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Running away from a deceased hospital system

President Muhammadu Buhari’s frequent overseas trips for health checks and medical treatment have exposed the government’s duplicitous commitment to improve the poor state of health care in Nigeria. Buhari’s trips have been used by his critics to ask serious and unsettling questions about the quality of public health system in the country, lack of basic diagnostic equipment, the absence of highly qualified consultant physicians, as well as the failure to find a reliable business model that would enable government to fund hospitals and restore the confidence of the people in the health care system.

LALONGPublic concern has grown and is continuing to grow over the poor quality of public hospitals. The situation is so bad that many people now refer to public hospitals derisively as a place where sick people go to die unnecessarily. The portrayal is apt. There haveb been far too many cases in which people in desperate need of blood transfusion, for example, lost their lives because the hospitals they were taken to did not have appropriate facilities or, worse still, there were no qualified doctors to attend to them.

One of the grounds on which the people and the press criticise Buhari’s overseas medical trips is that the money incurred in his health checks, his treatment, his air travel, his accommodation and feeding (which have become guarded secrets in a country in which financial transparency is taboo) could be used to significantly improve and equip existing medical facilities to the level where the president and senior government officials would feel confident enough to use our hospitals for comprehensive health checks.

When a president and senior officials of government adopt a standard practice of rushing to overseas medical centres whenever they experience some kind of heart murmur or dizziness, it signals an adverse vote of confidence on Nigeria’s hospital system. The debate has persisted over whether it is appropriate for Buhari to seek overseas medical treatment. The debate is unnecessary. In his capacity as the number one citizen, the president is accorded the best medical experts and services as the need arises. Medical care is just one of the privileges to which the president is entitled. Few would question that the president should enjoy the privileges. The question, however, is whether the president should enjoy these rights within the country or at overseas medical facilities.

There is a moral argument that goes this way: if the president does not consider public and private hospitals in Nigeria good enough for his regular health checks and medical treatment, the citizens should have no confidence in using the hospitals. Another source of concern is the impact the president’s regular overseas medical trips would have on the nation’s diminishing financial resources. When the president and his officials go overseas for health checks, they take along with them foreign exchange needed for renovating the decrepit public hospitals in the country.

There are many sound reasons why everyone should engage in regular health checks. Regular checks facilitate early detection and treatment of life-threatening conditions. Doctors are equipped by training and experience to assess our medical conditions, to detect early warning signs of ill health that could become terminal if unnoticed, and to assist in treating the disease. Prompt identification helps to clear up future trouble spots. We ignore regular medical checks to our own detriment. Without regular health assessment, a tiny blot spotted on the skin today could turn into a fatal disease tomorrow.

There is no better place for everyone to undertake medical checks than a highly-equipped and professionally staffed hospital. Unfortunately, finding a good hospital to undergo comprehensive health checks in Nigeria has become something of an optical illusion. Every day, we see public hospitals that are struggling to provide basic services lose experienced medical doctors, consultants, and nurses. For less privileged people, private hospitals are not an option, owing to the high cost of diagnosis and treatment.

This is not to suggest that the situation in developed countries is foolproof. There is constant pressure on resources available in public hospitals because of the huge demands on those hospitals. The challenge for governments in those developed countries is how to fund and effectively manage the health care system.
For example, in Australia, a country that has an aging population, attending to the needs of elderly people puts a strain on medical services. This contributes to the huge cost of managing public hospitals. Under the existing health care system, citizens and permanent residents are treated mostly free in public hospitals. Of course, some patients still have to pay some fees.

Free medical services do not come cheap. There are consequences for the government, the hospitals, and the public. Free treatment in public hospitals implies the government has to commit more funds to the hospital system in order to meet the health care needs of the population. Many people aim to access the free health care services provided by public hospitals. This results in a longer line of people waiting to be attended to by doctors, nurses, and specialists/consultants. To reduce the pressure on public hospitals, government has gone on a campaign to encourage citizens to take out private health insurance cover.

This is one way the government has tried to relieve public hospitals of the pressure of public demand for free services. A reduction in public use of hospitals would also result in reduced government budget for funding hospitals. Regardless of the carrot offered to the public, government has to deal with the challenge of how to stop baby feeding a population long used to free medical services in public hospitals. Experience shows that once people get used to free hospital services, it is difficult to convince them to pay for private health insurance.

Comparing the situation overseas with the deplorable state of health care in Nigeria, there is no question that public hospitals in Nigeria are in a state of chaos and total government neglect. In every street corner in the country, you will find illegal private health clinics operated by quacks, impostors, and pretenders who have no qualifications or requisite experience. The pharmaceutical industry is even in a worst condition. Chemists and pharmacies are operated by school dropouts, or people drawn straight from primary or secondary school who have no knowledge of health care management or how to dispense drugs.

There is reason to be concerned about the health and wellbeing of Nigerians in the current environment in which the hospital system is crumbling, an environment in which people with dubious credentials engage in free marketing and administration of drugs.

Government must show greater commitment to improving the health care needs of the people. The medical association and the pharmaceutical bodies must come up with strategies to tackle the problem and restore the image of their profession. The first step is to stop pretenders from selling and dispensing drugs. The second step is for the president and senior officials to lead by example, by equipping and using hospitals in Nigeria.


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1 Comment

  1. Peter Okeke 22nd May 2018 at 2:50 pm

    Our leaders surely know how to make right decisions concerning where they get medical treatments using public fund abroad but do not know what to do about the dilapidated health facilities in Nigeria. They do not see their position as that of problems solvers but rather they see their positions as instruments of exploitation of the people who elected them there. After spending so much money to corner their positions they feel that they have sufficiently paid for those position that guarantee best possible opportunities for themselves, families and cronies. There is nothing that they know to do except milking the people dry. That is the nature of our system with no set standards, accountabilities and checks and balances. The present system is overripe for a change through effective restructuring programme.

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