Crisis looms over plans to sell LUTH, UCH, ABUTH, others
Benefits of proposed sale, by ministry
IF the Federal Government goes ahead with plans it has so far made, apex public health institutions like the Lagos University Teaching Hospital (LUTH), the University of Nigeria Teaching Hospital (UNTH) Enugu, University College Hospital (UCH) Ibadan, Ahmadu Bello University Teaching Hospital (ABUTH) Zaria, among others, will be put up for sale or rather privatisation, soon.
But health workers have rejected such plans. Last week, they, excluding medical doctors, petitioned President Muhammadu Buhari over the plans to privatise the health sector and vowed to resist what they have called “a version of reforms in healthcare that are self-serving in terms of their narrow commercial interests and those of foreign pay-masters.”
The plan by the Federal Government to ‘sell’ public health institutions was confirmed in a document prepared by the Federal Ministry of Health (FMoH) in November 2014 titled “Recommendations for a National Policy on Incentivising Healthcare Investments.”
Because of the success recorded by reforms in the telecom, energy and banking sectors, advocates of the sale option believe it will bring in additional private capital that will encourage better quality care at the lowest cost and improved benefits to all stakeholders in the sector.
That in turn, according to them, would guarantee an economic imperative to invest into healthcare for a healthier population.
It will also stem the pressure on the naira from foreign capital flight due to outward bound medical tourism.
The health workers under the aegis of Joint Health Sector Unions (JOHESU)/Assembly of Healthcare Professional Associations (AHPA) alleged that the health sector is one of those sectors placed under the supervision of Vice President Yemi Osinbajo and that six doctors including agents of Western donor agencies in Lagos State that championed the commercialisation of health facilities were charged with the responsibility of crafting the health policy of the Buhari administration.
The health workers said one of the key recommendations of the six-man committee was to canvass a ‘‘reform of the Federal Ministry of Health and reduce the number of agencies from 14 to three based on alignment of scope and deliverables.’’
The health workers had alleged that the Buhari administration has sought views and position papers on healthcare agenda from strange templates, especially a particular group of entrepreneurs in healthcare rather than the true representatives of healthcare providers who are well structured into various healthcare professional associations and trade unions.
They further alleged that the pecuniary motives of the entrepreneurs in healthcare who belong to an array of professions and background remain an inclination to access funds provided by the International Finance Corporation (IFC). “They plan to lord their concept of privatisation and commercialisation on the health sector, notwithstanding the damaging effects it will bring to consumers of health services and the economy of the Federal Republic of Nigeria. It is apt to put on record that the operatives of International Finance Corporation who are citizens of Nigeria have no respect for our laws,” they said.
The health workers added: “They insist on a version of reforms in healthcare that are self-serving in terms of their narrow commercial interests and those of their foreign pay-masters.
“The team has been canvassing the agenda of bringing foreign chain retail promoters in pharmacy practice into Nigeria for instance.”
The health workers warned that foreign company domination prevents Nigeria from building capacity through Nigerian providers.
They called on Buhari to redress the impending damage the re-structuring of healthcare sector will occasion, in the public interest by directing appropriate quarters to embrace rational and home grown-initiatives to tackle challenges in the health sector.
Proposed benefits of planned ‘sale’ by FMoH
According to the document, the incentives being proposed will specifically impact the healthcare sector through: Improving healthcare delivery infrastructure within the sector; improving access to medical technology necessary for the practice of modern evidence-based medicine; increasing the level of technical skills within the industry, (public and private sector) through trainings, re-trainings, quality assurance and improvement programmes, certifications, investments in medical technology among others.
It would also create new opportunities for employment and growth within and outside the sector, especially for women and the youth. These opportunities would include: providing logistics; home and hospice care; clinical and non-clinical roles; information technology (IT) and health information management; research and development; diagnostics support personnel and preventative care promotion among others.
X-ray of private-sector healthcare investments
According to the document, the Federal Government has facilitated rapid diagnostic surveys on private-sector healthcare investments, with a view to expanding these initiatives, and some of the constraints identified include the difficulty in accessing growth capital; the high cost of doing business; the general lack of market information; the fragmented nature of the sector; a difficult business climate; restrictive fiscal policies; burdensome regulations and limited business/financial knowledge amongst health care delivery business owners.
It reads: “Consequent to this, the Federal Government mobilised private-sector-led approaches to expanding access of patients to quality healthcare, with a view to leveraging on the unique strengths inherent to the private sector including competition and efficiency. This approach is even more relevant in recent times as government funding to the healthcare sector continues to decline, both in real terms and as a percentage of Total Health Expenditure. The era of a government-dominated sector, with central control of health care service provision is gradually coming to an end and the private sector needs to be positioned and strengthened to plug the resultant gaps.
“Nigeria’s current population of about 160 million is estimated to increase to 200 million by 2020, which is then projected to double in another 30 years. Aside from providing much needed healthcare to its citizens, growing the sector will also translate to massive employment and entrepreneurial opportunities, for both skilled and unskilled labour.
“This incentives programme aims to focus on improving investments into the healthcare sector through strategic partnerships across all levels of government (Federal, State and Local), the private sector, development partners, donor organisations as well as development finance institutions and other financial institutions.
“It shifts the current healthcare industry focus from healthcare as a social programme of the government to a healthcare industry focused on service delivery and quality of care centred around the patient with robust participation of the private sector.
“Investing into healthcare will yield immediate benefits in the form of stemming the pressure on the naira from foreign capital flight due to outward bound medical tourism, as well as positive returns on investment and social capital for the private sector and the population.”
Nigeria and poor health financing
The document argues that Nigeria has had a steady rate of Gross Domestic Product (GDP) growth in the last decade annualised at 6.8 per cent per year and is now Africa’s largest economy (National Bureau of Statistics 2014).
Unfortunately, all of this has not translated into shared prosperity nor has it produced a reduction in extreme poverty. Despite the Federal Government’s commitment to improving healthcare delivery to its citizens, health outcomes continue to be sub-optimal with poor quality healthcare services and insufficient financial risk protection. In addition, infrastructural challenges, human resource constraints, a fragmented system and a lack of investment into the sector continue to haunt the healthcare sector.
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20 Comments
Who ever may have been part of such callous, insensitive and unacceptable recommendation are virtually asking government to undermine their basic responsibility to its citizens. This clearly shows how mischievous and uncaring
Some Officials of the past Administration conducted business .
Why would any responsible developing nation government engage in such hostile concept that has never been adopted in advanced nations particularly in Europe??.
However, I am sure the present administration will jettison such recommendation.
This is a decision long over due. Let’s begin to face reality that all isn’t well with our health sector, amidst other challenges of national development.
Lets face it – Health care delivery in this clime is at best shoddy like the rest of the Civil Service, privatization (handled properly) is the key to efficient healthcare delivery. IF Britain’s famed NHS is partly privatized, why can’t Nigeria’s public health system be overhauled. Are the incompetent current managers afraid of losing their jobs? at the detriment of the larger populace?
Go on FG, if you are serious about turning this country around.
The idea for privatization of these hospitals is overdue in the sense that it will yield positive results compared with what we have right now. It is a well known fact that in any industry, privatization promotes competition, accountability and efficiency. Our major teaching hospitals are overstretched and underperforming largely due to inadequate funding which in turn discourages innovation, scholarship and research. If the government can enact enabling laws that will enforce adherence to guidelines and oversight of the private sector that may emerge down the road in conformity with what obtains in other industries then I have a feeling this idea will fly. The few private hospitals in Nigeria comparatively are doing better even though at a higher cost largely due to lack of infrastructure which the government needed to have provided. Either way, health care industry in Nigeria is very far behind and to come up the stream privatization is the answer. Let the government spend her energy on primary health care delivery as this will impact more Nigerians than anything else and as for tertiary or referral centers let’s privatize.
Nothing wrong with health care under private managed care. This will allow more capital inflow to health care industry, but government overall supervision will still be required.
PRIVATISATION OF TEACHING HOSPITALS
This is one privatization that Nigerians must fight against.
A country that does not see anything wrong in subsidizing a petroleum product, PMS to be exact, cannot justify
privatizing any Government Tertiary Medical institution. No, it does not make
sense. Nigerians know the level of corruption involved in the subsidy of petrol,
even though we are told the other petroleum products are not being subsidized.
Yet the country is spending over a trillion Naira on petroleum subsidy every
year. How can such a country justify selling off any of it Teaching Hospitals? It
does not make sense.
A country that refuses to deregulate the petroleum product
sector which, ordinarily, would attract both local and foreign investors now
wants to sell the government tertiary medical institutions in a sector that is
already deregulated. It does not sound logical. Health sector is already
deregulated, which is good. Hence, we have private clinics, private hospitals
and private health establishments that are of the same standard as government tertiary
institutions. So why sell off the government ones? Some of the private
hospitals are already being used as Teaching Hospital by some Universities
because they meet the required standards. Why not allow the private “tertiary”
hospitals run side by side with the public ones? Why not encourage more of the
private ones to be set up by both local and foreign investors? After all even
the Government Teaching Hospitals are not as cheap as Nigerians would want them
to be.
To me, the proposal does not make sense. Not when considered
along side government’s view on not
wanting to remove subsidy on PMS. Saving a trillion Naira every year by
removing petroleum subsidy will go a long way in improving the service delivery
of not only the government health institutions but also the educational ones at
all levels.
I have a feeling some selfish people in the corridors of
power in Buhari’s administration are already working on how to rip the country
off the way they did during previous administrations. Nigerians must fight against
this vigorously. It simply does not make sense.
To start with health is fundamental human right. That can not be said of oil, banking or telecoms. Those are the things u can sell off. Secondly, financing is not the problem of our health sector. it is merely a symptom of a problem. The problem is lack of political will. Which will worsen when the hospitals are out of governments hands. So don’t solve the symptom. Solve the problem.
Govt should take intelligent control of our health sector. There is a role for the private sector in health but not a controlling role. Just a partnership. Government must keep the steering wheel. we can not sell off health. it is not a profit making sector like telecoms or banking. it is a fundamental human right and will not respond well to the forces of market economics. it will lead to privileges, disparities and schisms which will further disadvantage those who are already poorly affected by the state of health in Nigeria.
If you doubt go ask the Americans why after 300 years of democracy with a fragmented and privatized health system they just instituted ObamaCare. Also find out why ObamaCare was kicked against by the entrenched republican majority. and why it is considered revolutionary.
It is not impossible to have hospitals run as a business with the government awarding treatment contracts to these, but you risk serious dislocation of the health sector and undanger the sick and vulnerable as it is in the US, I understand with the specter of Obama health provision which is constantly under attack by greedy people. Here in the UK, most hospitals and teaching hospitals are owned by private companies and charites with the treatment of the population free at the point of delivery. In fact, some iconic hospitals were built through the public-ptivate partnership and the NHS commisions these to deliver care to the population on a bugget. Rhis is clearly not perfect as these hospitals often report overspend and have to go to the health secretary to ask for more funds. One argument is that this means that they cannot be awarding themselve huge pay rises as the citizen will see it in the accounts and will take exeption to public money being syphoned into private pockets, some of home are not UK nationals. What I am saying is that we should look at the wealth of evidence on the health sector worlwide for effectiveness before addopting any system. Perhaps a mixture can provide benchmarking and pressure on qualitiy of helth infrastructures.
When would we as a nation stop the prevailing self-delusion, lies and lying propaganda that we have indulged in since the build up to the 2015 elections. With the promise by Gookluck Jonathan administration to plough part of proceeds of partial of removal of subsidy which he kept to and President Buhari’s promise of free healthcare for infants and elderly and affordable healthcare for other citizens his administration of selling the commanding heights of our healthcare amounts not just to insincerity and barefaced cheating of the citizens but unleashing of the oppressive Shylock wholly profit-driven private investors operators on Nigerians that would take healthcare beyond the reach of the over 90% poor Nigerian citizens. In effect this issue should turn on integrity and the welfare of the citizens and not the profit motive of some bourgeoisie. Without bias we must put every administration to delivery on its electoral promises and President Buhari is one man that made quite a lot of electoral promises.
I just began to fear the future. Government owned hospitals is sure known to be the cheapest centre for healthcare in this country. Privatization yes agreed will bring competition but it will be for the high class. We are all looking for quality and standard healthcare but it wunt come cheap when privatized. In gov hospitals (lagos)one can have a CS done as low as 60 to 70k while the least substandard hospital will charge nothing less than 150 talk less of of others that charge about 600k for the same procedure. Which way nigeria
Fellow Nigerians Let no one be deceived by the false alarm by JOHESU Union. As far as we know Govt does not plan to privatise whole hospitals. We are told that what Govt plans to do which works every where it has been tried is target Public Private Partnership at some of the aspects of care: security, catering, sanitation, drugs and commodities, radiology and laboratory services and the mortuary service. Infact, when it was tried in some sates like Cross river and Bauchi the cost of services and drugs actually came down so much so that private pharmacies in the state used to go and buy drugs fro the state drug stores. Coupled with the state joining the National Health Insurance Scheme, it was a huge success. Any doubters can ask cross riverians how good it was in 2004-2008 when PPP and NHIS were operated in the state. The clinical care given to patients actually improves once you introduce PPP to these selected services.
The reality at this time is that there is very poor health care delivery in our nation right now. As one who has been privileged to train and work in 2 of our “centers of excellence”, I have to submit that we have been deceived and our facilities and skills are about 4 decades behind. Some form of privatisation if it will help provide the necessary facilities, provide skilled health care workers and stop the flow of precious $1-2 billion dollar that we spend annually in India, South Africa etc, then I say let it be. If private Universities have provided some stability to those who can afford their high cost, how come we still do not have quality health care providers in Nigeria 55 years after independence?
You are point my brother. Whatever that will not move up forward should be jettison. Public institutions are just avenues for corruption. You will agree with me that in-spite of the funds pumped into these institutions, they are mere shadow of themselves.
The fact that they are also use for training does not stop it from performing that function.
If hospitals should be privatised, all sectors including the clinical services should go. Only total privatisation is acceptable to Nigerians
you cannot privatise clinical services, that is the heart of medical healthcare, government always regulate that.
If it is true such a plan is in place to sell the tertiary health care institutions, it is ill-advised. It could be so with the Federal Medical Centres (FMC) across the country. Because the Teaching Hospitals double as Colleges of Medicine i.e. for training of medical doctors and research. So it does not make sense at all to sell them. This time around, Bulala for Buhari !!!!!!!!!!!!!!!!
This is not Buhari. Na osibanjo dey manipulate the thing for some lagos mafia
I tell una say dem go soon sell teaching hospitals and universities, una dey argue and laugh with me.
It was November 2014 plan…Osinbajo was NOT in government. It was GEJ and the PDP mentality of sharing everything to cronies. They found nothing else to share, after the oil wells and all infrastructure had been shared out…next..teaching hospitals…after that…Federal Government Colleges….inane looters. Thank God we changed them out
Thank God for the change election – this was also an example GEJ and the PDP mentality of sharing everything to cronies (started well meaning way under Obasanjo and went awry under Jonathan). They found nothing else to share, after the oil wells and all infrastructure & companies had been shared out…next..teaching hospitals…after that…Federal Government Colleges….inane looters. Thank God we changed them out
We will review and take appropriate action.