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NIGERIA | The Health Sector We Need Under Buhari – Oluwole, MDCAN President

Victoria Ojeme
Steven-Oluwole

The President, Medical and Dental Consultants Association of Nigeria (MDCAN), Dr Steven Oluwole, in this interview, explains the expectations of his members from the president – elect, Major General Muhammadu Buhari (rtd).

You have seen many elections in Nigeria. What do you make of the 2015 presidential election?

The presidential election produced a seismic shift of the political structure and alignments, but the energy must be harnessed to drive development and progress rather than to drive extinction or annihilation of non-participating or dissenting tribes, ethnic groups, and members of discordant schools of thought. The outcome of the election says a lot about the vision and expectation of Nigerians for their country. The voting, which was for an ideal, was not a gift to a party to proceed on triumphal procession, but to get to work and fix a crumbling nation. The territorial integrity of the country, which did not disintegrate as predicted, must be preserved.

It is gratifying that the card reader won the accolades of established democracies, which indicate that we can offer the world a lot, rather than copying at all times.

Corruption and security are the major issues the Buhari government promised to tackle. Given how corruption has become so endemic in our national life and also how security has been ‘politicised’, do you see Buhari resolving these challenges?

The phenomenon of the campaign, which centred on the tested integrity of the president-elect, should not be a political device to win election, but the very instrument to govern, and truly reform the culture of ‘government money in Government House’, graft, reckless spending, and impunity of public office holders. The political capital gained by the party in power should transform the landscape and curb the rot only known in Nigeria, where a senator’s annual take-home pay exceeds that of the President of the USA. Governors’ security votes, which make mockery of sanity, should be streamlined to reality. There must be complete reform from the Presidency to all tiers of government. A fleet of 11 aircraft for the Nigerian President, if indeed true, is inexplicable and outrageous when the President of the US officially has one, and the Prime Minister of the UK has none! It is difficult to defend allocations for meals, diesel and other expenses at the State House when the President of the US pays for his meals!

The difference between what is good for the political ruling class, which works for four years, but wants taxpayers money to purchase and maintain mansions, fleet of cars, and pay health bills in perpetuity, and that for the citizens must be rectified. The lifestyle of government officials from the President to the least designated should mirror that of the citizens like we have in Europe. The unions and labour must not become part of the problem, but must remain vigilant to prevent this golden opportunity from slipping away.

You have several unresolved issues and negotiations with the outgoing government. Considering that a new government will be sworn in on May 29, do you see some of these agreements being implemented or abandoned by the incoming government?

The health services have moved from the mere consulting clinics status, which defined the basis for the 1983 military coup. The tertiary level health care has received remarkable upgrade in the past decade. The present government has addressed several problems that have bedevilled the health sector, but a lot remains to be done. A major focus of the present government is the unhealthy rivalry among professionals in the health services. The White Paper on the Presidential Committee Of Experts On Inter-Professional Relationships in The Public Health Sector (Yayale Ahmed Committee) Report, which was promised within three weeks, is yet to come out three months after the deadline. It will be monumental waste of resources if this is unfinished.

What are you expecting from the new government in the health sector?

The Health Act is a major step to provide framework and structure for health care delivery in the country, but the implementation must be driven and well guided by all stakeholders to achieve the stated objectives. The primary and secondary tiers of health care delivery must be made to function and the referral system must be strict for the health services to recover. Currently, the tertiary tier is responsible for practically all meaningful health service delivery in many states of the federation. The teaching hospitals cannot perform their traditional roles when they take on primary and secondary tiers functions and duties. The internal brain drain, which is preventing health professionals from taking up jobs at primary and secondary tiers, should be addressed. Unless relevant laws are enacted to enable health professionals to earn equitably, whether they work for the federal or state governments, the primary and secondary tiers of health care will remain underdeveloped.

Appointment of the Minister of Health

The position of MDCAN regarding appointment of the Minister of Health is unchanged. This should be guided by professionalism rather than politics. As stated before, the Minister of Health must not merely be a medical doctor, but must minimally possess the following:

Basic degree in medicine and surgery; postgraduate qualification, not necessarily in public health; proficiency in public and international health; considerable skills in administration and leadership; must show equanimity towards all professionals in the health team without ethnocentricity

Staff training and development

Training and development of staff in all fields in the Health Services should continue to make the Nigerian system competitive and attractive such that foreigners will seek health care in Nigeria. Government policies must promote harmony among all professionals in the Health Services.

Research

Government should initiate and support research to develop local areas of interest that international agencies will usually ignore.

Training of undergraduates and postgraduates

Curriculum of training undergraduates and postgraduates should not be motivated by politics. Training that should not last more than three years or less should not be stretched to six years to attain contrived status or achieve dubious skills that expose patients to incompetent care givers.

Any advice for the APC led government?

Change must not be wholesale rejection of the past and present! There must be systematic appraisal of the entire system, which should lead to retention of the good, upgrade of the deficient, and replacement of the repugnant. Health services should be depoliticised, and policies should not be based on demands and threats of unions or groups that can shout the loudest.

The questionable, and possibly ill-motivated, drive to privatise tertiary health care should be resisted. Teaching hospitals should not be converted to for-profit institutions. Such conversion will limit the number and category of patients that can receive teaching hospital services to those who have resources to pay. They will be robbed of their traditional values, and hindered from effective teaching, research, and development of medical services.

Published: April 12, 2015. By Victoria Ojeme
Copyright © 2015 Vanguard Media Limited, Nigeria

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