Last week’s sack of 16,000 resident doctors by the Federal Government is careless, unscrupulous and clearly an indefensible action. It could turn out to be a social catastrophe that will worsen a medical system in severe crisis. As said by the Nigeria Medical Association, NMA, this action can only worsen the abysmal doctor-patient ratio, which stands at 1:6,300 today, which is among the continent’s worst examples of the dearth of medical manpower. It similarly highlights the ill-health of the health sector and lays bare the increasing alienation of government of the country from its subjects.
In this country, governments have for a long time withdrawn their responsibility for healthcare and education to the common people and have left the field open for persons seeking profits. That accounts for why Doctors have continued their strike into the second month and a façade of normalcy appears to pervade the environment. People here stay alive because God cares. No one looks after the patients. The National Association of Resident Doctors, NARD went on strike to mainly press the government to implement agreements earlier reached. Other issues are secondary to this. It is only in this country that government will consciously enter into agreement with labour unions without the intention to implement them. They just walk away from doing its part without any qualms. This had been the bone of contention between the Academic Staff Union of Universities, ASUU.
A government so bereft of credibility could only convince the university teachers to go back to classrooms after the Central Bank published a statement indicating that money expected as part of the agreement was on account. The Nigerian health structure has grown largely in spite of the government. Successive administrations have failed to catch up with the growing needs of rapid population growth, modernization, research and the changes in medical science. Governments get away with doing little or nothing because we have a two-tiered system that permits for-profit hospitals existing side-by-side with public facilities.
Given this situation, the private hospitals have offered succour to families who can afford to pay their often exorbitant charges. The well-off get treated with top-notch medical practices and medicines and the poor Nigerians gets far less or no care at all. Some government hospitals are no more than a place to die under a roof.
When you talk to them, there are many of our countrymen who are afraid to go before doctors and hospitals and they double-up abroad at the slightest sign of sickness. I am told that between a half and two-thirds aboard every Egypt Air Flight out of Kano, five times a week is made up of medical tourists trooping to Egypt, Saudi Arabia and India for treatment. But the private sector cannot provide affordable healthcare neither can it fulfil the needs of the population from their government. That is why they have the NHIS in the UK and Medicare in the United States.
While governments continue to fail in both the provision of adequate healthcare and a competent regulatory regime over the blossoming for-profit healthcare system, overall deterioration of the system has come to a point where many of the so-called private healthcare facilities have become no more than medical and diagnostic shops. Without a government policy to audit their services, private hospitals are known to prescribe unnecessary investigations, procedures and medicines. Making profits is not a bad thing by itself. No business can exist if it is not profit-making. The problem as we have here is that this is not governed by ethics and morality.
In the United States, six hospitals have so far this year been fined millions of Dollars for conspiring with diagnostic centres and recommending needless procedures. These include Kentucky Hospital, fined 41Million Dollars for prescribing an unnecessary procedure.
Since our governments are unprepared to rise to the challenges of providing modern and competent healthcare services to the ordinary citizens, the least they owe to us is to wake up to their duty of surveillance, enforcement and regulation so as to save us costs and life as well. They must throw a spotlight over this dark side of the country’s healthcare segment. To do this, a good starting point is to call back the sacked doctors, sit down with them and listen to their grievances. There is nothing to gain from the sack of thousands of doctors. This country is still to recover from the exodus of doctors following the proscription of the NMA and NARD by the military regime in 1985.
Treated with decency and respect, our doctors are reasonable and would act with reason and patriotism especially in view of Ebola and other epidemics such as cholera that are making new in-roads.
Our doctors are not all saints but they certainly are no prostitutes as some in government will like to us to believe. In which case it is better we seek to end the epidemic diseases rather than ending doctors’ careers.