Ladies and gentlemen of the press, thank you very much for honouring our invitation to this conference.
This is an unusual yet unique conference because it has brought doctors out of their consulting rooms, particularly doctors in private practice.
It’s common knowledge that the business environment in Nigeria is challenging, and this is even worse for doctors in private practice who, mostly out of patriotism, have chosen to remain and practise within the shores of this country.
But it appears that there is a deliberate attempt to stifle private medical practice and run us out of business-owning to the myriad of obstacles placed in our way.
The recent case of one of our members is the climax of all the harassment, intimidation and exploitation by the Lagos State Government and her agencies, especially the Health Facility Monitoring and Accreditation Agency (HEFAMAA).
Precisely on November 8, 2021, at about 2:00 p.m, a “team” of the Lagos State Health Facilities Monitoring and Accreditation Agency (“HEFAMAA”) officers led by the Executive Secretary (ES), Dr (Mrs) Abiola Idowu, went to King Solomon Hospital at 4A, Bola Crescent, Anthony Village, Lagos State in what appeared to be an unannounced routine monitoring and supervision exercise under the functions of HEFAMAA.
Instructively, the HEFAMAA “team” was composed of two [2] persons, namely, Dr (Mrs) Abiola Idowu and another lady whose name and status we have not been able to ascertain at this time.
The Medical Director, a 73-year old Medical Practitioner, out of courtesy, opted to conduct the HEFAMAA team around the facility.
While performing the inspection and supervision of the medical facility, the ES, who is a medical doctor and not a laboratory scientist, alleged, without basis, that the hospital laboratory was dirty and that the medical equipment therein was not correctly calibrated.
As the inspection was ongoing, the Medical Director, for record purposes and the sake of transparency, asked the Manager of the laboratory [who happens to be his biological son] to record with his phone the supervision and monitoring so that any corrections that may subsequently be specified/issued by the HEFAMAA monitoring team would be correctly complied with.
Curiously, upon noticing that the exercise was being recorded, the ES became uncomfortable, unnecessarily aggressive and violent to the laboratory manager. Specifically, without a reason, she snapped the mobile phone used for the recording out of the Manager’s hands before proceeding to rain slaps on him.
The Medical Director, in an attempt to defuse the situation and avert a further physical assault, was also assaulted by the HEFAMAA team.
The 73-year-old medical director with over 42 years of medical practice was slapped to the chagrin of his staff and patients of the hospital who witnessed the ugly and embarrassing incident.
The foregoing is well documented in the video recording.
To forestall a further breakdown of law and order, Dr Oladosu was constrained to excuse the HEFAMAA team out of his medical facility.
Shortly after that, he (Dr Oladosu) visited and reported the physical assault on his person and member of staff to the Office of the Permanent Secretary, Ministry of Health, Lagos State.
Despite being the aggressor, the ES proceeded to complain to the Anthony Division of the Nigeria Police, which led to the invitation of the medical director by the police.
But after a review of the video recording, which showed beyond the shadow of a doubt that the ES was the one who physically assaulted the medical director and a member of his staff, Dr Oladosu was subsequently asked to go.
Unsatisfied with the above finding, in an apparent abuse of office and by way of a pre-emptive strike, the ES, in addition, proceeded to lodge another criminal complaint and instigated the unlawful arrest and detention of the Medical Director at the State Criminal Investigation Department of the Nigerian Police, Panti, Lagos State where he was kept in a dingy cell with hardened criminals notwithstanding the clear and compelling video recording evidence.
After many hours of inhuman and degrading treatment at the instance of the ES, he was released without any criminal charge preferred against him by the police as it was clear that all her accusations were baseless and uncalled for.
The conduct of the ES raises a lot of questions. The government entered a facility and told you that your machine is not calibrated by merely looking at it. This is one of the numerous acts of aggression by this Agency against private medical practitioners in Lagos.
First, let it be known that HEFAMAA was the brainchild of private medical practitioners in Lagos in a bid to curb quackery. The Agency was later commissioned with an enabling law by the government.
This point becomes necessary to let the world know that doctors are not averse to regulations and standards to bring sanity into medical practice in Lagos.
In the past, doctors used to call the attention of the Agency to those quacks operating around their practices, but at a point, the Agency will turn around to point the name and address of such doctors to the quacks who will, in turn, come after the doctors.
Some doctors have received death threats or some even lost their lives because of these issues in the past. Therefore, doctors stopped any of such reporting to HEFAMAA.
However, rather than go after quacks that are now thriving in Lagos, the Agency now sees innocent qualified and licensed medical practitioners as victims which they intimidate, harass and exploit.
The time has come for us to ask critical questions about the operation of HEFAMAA as an agency of government and indeed the law establishing it.
It is important to know if the Agency is revenue-generating or just a monitoring and accreditation Agency.
In a bid to further their revenue drive and the milking of private medical practitioners, we are aware of the agency’s effort to contract private medical facility monitoring to franchisees who are their cronies and then impose arbitrary fines on hospitals in the name of monitoring, thereafter share the revenue so generated between the agency and the franchisees
It is obvious that the agency is only interested in shutting down a facility, and after paying a fine, the facility is reopened without any investigation.
We have been observing some dangerous trends against many of our members’ practices, many of which have been shut down over spurious and unfounded allegations and made to pay a fine.
The question to then ask is: which body is responsible for regulating medical practice in Nigeria, MDCN or HEFAMAA?
When there is an unlicensed doctor in a hospital, the appropriate Agency is MDCN to deal with such an issue and not HEFAMAA shutting down the facility and slapping a fine after paying to reopen the facility.
What is the shutdown meant to achieve? Whenever there is any allegation or suspected misconduct, the first step by HEFAMAA is to shut down the facility even before investigation, sending staff and patients home doing incalculable damage to the facility’s image and then imposing a fine even without investigation before the facility is reopened.
The statutory body to investigate any alleged misconduct by medical practitioners is the MDCN tribunal and Not HEFAMAA but HEFAMAA has now constituted herself into the accuser, and the judge, which leaves much to be desired.
We are aware of many allegations of misconduct against our colleagues in government practice and the next thing is not to pronounce the doctors guilty as charged without investigation, except and until being properly investigated by the appropriate MDCN tribunal and a judgement passed, why have we not seen HEFAAMA go in and shut down those facilities? Does a different law apply to government and private health facilities?
Even doctors in HEFAMAA are subject to the laws and ruling of MDCN when they engage in any unprofessional or unethical practices
The kind of law that places people’s business and means of livelihood at the whims and caprices of an individual needs to be looked into.
While the government asks you to have state of the art equipment, which is not available in many government-owned institutions, they also want the provider to treat the patient for free during an emergency without telling who is responsible for paying for the service rendered.
You would have thought that there will be certain reliefs to cushion the effect, but no, when it’s time to render service you are humanitarian, but when it’s time to pay levies and taxes, you are a business entity.
The government sees hospitals as private businesses and imposes all sorts of taxes and levies from LIRS to LASRA, to LAWMA MEDICAL, LAWMA DOMESTIC, TO TENEMENT RATE etc., radio and television,
HEFAMAA team comes for inspection without prior notice at a time that the doctor is not on seat (even they are told by staff that the doctor went out for lunch) the hospital will be slammed with fines or shut down because “the doctor was not on seat” or for no adequate nursing staff.
The question to ask is: how many of the government primary healthcare centres have doctors, even those that have, how many times are the doctors there, how come none of these PHCs has been shut down?
Yet, HEFAMAA goes about shutting down private hospitals on the flimsy excuse that doctors are not on seats.
It is no news that human resources are scarce for health services in the country, be they doctors or nurses, yet those in private practice are subjected to inhumane treatment by some government agencies.
It is also common knowledge that private hospitals are competing with the government on the few available professionals who, even when they are eventually employed, will resign within a very short time for greener pastures
Quacks who are uncomfortable with any genuine private medical practice can instigate HEFAMAA to shut down any facility
When there is an unlicensed doctor in a hospital, the appropriate Agency is MDCN to deal with such an issue and not HEFAMAA shutting down the facility and slapping a fine after paying to reopen the facility.
We reiterate that HEFAMAA is now a revenue-generating agency rather than a monitoring and accreditation agency
The kind of law that places people’s business and means of livelihood at the whims and caprices of an individual needs to be looked into.
The slightest allegation against any private hospital earns you a shutdown by HEFAMAA without conducting any investigation. The next thing is fine; once you pay the fine, you can go and sin no more.
We can’t continue to place people’s business in a profession that is a highly specialized field in the hands of charlatans.
And we as private medical doctors say no to all the debasement of our practices and indeed the health sector.
Signed:
Dr Makinde Akinlemibola
Chairman
Lagos State Branch
Association of General and Private Medical Practitioners of Nigeria (AGPMPN)
now renamed:
Association of Nigeria Private Medical Practitioners (ANPMP).
