Why health workers reject concession of facilities at teaching hospitals, by JOHESU/AHPA
The ICRC had, in August 2019, granted the Federal Ministry of Health (FMoH) the nod to concession 22 tertiary hospitals and the selected teaching hospitals would be run on a public-private partnership (PPP), with the aim of improving access to quality healthcare services.
Chairman, JOHESU, Comrade Bio Joy Josiah, told journalists: “This is a hurricane that catalysis a descent to a bottomless pit of fruitlessness and unproductivity in healthcare. The reality in economic terms is that the majority of our people live in poverty and squalor. They cannot access or afford health and its major components safe and efficacious drugs even in public facilities as it stands at the moment.
“Any attempt to concession facilities in public health institutions compromises the lives of the vast majority of Nigerians and compounds their existing woes. As a matter of fact, concession, privatisation or mutilated PPP agenda 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 remain a social welfare service to consumers of health.
“The JOHESU/AHPA makes bold to say that the Federal Government should admonish the profiteers and greedy entrepreneurs jostling to take over public health facilities to be responsible enough to build their own world-class health facilities like their counterparts do in the global arena.”
The health workers said the Federal Government should be decisive in taking a position that the profiteers, greedy entrepreneur and their collaborators in government circles jostling to take over public health facilities in Nigeria be responsible enough to build their own world-class health facilities like their counterparts do in the global arena.
Josiah said the tragedy of the ICRC approval of the concession of 22 FHIs is one of the tragic fall-outs of the Economic Team of the FG between 2015 and 2019, and in Lagos State where the privatisation of healthcare was kick-started by these same dramatis personae, the experiment has failed.
The health worker said at the Federal level, the commercialisation of the pharmacy facility of the University College Hospital (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 wide cognoscenti of consumers of health in the Abuja area,” he argued.
Josiah said JOHESU/AHPA therefore strongly urges the Federal Government to immediately stop the concession of Teaching Hospital facilities to private profiteers. “We must seize the discourse to advise other health professionals who have been promised that concession of these facilities will not affect them to be wary and discern wisely,” he said.
The health worker said private profiteers will naturally get rid of the block of health professionals whose wages consume 60 per cent of the entire health workforce in FHIs even when they constitute less than five per cent of the entire personnel in the health sector.
Josiah said the JOHESU/AHPA continues to collate evidence-based data at the local and international levels on the desirability or otherwise of concession, privatisation or mutilated PPP agenda.
The health worker said after a very thorough critical evaluation of the various issues, JOHESU/AHPA wishes to further posit as reflected thus:
*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 order 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 need 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, appointment of competent Chief Executive Officers (CEOs) for the FHIs as well as a responsible benefit package for all cadres of the healthcare workforce in the various FHIs.
*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. 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 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 2005, 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. In a similar vein, life expectancy will be jeopardized when the cardinal goal of National Health Policy, which also seeks accessible and affordable healthcare services, is truncated.
A scenario whereby presumably consumers of health cannot afford state of the art health facilities makes them inaccessible contrary to the goals of the National Health Policy.
*The United Kingdom (U.K.) that has always been adjudged an international benchmark in a workable version of Social Health Insurance and health system is beginning to fail because of the increasing influence of private profiteers. More private sector engagement in health is surely beginning to hurt the U.K. economy in the last few years. The involvement of Private Finance Initiative (PFI) in the health system of the UK has increased the cost of health by a factor of three.
These developments are hinged on the reality that Public Systems better control over-servicing and ensure the most appropriate form of treatment. Conversely, private providers also pay more to borrow, exploding the myth that they bring more and cheaper financing to healthcare.
Despite widely held beliefs to the contrary, funding universal public healthcare systems through general taxation are more efficient, creates better healthcare outcomes and is more equitable than the private alternatives.