Mega hospital project: Concerns mount over accessibility, cost

MIXED reactions have continued to trail government’s plan to set up private sector-managed mega hospitals in Nigeria’s six geo-political zones and the commissioning of experts to draw a road map for the actualisation of the long-term dream. Under the scheme, the government is giving the private sector the nod to mobilise resources to set up and manage the facilities in a selected state in each of the six zones. The committee is headed by former United Bank for Africa (UBA) Chief Executive, Tony Elumelu, representatives of the Nigerian Economic Summit group (NESG), the Association of General and Private Medical Practitioners of Nigeria (AGPMPN) and several other members from the sector in Nigeria. The projects are part of the government’s renewed attempt to bring affordable health services to Nigeria and check the exodus of the citizens abroad for medical tourism. The panel will also draw up an implementable plan for President Goodluck Jonathan’s vision of setting up at least one world-class private hospital in each of the zones before the end of his tenure in 2015. They are also to identify and engage potential investors with a view to guiding them to develop business models and plans for the setting up of world-class hospitals in the country. The team will also look into and propose an accreditation scheme that would ensure full compliance with global best practices in the operations of the proposed facilities. The plan has drawn intense applause from some stakeholders. Some stakeholders are also calling for caution. In separate interviews with The Guardian, they attempted to set agenda for government, insisting that the efforts to attract private sector investment into the healthcare system should primarily focus on affordability. Former Federal Commissioner of the National Human Rights Commission of Nigeria, Emmanuel Onwubiko says that the critical issues of healthcare are not one to be left entirely to the private sector to drive because of the cost implication on the poorest of the poor. He said, “if we allow the private sector to drive process of building, maintaining and running healthcare facilities across the country, this will adversely affect the enjoyment by the citizenry of the fundamental freedom of right to life because basically, the private healthcare providers are interested in maximising profits.” He rather tasked government to strengthen the primary healthcare facilities in the rural areas and put strategies in place on how to make them function optimally to bring succor and healthcare at very affordable rate to the poor rural inhabitants. His words, “government must not hand over the running of hospitals especially in the rural areas to the private sector because that would be suicidal and, in fact, would mean the end of government because the rural poor have no other way of feeling the impact of government other than the healthcare they receive from little healthcare facilities that are at present in those local council areas. “There has to be a clear determination of stakeholders in the political process to ensure that democracy works at the level of the local councils so that the elected officials are compelled to run the rural healthcare facilities efficiently making use of the allocations that they are entitled to from the federation account.” For the city and urban areas, Onwubiko, who is also executive director of Human Rights Writers Association of Nigeria (HURIWA), argues that government could allow the private sector investor to drive investments, noting, however, safeguards should be put in place to ensure that patients are not exploited unduly. “Government can grade the hospitals in such a way that government would have a way of offering incentives to Nigerian patients to enjoy some affordable healthcare. Government must ensure that there is a national health insurance scheme that is workable and not encumbered by bureaucracy but is run efficiently to enable every Nigerian to buy into the scheme. This health insurance scheme should be used to raise some fund that could be used as subsidy for poor patients in the urban areas who may not be able to afford the regular cost of healthcare in the privately run hospitals...” Director, Capacity Building /Programme Manager, Health at ActionAid International Nigeria, Ipoade Omilaju, raised fears that the mega hospital concept could create unnecessary class in the nation’s healthcare system. He commended the optimism displayed by the minister of Health on the workability of this initiative, but raised concerns about affordability. His words, “the minister spoke as if he is not a Nigerian and pretends as if he is not aware of the 70 million Nigerians who go to bed daily without a meal and without hope for the following day. How will they be able to afford this or in whose interest are we creating this? “I see this as another opportunity to transfer government responsibility in protecting and upholding the right to health of the citizens. Agreed, government might not be able to do everything but government should at least make the primary healthcare system work and affordable to all; be committed to providing needed things that make up minimum health package.” According to him, “promoting this kind of initiative is another way to create class in the healthcare system and widening the already existing gaps between the rich and the poor in access to quality healthcare services.” National President, Association of General and Private Medical Practitioners of Nigeria (AGPMPN), Dr. Anthony Omolola, on his part, assured that his association would give the committee all the support it requires to succeed. Founder of Community Health Information Education Forum (CHIEF), Remi Akinmade prefers that the project be run as private-public partnership, instead of leaving it entirely in the hands of private investors. http://www.ngrguardiannews.com/index.php?option=com_content&view=article&id=97103:mega-hospital-project-concerns-mount-over-accessibility-cost&catid=93:science&Itemid=608