Abuja — Quality health care the world over is a very crucial business that attracts the attention of all governments, be they democratic, dictatorial, theocratic, or monarchic. Apart from food and shelter, health is probably the most critical area of life that individuals and nations alike devote so much resources and attention to.

Advanced nations of the world have continued to achieve breakthroughs in their health care delivery systems, such that life expectancy is not only high, but productivity is maximally utilised. That, by no means suggests that they are resting on their oars towards improving their systems.

That the African continent lags behind in quality health care delivery, as in many other areas, is no longer news. What is of greater interest is how to get out of this unfortunate and unacceptable situation that has seen the loss of a sizeable proportion of the vibrant and industrious population of the continent. Several initiatives at national, regional and continental levels have attempted to find answers to the question of quality, affordable and accessible health care to the people. While some of these initiatives have succeeded, others have failed to achieve their desired objectives.

In Nigeria, the government is central to health care delivery, at the local, state, and federal levels. The three tiers of government have thus committed colossal sums of money in an attempt to improve the lot of Nigerians healthwise. Whether those funds were properly deployed and judiciously used or not is a matter of debate. If the standard of our primary, secondary and tertiary health institutions are indices to use, then certainly there are questions to be answered by those who have been given this mandate over the years.

It was in the continued bid to improve health care delivery to its residents that the last FCT administration under Mallam Nasir el-Rufa'i proposed to experiment a public private partnership programme by concessioning Garki Hospital to the private sector to manage. Being the first of its kind in the country, the concessioning at first, was misunderstood and misinterpreted by many people, especially those who are comfortable with the status quo. The misinformation was to the effect that Garki Hospital was being sold. Such insinuations confirmed the ignorance and fear of the unknown that trail the introduction of new ideas into our society.

Those who cared to find out know that the bid to concession the hospital was based on the desire to involve the private sector in the management of health institutions, with a view to enhancing service delivery. This idea was based on the evident data of the history of structural dilapidation, nonchalant attitude of staff and general poor services of public-run hospitals in Nigeria, and the FCT in particular. Garki Hospital was the perfect experiment for this programme, having been shut for over three years due to deterioration. It was made clear that there was no hidden motive to sell or privatise the hospital, as was being insinuated by those who did not understand the concept.

To confirm this position, a widely publicised open bidding process was followed. National and international publications were made, while the internet was as well used. Little wonder then that interested firms from within and outside Nigeria bid to manage the hospital. At the end, both the selection board and the then FCT Executive Committee agreed with the declaration of Nisa Premier Hospital, Abuja as the winning bidder. Soon afterwards, the concession agreement was signed by the then minister of the FCT, Mallam Nasir el-Rufa'i and Nisa Premier Hospital's medical director, Dr Sunday Onuh on 20th March, 2007. Proper health care services resumed on 11th May, 2007.

The biggest question for all stakeholders, especially the public, is what value has this concession agreement added to the health care system in the FCT? This is a crucial question to answer, because without any significant improvement, the concessioning of the hospital will make no meaning. In trying to answer this question however, one should also appreciate that it is not yet a year since Nisa Premier took over the management of the hospital. However, quite a lot has been achieved.

First, structural adjustments were made to ensure that the hospital fits into the modern medical facilities around the world. For instance, prior to the concessioning, the mortuary was not far from the entrance to the hospital. This had to be moved behind to avoid creating unnecessary inconvenience to the patients and staff of the hospital. Electrical, mechanical, as well as plumbing work had to be carried out in order to modernise the hospital. Even the paediatrics unit was given unique features that embody a child-friendly environment with colours and a play area. Today, the hospital functions better in the areas highlighted.

Coming to the area of equipment, the hospital has been able to upgrade most of the obsolete equipment that was found on ground. This has seen the removal of one of the two old x-ray machines and the procurement of an ultrasound machine, an echocardiogram and an ECG machine. The theatre has also been upgraded to serve the people better. The laboratory has more equipment, as microbiology, haematology, and chemical pathology services are being provided. The pharmacy is fully stocked with quality drugs. This is why the patients hardly come across the out-of-stock factor in Garki Hospital.

In the area of obstetrics and gynaecology, broad spectrums of clinics are run in gynae, antenatal and infertility. Intro-fertilisation, cancer screening and sickle cell treatment are about to commence. In addition to these, Garki Hospital has become the first to introduce electronic operations, which make it possible for all arms of the hospital to access patient's medical records through a network of computers. The implication is that soon, the card system will be phased out, thus improving efficiency and eliminating time wasting, as well as the loss of records. In addition, confidentiality is enhanced.

Any patient visiting Garki Hospital meets a hotel-like reception; qualified staff have been employed. In addition, consultants in all areas and other support staff with vast experience are changing the face of health care services in the hospital.

From the foregoing, the issues of cost and access to all sections of the society arise. No doubt, the cost of services has expectedly gone up slightly. For those who want to be realistic, such quality services rendered to patients need to be paid for. This does not suggest that the cost has hit the roof such that the poor cannot afford. But so far, the cost of services at Garki Hospital is moderate, compared to many private hospitals in its category, and certainly below the rates of National Hospital. To ensure that even the poorest of the poor get services in Garki Hospital, the management has introduced a Pro-Poor Fund that subsidises the cost for those who cannot pay for services at other public hospitals. This has ensured that no patient has been turned back from Garki Hospital for lack of money since Nisa Premier Hospital took over the hospital.

On the whole, the public has not lost anything by the concessioning of the hospital to the private sector to manage. After all, the government shares in any profit made by the hospital, while a clean and high standard environment has not only maintained, but is being improved upon daily. So far, the hospital management has kept faith with the agreement reached with the government and has proved that Nigerians are capable of upholding public trust in an excellent manner. The amount of money injected into the hospital by Nisa Premier will further buttress the confidence of Nigerians in the government and its determination to better the lot of the system. For sure, the success so far also points to the fact that the future of Garki Hospital is bright.