There is very little doubt that our Healthcare system is in crisis. There is near total collapse of the system with a complete loss of confidence by the citizenry, the patients, as well as its workers.
With mortality indices soaring to the high heavens, poor to non-existent Primary health Care, a disenfranchised and poorly motivated workforce, mass exodus of personnel, poor and obsolete training and pedagogic methods, failure of government to recognize the pivotal role of healthcare to the wealth of a nation and general lassitude of the political class to effect a change, there is little doubt about the urgency of the matter….
Our politicians have resorted to ‘travelling out’ at the slightest medical ailment, not just because they could, but because there is absolutely no faith in the system. Unfortunately they are prime culprits in the near collapse of the system.
Everyone seems at a loss or totally uninterested to reverse this decadence. Like the power sector, there is a lot of confusion as to the way out, with so much motion and very little movement.
I submit that nothing short of a bold, courageous overhaul and restructuring of the system will do.
Nigerian healthcare workers work in very deplorable conditions-Ill equipped hospitals, less than dignifying work offices etc. They are also one of the least remunerated worldwide.
Medical education is easily the most arduous academic endeavour anyone can undertake with respect to time, effort and cost implications and the least is for these professionals to be adequately compensated. Small wonder Nigerian doctors are jetting out in droves to places they are well compensated. See the Occupational Outlook Handbook.
The training methods and methodologies have also gone unrevised for ages. The same pedantic techniques are still employed, with very little audiovisuals, models and education training of the trainers. Assumption is…if you re qualified to practice, you are also qualified to teach. This is not necessarily so. Doctors must be trained in how to train as well as to examine their candidates.
These poor training and examination methods have left not a few demoralized as a candidate may have to sit a single post graduate exam up to 4 to 5 times. And because of the premium placed on these exams for Promotion, your years of experience and competence do not count. A case of 'Certificate is all' syndome.
Consequent to all these, I propose the following:
•The convening of a series of public hearings aimed at listening to the various stakeholders in the sector.
•The drafting of a new policy framework and structure for the sector.
•The pursuit of this policy framework to its logical conclusion-Legislation.
I also recommend the following actions:
1. The creation of the position of Surgeon General, thus recognising the import and relevance of healthcare to the wealth of a nation. This elevates Health and allied matters to be at pars with the Judiciary in its sacrosance.
2. All health and allied matters to come under the purview and oversight of the Federal government, rather than the states and Local governments who have failed woefully in its discharge of Prrimary Health Care.
This has the following advantages;
• A more hands-on approach to the delivery of Primary Healthcare by the Federal Government.
•It will ensure uniformity of remuneration and preservation of the right of the individual worker to earn a decent wage, not exposing them to exploitation by divergent employers.
•It will ensure uniform distribution of health personnel all across the country, as against the present situation where greater than 70% of healthcare givers are situated in urban areas.
•Oversight of this organ will be easily administered, which is nearly impossible in the present circumstance where even where roles and functions are properly delineated to the states and LGs, there is shabby and half hearted implementation or outright negligence. Everyone’s job is no ones job.
3. The creation of an RMAFC-like committee to determine, and regularly review the wage appropriate to each class of health professionals. They will ensure a handsome and globally competitive remuneration for each healthcare professional.
4. Emoluments of healthcare givers should be given as a percentage upfront, the other percentage spread over twelve calendar months like other political office holders to enable them do a few tangible things.
5. The restructuring of the conditions for promotion, with a greater emphasis on experience, and continuing medical education, skill and competence rather than the undue emphasis on passing certain examinations.
6. Creation of separate but complimentary pathways for career progression. Example is the Singaporean model where there are Residency and Non-residency pathways.
7. The formation of a committee to oversee the administration of the National Health Insurance Scheme. It shall comprise of stakeholders from the ministry, HMOs, the clinician and the patients.
8. It shall also ensure compliance and adherence to best global practices with respect to quality of care, funding and reimbursement.
9. Finally, Healthcare Managers, and only Healthcare managers should be saddled with managing these sensitive systems.
With mortality indices soaring to the high heavens, poor to non-existent Primary health Care, a disenfranchised and poorly motivated workforce, mass exodus of personnel, poor and obsolete training and pedagogic methods, failure of government to recognize the pivotal role of healthcare to the wealth of a nation and general lassitude of the political class to effect a change, there is little doubt about the urgency of the matter….
Our politicians have resorted to ‘travelling out’ at the slightest medical ailment, not just because they could, but because there is absolutely no faith in the system. Unfortunately they are prime culprits in the near collapse of the system.
Everyone seems at a loss or totally uninterested to reverse this decadence. Like the power sector, there is a lot of confusion as to the way out, with so much motion and very little movement.
I submit that nothing short of a bold, courageous overhaul and restructuring of the system will do.
Nigerian healthcare workers work in very deplorable conditions-Ill equipped hospitals, less than dignifying work offices etc. They are also one of the least remunerated worldwide.
Medical education is easily the most arduous academic endeavour anyone can undertake with respect to time, effort and cost implications and the least is for these professionals to be adequately compensated. Small wonder Nigerian doctors are jetting out in droves to places they are well compensated. See the Occupational Outlook Handbook.
The training methods and methodologies have also gone unrevised for ages. The same pedantic techniques are still employed, with very little audiovisuals, models and education training of the trainers. Assumption is…if you re qualified to practice, you are also qualified to teach. This is not necessarily so. Doctors must be trained in how to train as well as to examine their candidates.
These poor training and examination methods have left not a few demoralized as a candidate may have to sit a single post graduate exam up to 4 to 5 times. And because of the premium placed on these exams for Promotion, your years of experience and competence do not count. A case of 'Certificate is all' syndome.
Consequent to all these, I propose the following:
•The convening of a series of public hearings aimed at listening to the various stakeholders in the sector.
•The drafting of a new policy framework and structure for the sector.
•The pursuit of this policy framework to its logical conclusion-Legislation.
I also recommend the following actions:
1. The creation of the position of Surgeon General, thus recognising the import and relevance of healthcare to the wealth of a nation. This elevates Health and allied matters to be at pars with the Judiciary in its sacrosance.
2. All health and allied matters to come under the purview and oversight of the Federal government, rather than the states and Local governments who have failed woefully in its discharge of Prrimary Health Care.
This has the following advantages;
• A more hands-on approach to the delivery of Primary Healthcare by the Federal Government.
•It will ensure uniformity of remuneration and preservation of the right of the individual worker to earn a decent wage, not exposing them to exploitation by divergent employers.
•It will ensure uniform distribution of health personnel all across the country, as against the present situation where greater than 70% of healthcare givers are situated in urban areas.
•Oversight of this organ will be easily administered, which is nearly impossible in the present circumstance where even where roles and functions are properly delineated to the states and LGs, there is shabby and half hearted implementation or outright negligence. Everyone’s job is no ones job.
3. The creation of an RMAFC-like committee to determine, and regularly review the wage appropriate to each class of health professionals. They will ensure a handsome and globally competitive remuneration for each healthcare professional.
4. Emoluments of healthcare givers should be given as a percentage upfront, the other percentage spread over twelve calendar months like other political office holders to enable them do a few tangible things.
5. The restructuring of the conditions for promotion, with a greater emphasis on experience, and continuing medical education, skill and competence rather than the undue emphasis on passing certain examinations.
6. Creation of separate but complimentary pathways for career progression. Example is the Singaporean model where there are Residency and Non-residency pathways.
7. The formation of a committee to oversee the administration of the National Health Insurance Scheme. It shall comprise of stakeholders from the ministry, HMOs, the clinician and the patients.
8. It shall also ensure compliance and adherence to best global practices with respect to quality of care, funding and reimbursement.
9. Finally, Healthcare Managers, and only Healthcare managers should be saddled with managing these sensitive systems.
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