Nigeria: Controversy On Overseas Medical Treatment For Public Officials
by Ayo Olukotun
The country is still reeling from the shock of the exposure of the horrible and dehumanizing condition of the Ikeja Police College. So frighteningly degraded is the shape of the college that the President following his unscheduled visit has reportedly ordered a probe into how matters turned so awry in what was conceived as a top flight security institution.
Equally, if not more important, and certainly warranting presidential intervention is the status of our much decayed public health institutions, whether they are owned by federal or state governments. The impetus for commenting on this subject was provided by the National President of the Nigerian Medical Association (NMA), Dr. Osahon Enabulele who was quoted in The Punch of 20th January as advocating the use by public officials including the President and the Vice-President of our national medical facilities rather than spending hard currency on overseas treatment and check-ups. Pointing up the edifying example of the Kogi state governor, Mr. Idris Wada who insisted on being treated at the National Hospital, Abuja after a car accident, Enabulele argued that the only way to ensure that our national health institutions get the attention they deserve is to insist that high-ranking state officials should use them. In his words, “If the president stays on the same queue with others at the National Hospital in Abuja to receive health services people will start to believe in that facility. People will get serious about committing resources and excellence to the development of the hospital.”
To be sure, government itself recently mooted the idea of putting a moratorium on funding overseas medical services for public officials except in acute cases which cannot be handled nationally. Indeed, the health minister, Professor Onyebuchi Chukwu said a few months back that President Jonathan emphasized to him the need to raise our health care to world class standards as well as curtail overseas treatment for public officials at government’s expense. The issue of course is not that public officials who can afford overseas treatment should be prevented from using it but that the public should not have to pay for it considering for example that high state officials usually travel abroad with a retinue of aides also at our expense. It will be interesting to know for example how much the country has expended on medical treatment abroad for public officials in the last two or three years and what alternative uses that money could have been put into if we had a credible health infrastructure.
True, there are several dimensions of health-care crying for attention but we can gain an entry into that Pandora’s Box by considering the NMA’s demand for high state officials to be compelled to use national healthcare as the Kogi governor commendably recently did. Let us raise the question then: What is the status of our national health institutions and why are public officials and others so scared of using them? A recent document jointly authored by the Ministry of Health and an international institution informs that, “the quality, access efficiency and service availability of the health care system has stagnated and declined over the past decades.” Some of the well known problems in this sector include chronic under-funding despite the mark up of budgetary allocation to the sector in the 2013 budget, shortage of health personnel, rusty and outdated equipment, laggard work ethics, the supply of fake or sub-standard drugs as well as less than hygienic conditions in many instances. In the course of discussing the issue with Professor Friday Okonofua, former Provost of the College of Medicine, University of Benin, the Don started out by saying that things are so bad in the health sector that he will not subject himself to being treated within the country if he was in a critical condition. Okonofua went on to itemise the problems as including outdated medical school curriculum, wrong diagnosis of diseases, poorly trained doctors, poor health funding as well as the politicisation of appointments into university teaching hospitals and the neglect of training and retraining health workers. Quite a mouthful if you ask me.
Talking about funding for example, and to be fair to the Jonathan administration, it is pertinent to note that in 2011, 4 percent of the national budget was apportioned to health, in 2012 it increased to 5 percent and in 2013 it increased to 6.4 percent. One can say however, that this marginal increases are too little and too late to make significant impact on that deteriorating sector considering for example that the stipulated percentage of national budget to health by the World Health Organisation(WHO) is 15 percent. The argument is also made that several countries in Africa including Rwanda and South Africa have already met the WHO standard with respect to health sector spending. The point then would be why Nigeria cannot do much better than it is currently doing considering its population and the heavy burden of diseases and epidemics that the country bears.
In the same vein and given the recent revelation that monies annually appropriated to the severely blighted Police College appeared not have made any difference to its worsening plight, it should be factored that monitoring and implementation are just as important if not more important than a slight bulge in health sector allocation. The status of our health institutions often reminds this writer of an evocative article by Dr. Ngozi Ayegbunam who after a harrowing experience involving a close relation at one of our apex medical facilities cried out: “Thou must not be sick.” In other words, we must first appreciate the magnitude of the rot in public health care and its underlying as well as contingent causes in order to provide a roadmap out of the woods; as careful and correct diagnosis must precede scientific prescription. Obviously, a holistic revamping or transformational health agenda must take on board a wide array of issues which as Okonofua noted earlier include the quality of medical education as well as capacity gaps in human resources.
To connect back to the demand made by the NMA for mandatory use of national health care by high state officials in the mould of the Kogi state governor, it is clear that a government that is truly keen on health care reform would after putting the necessary policies in place seek to grant them credibility by asking its members to submit themselves to national health care. It is contradictory to in one breath advertise that health care is being transformed and in another compel the nation to fund overseas health care for high state officials. Government is enjoined to fast track the policy to stop the funding of overseas healthcare for public officials if it means to be taken seriously on its pledge to turn around the health sector.
Prof Olukotun is Dean of the Faculty of Social Sciences and Entrepreneurial Studies at Lead City University, Ibadan. firstname.lastname@example.org 07055841236