How to check rot in state-owned tertiary health institutions, by NMA President

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President of the Nigeria Medical Association (NMA), Dr. Francis Faduyile, has called on stakeholders in health sector to evolve pragmatic
solution in tackling both the syndromic manifestations, and roots of
the challenges confronting state-owned teaching hospitals in the
country.
Faduyile made the call at the annual general meeting and scientific conference of the Association of Resident Doctors, Ladoke
Akintola University of Technology Teaching Hospital, Ogbomoso, Oyo
State.
The theme of the conference is, STATE TEACHING HOSPITALS IN NIGERIA: A
BLESSING OR A CURSE?
He said the bulk in this regard lies on the table of Governments of
the States with doctors, especially the specialists in training,
facing these unpalatable circumstances.
NMA President noted that the challenges emanating from the
administration of State Teaching Hospitals as of today are ‘’enormous
enough to tempt the Association to conclude that the emergence of
these tertiary health institutions appears to have brought with it
unimaginable circumstances that could be likened to curses’’.
Faduyile, an Associate Professor of Pathology, however stated that a
critical look at progress made in medical education, medical research,
and healthcare delivery at this level, including advances in
international care, with some forms of economic succor in respect of
medical tourism, are enough to make convincing declaration that the
state-owned teaching hospitals are huge blessings to all stakeholders.
Some of the challenges, according to him, include distortion in the
balance of the core purposes of a teaching hospital, provision of
services with other components are relegated to the background,
non-adherence to the extant laws on training of Specialists, and non-
payment for update courses and examinations regularly. Unfortunately,,
this is common in the state-owned teaching hospitals leading to
inadequate training hours and increased failure rates’’.
Faduyile submitted that some States see the establishment of teaching
hospitals as political and money making ventures, hence the
responsibilities of such States are left in the hands of their
managements.
‘’ Irregularity in salary or non-payment with months of arrears,
distruption in salary scales ratio between medical, dental
practitioners and other health workers either as a result of omission
or aimed at divide and rule. All the factors enumerated above
ultimately results in mutual mistrust, unhealthy relationship between
management and workers union leading to incessant strike action, and
with consequent prolongation of training duration for both medical
students and resident doctors, as well as disruption of patients’ care
with all its aftermaths.’’
On the issue of finance, NMA President who specifically chosen LAUTECH
Teaching Hospital, Ogbomoso as a case study said thus, ‘’ if we
speculate that the Osun State Government may have difficulties in
meeting her financial obligation to the health workforce especially
the medical and dental practitioners, do we as well justify the
continuous non-payment of the wages of these same group by the Oyo
State Government with months of arrears pending, and in view of its
population vis-a vis the ratio of doctors to this population and the
Internally Generated Revenue [IGR] of 2017?’’
Given the breakdown of statistics, Faduyile disclosed that Oyo State
was included in the list of States with impressive IGR IN 2017, while
Osun State was classified as one of the internal generation earner
States with N6.4 billion compared to     FAA of N72.9 billion
representing 8.49 percent.
NMA President who further gave statistics on state teaching hospitals
and public health, hinted that ‘Nigeria with about 40,000 doctors
presently is in dire need of no fewer than 237,000 medical
practitioners to achieve the ideal doctor/ patient ratio of 1 to 600.
‘’In 2016, Nigerian population was 185 million, while life expectancy
at birth is between 55 and 56 years. Probability of dying between 15
and 60 years per 1,000 population male or female is 372 and 333, while
total expenditure on health as percentage of of Gross Domestic Product
[GDP] as at 2014 is 3.7’’.
 In his welcome address, President of Association of Resident Doctors
[ARD], LAUTECH Teaching Hospital, Ogbomoso, Dr. Ayobami Alabi, said
his administration came on board, there has been gradual close up of
the perennial delay in salary payment from the initial regular four to
five months outstanding.
He added that as at today, the teaching hospital is being owed an
outstanding of November 2018 salary, and hope that the salary will
remain regular even after February 2019 election.
Alabi explained that the year under review also witnessed the
employment of over 20 new house officers, though lesser to what the
teaching hospital used to have, but at least a departure from just
very few which led to post-crises of 2017.
Said he, ‘as Resident Doctors, our training is our primary priority
and this we have not handled with levity despite serious challenges
facing our members. I am glad to announce that just in this year alone
we have produced seven new Fellows across the department. In fact, I
am bold to say that in the last outing in October/November, we
recorded hundred percent in both Part I and II of West African College
of Physicians [WACP], and higher percentage in West African College of
Surgeons [WACS], and NPMCN. We did not just pass but we excelled’’
Despite these achievements,  Alabi pointed out that all is apparently
still not well about LAUTECH teaching hospital, as the tertiary health
institution cannot boast of fulfilling the dream of the founding
fathers who set out to establish a world class and referencing
hospital in all ramifications among equals vis-a -vis, teaching,
research services renumerations, welfare and comfort of staffers.
 ‘’But today what we have is a shadow of reality. Our hospital is
poorly funded, renumerations of Doctors are far from what the edict of
the hospital gazette, sponsorship for training not consistent but
meagre and haphazard, infrastructural development at the lowest level
and funding from the owner is far from the expedient, while government
commitment has remained like a swinging pyrexia that devour linear solution’’.

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