains and interest of a few stakeholders, especially privileged government officials who hold sway as CEOs of the various FHIs and their godfathers who have run the FMOH in recent years, than national interest.’’

“Privatisation symbolises a total sale or transfer of the public or government assets to private investors or companies with a sole motive of making profit. This way, government enterprises and ownership are transferred to individuals/profiteers while the government plays only the role of a regulator. This model of PPP is the norm in the corrupt laden governance architecture of developing countries, including Nigeria.”

They insisted that “concessions, privatisation, or mutilated public private partnership (PPP) agenda of public hospitals at this point in the evolution of health endeavour in Nigeria is a direct invitation to morbidity and mortality.

“The only option that works in the maximum interest of Nigerians at this time is to allow healthcare to remain a social welfare service to consumers of health.

“This model of PPP is the norm in the corrupt laden governance architecture of developing countries, including Nigeria, warning that alerted other health professionals that the sale of the teaching hospitals would adversely affect their emoluments, contrary to their thinking, adding that the sale of Federal Health Institutions (FHI) was not in the interest of 20 per cent of the sector’s workforce whose salaries represent 60 per cent of the personnel costs of the entire health workforce in FHIs.”

Describing the call by the NMA as “a continuation of the diabolical attempts to railroad an apocryphal reform agenda in the health sector, JOHESU/AHPA  accused the 24-man Health Reform Committee led by former Vice President, Yemi Osinbajo, as architect of the initiative which was designed to fail as it was not an all inclusive team .

 “When the immediate past administration constituted a 24-man Health Reform Committee under the headship of former Vice President Yemi Osinbajo, that committee was designed to fail ‘abinitio’ because it had a composition of 18 physicians, one pharmacist, one medical laboratory scientist, one nurse, two administrators and one lawyer.

“All efforts to make the Osinbajo-led committee imbibe the tenets of justice, equity and fairness to all concerned were jettisoned which made us predict that the effort was going to be a waste of time and scarce government resources,’’ the bodies said.

“The logical question observers of the Health Sector continue to ponder on is why privatisation of health institutions? Our bureaucrats in the old order at the Federal Ministry of Health (FMOH) with a retinue of their accomplices who still dominate some strategic quarters of that Ministry continue to emphasise the plethora of problems which produce poor outcomes and extremely wretched global ratings. The Nigerian health system continues to struggle in the rear in the comity of decent nations for reasons including inadequate stewardship function of government and fragmentation of health service delivery.”

They also listed others as “inadequate, inefficient and inequitable health financing, mal-distribution of health workers, poor infrastructure in the healthcare delivery system and poorly motivated and restive workforce, especially within the ranks of JOHESU members.’’

They called on “conscionable Nigerians to assist the federal government to be decisive in taking a position that the profiteers, concessionaires, greedy entrepreneurs and their collaborators in government jostling to take over the FHIs be responsible enough to build their own world-class health facilities like their presumed equivalents do in the global arena.

“Even in Nigeria today, we have a few tertiary hospitals like the Duchess and the Reddington Hospitals which continue to make footprints in the sands of our evolving healthcare dispensation.

“In Lagos State, where the privatisation of healthcare was kick-started by these same dramatis personae, the experiment has failed. The privatised pharmacies which were about six at inception have totally failed in at least four of the centres at huge losses to Lagos State Government.

“At the federal level, the commercialisation of the Pharmacy facility of the UCH, Ibadan collapsed and the concession of Garki Hospital, Abuja has never been a value-added decision. Today, that facility is a shadow of itself, as it has become inaccessible to a wide range of consumers of health in the Abuja area.”

JOHESU/AHPA noted, “a glaring example of the exploitative propensities of the private hospitals in our health system is the pricing index of drugs, when private sector facilities are compared to public sector pharmacies and private sector pharmacy facilities.”

According to the document, “a World Health Organisation (WHO) studies reveal that there is a 193 per cent and 188 per cent differential in the baseline pricing of drug prices in private hospital pharmacy facilities over what is obtainable in public sector pharmacy facilities and private pharmacy facilities.

“This expressly defeats the goals and objectives of the National Drug Policy 2021, which advocates accessibility, affordability and efficacious drugs in our health system. At a time the life expectancy of a Nigerian is 54.5 years because of prevailing challenges in health, the situation will only get worse because more Nigerians will not have access to affordable and efficacious drugs.”

They further said, “the Guild of Medical Directors, an influential medical stakeholder, has continually insisted that over three-quarters of health facilities in Nigeria’s health sector are private concerns. In other words, if 75 per cent of the facilities are already private sector driven entities without commensurate impact, then compelling a shift/orientation of Federal Health Institutions (FHIs) which are public sector facilities to become private facilities will not fundamentally impact on the health system.

“What the health systems needs is a complete redress that takes care of the in-depth corruption in the management of the FHIs, lopsided composition of the Boards of Management (BOM) of the FHIs, the appointment of competent CEOs for the FHIs as well as a responsible benefit package for all cadres of the healthcare workforce in the various FHIs.”

JOHESU/AHPA appealed to well-meaning Nigerians to take action and prevent the federal government from privatising the FHIs, even as they reiterates its calls for the appointment of non-Physician Health Minister to pave way for the restoration of the hitherto great times when health administrators steered the ship of healthcare successfully to attract the likes of the Saudi Royal family to UCH, Ibadan in the ‘70s.

“This was the era our health system was rated as one of the top five in the commonwealth.

“The federal government must return the business of hospital management and administration to seasoned administrators and managers of cognate experience.”

They further advised that “all health professionals who desire to head hospitals in Nigeria must henceforth undertake specialist management and administrative courses at postgraduate levels in specialised schools and institutes.

“These health professionals including pharmacists, physicians, physiotherapists, medical laboratory scientists and other health workers must be made to study health administration and management in their reviewed curriculum even at undergraduate level moving forward,’’ they said.