Emmanuel Aziken
16 May 2008
THE National Health bill seeking to enact a comprehensive health policy for the nation was passed by the Senate yesterday. The bill reportedly facilitated by part of the unspent N300 million Federal Ministry of Health budget was passed in the absence of the chairman of the Senate Committee on Health, Senator Iyabo Obasanjo-Bello.
In her absence the Committee Vice-Chairman, Senator Gyang Dantong steered the bill through its final stages at yesterday's session presided over by the deputy President of the Senate, Senator Ike Ekweremadu.
The bill aims to establish a framework for the regulation, development and management of the national health system and underpins primary health care as the entry point into the national health system.
The bill also establishes a Primary Healthcare Development Fund which shall see to the provision of basic health care to as many as possible through the National Health Insurance Scheme. The fund is to be administered by the National Primary Health Care Development Agency (NPHCDA).
The bill provides that funding for the Primary Health Care Development Fund shall come from "an amount not less than two per cent of the value of the Consolidated Revenue Fund as well as grants from international donor partners."
The bill stipulates a sharing formula in the utilisation of the fund to the effect that "fifty percent of the amount in the fund would be expended on basic health care for all citizens," while 25 per cent of the fund would be used to provide essential drugs for primary healthcare and 15 per cent of the fund would be used in providing and maintaining logistics used under the primary health care system.
The remaining 10 per cent of the fund would be utilised in the building of the capacity of human capacity used under the primary healthcare system.
The bill also sets guidelines for states and Local Governments to benefit from the fund. For the States, the bill provides that the State should provide at least ten percent of the cost of the project envisaged while Local Governments are to contribute 5 per cent of the cost of the project costs.
The Senate however turned down a proposal to hike the contribution of Local Governments to 50 per cent.
The bill also sets measures for the elimination of quackery in the sector. Health organisations and groups who employ quacks are subject to two year jail term or a fine of N500,000.
A National Tertiary Hospitals Commission is also proposed in the bill and it would be vested with the responsibility of advising the President through the office of the Minister of Health on issues concerning teaching hospitals in the country.
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Healthcare Bill for Nigeria Healthcare Service
It is nice to hear of the interest of Nigeria Senate on healthcare development in Nigeria and the desire to underpin this essential public service by law. However, my concern which I have expressed in NTA TV programme, letter addressed to the Parliament, my articles and a book ‘Strategic Concept for Managing Healthcare in Nigeria’ is the need to establish a synergy that would allow co-ordination and seamless referral pathways across the boundaries of Health Centres through General Hospitals to Centres of Excellence (i.e. Teaching Hospitals). The three tiers of healthcare management; - Federal State and Local Government should be abolished and Federal government should take reasonable share for the funding, setting of standard and monitoring. Its funding responsibility should be hugely focused on research activities at the Centres of Healthcare Excellence.
I suggested several sources of funding. The States should take full responsibility for ensuring the functionality of healthcare activities in the states and should seek additional funding for specific healthcare interest in the respective states so that variations, competition and opportunity to expand knowledge and internal labour migration could become viable, which would invariably decrease the desire to travel abroad thereby addressing the brain drain syndrome.
The law should allow each institution to develop its management team in line with national directive with a structured reporting line from line management to directorate leadership and to the chief executive, who should report to the elected authority responsible for the welfare of the entire population in the state with relative impact on the President.
By the above, the institutions of healthcare will be run like a business for the public under the total accountability of the Political Party in power - nationally and in the respective States. The management team will be accountable for administrative the viability of the local operational system as well as for inefficiencies, such as poor performance of all the workforce, especially those in direct professional relationship with the patients and public, inadequate training of personnel, poor working conditions and employee remuneration, and poor data collection. Further, management should be held responsible for ensuring that specific institution is working to established national standard and beyond and should deal effectively and openly with public/patients complaints with a satisfactory outcome.
Another area of my concern is the aspect of the debate on contracting healthcare delivery to the private sector. In as far as some of our politicians are keen to see capitalist economic development in Nigeria; we are not yet ripe for transferring the most essential public services such as healthcare and education into public domain. In my opinion, these are not the aspect of the economy to be privatized.
Before any government could go down that line, there is need to put in years of research into how the processes, procedure, accountability and standards would be effective and capable of accommodating the healthcare needs of all the population across the rural and urban areas. The processes and procedures includes issues relating to location of the services, ease of access, responsibility for payment, quality of staff, standard for workforce training and development and protection of employee rights and responsibilities to the public etc.
I am of the opinion that our politicians charged with the responsibilities for making laws would be wise, patient and courageous to consider the options available to them and the alternatives and consult adequately across several stakeholders, particularly the teams of management and clinical experts, excluding Nigerians in Diaspora who could add extra value to the direction the legislation might go for the betterment of Nigeria and the entire population.
David Eboh BA (Hons) Health Services Management, MBA, PgDipHE, MIHM, AfCIPD CEO Mebod Management Ltd, England. +44(0)7956378017
Healthcare Bill for Nigeria Healthcare Service
It is nice to hear of the interest of Nigeria Senate on healthcare development in Nigeria and the desire to underpin this essential public service by law. However, my concern which I have expressed in NTA TV programme, letter addressed to the Parliament, my articles and a book ‘Strategic Concept for Managing Healthcare in Nigeria’ is the need to establish a synergy that would allow co-ordination and seamless referral pathways across the boundaries of Health Centres through General Hospitals to Centres of Excellence (i.e. Teaching Hospitals). The three tiers of healthcare management; - Federal State and Local Government should be abolished and Federal government should take reasonable share for the funding, setting of standard and monitoring. Its funding responsibility should be hugely focused on research activities at the Centres of Healthcare Excellence.
There is also a need for the bill / law to consider the inclusion of supporting research and development of Centres for Traditional Treatment and Care (CTTC) in view of the opportunity for exploring our peoples’ natural talents and packaging it for global glory and patent authority. We have the capability and capacity of translating the crude traditional treatment which more than half of the population uses into scientifically refined orthodox therapeutic values. I belief that we have all that it takes to make our herbs and animal extracts to become sources of innovation and creativity, but what we lack is the law, political will and motivation.
I suggested several sources of funding. The States should take full responsibility for ensuring the functionality of healthcare activities in the states and should seek additional funding for specific healthcare interest in the respective states so that variations, competition and opportunity to expand knowledge and internal labour migration could become viable, which would invariably decrease the desire to travel abroad thereby addressing the brain drain syndrome.
The law should allow each institution to develop its management team in line with national directive with a structured reporting line from line management to directorate leadership and to the chief executive, who should report to the elected authority responsible for the welfare of the entire population in the state with relative impact on the President.
By the above, the institutions of healthcare will be run like a business for the public under the total accountability of the Political Party in power - nationally and in the respective States. The management team will be accountable for administrative the viability of the local operational system as well as for inefficiencies, such as poor performance of all the workforce, especially those in direct professional relationship with the patients and public, inadequate training of personnel, poor working conditions and employee remuneration, and poor data collection. Further, management should be held responsible for ensuring that specific institution is working to established national standard and beyond and should deal effectively and openly with public/patients complaints with a satisfactory outcome.
Another area of my concern is the aspect of the debate on contracting healthcare delivery to the private sector. In as far as some of our politicians are keen to see capitalist economic development in Nigeria; we are not yet ripe for transferring the most essential public services such as healthcare and education into public domain. In my opinion, these are not the aspect of the economy to be privatized.
Before any government could go down that line, there is need to put in years of research into how the processes, procedure, accountability and standards would be effective and capable of accommodating the healthcare needs of all the population across the rural and urban areas. The processes and procedures includes issues relating to location of the services, ease of access, responsibility for payment, quality of staff, standard for workforce training and development and protection of employee rights and responsibilities to the public etc.
I am of the opinion that our politicians charged with the responsibilities for making laws would be wise, patient and courageous to consider the options available to them and the alternatives and consult adequately across several stakeholders, particularly the teams of management and clinical experts, excluding Nigerians in Diaspora who could add extra value to the direction the legislation might go for the betterment of Nigeria and the entire population.
David Eboh BA (Hons) Health Services Management, MBA, PgDipHE, MIHM, AfCIPD CEO Mebod Management Ltd, England. +44(0)7956378017
Healthcare Bill for Nigeria Healthcare Service It is nice to hear of the interest of Nigeria Senate on healthcare development in Nigeria and the desire to underpin this essential public service by law. However, my concern which I have expressed in NTA TV programme, letter addressed to the Parliament, my articles and a book ‘Strategic Concept for Managing Healthcare in Nigeria’ is the need to establish a synergy that would allow co-ordination and seamless referral pathways across the boundaries of Health Centres through General Hospitals to Centres of Excellence (i.e. Teaching Hospitals). The three tiers of healthcare management; - Federal State and Local Government should be abolished and Federal government should take reasonable share for the funding, setting of standard and monitoring. Its funding responsibility should be hugely focused on research activities at the Centres of Healthcare Excellence.
I suggested several sources of funding. The States should take full responsibility for ensuring the functionality of healthcare activities in the states and should seek additional funding for specific healthcare interest in the respective states so that variations, competition and opportunity to expand knowledge and internal labour migration could become viable, which would invariably decrease the desire to travel abroad thereby addressing the brain drain syndrome.
The law should allow each institution to develop its management team in line with national directive with a structured reporting line from line management to directorate leadership and to the chief executive, who should report to the elected authority responsible for the welfare of the entire population in the state with relative impact on the President.
By the above, the institutions of healthcare will be run like a business for the public under the total accountability of the Political Party in power - nationally and in the respective States. The management team will be accountable for administrative the viability of the local operational system as well as for inefficiencies, such as poor performance of all the workforce, especially those in direct professional relationship with the patients and public, inadequate training of personnel, poor working conditions and employee remuneration, and poor data collection. Further, management should be held responsible for ensuring that specific institution is working to established national standard and beyond and should deal effectively and openly with public/patients complaints with a satisfactory outcome.
Another area of my concern is the aspect of the debate on contracting healthcare delivery to the private sector. In as far as some of our politicians are keen to see capitalist economic development in Nigeria; we are not yet ripe for transferring the most essential public services such as healthcare and education into public domain. In my opinion, these are not the aspect of the economy to be privatized.
Before any government could go down that line, there is need to put in years of research into how the processes, procedure, accountability and standards would be effective and capable of accommodating the healthcare needs of all the population across the rural and urban areas. The processes and procedures includes issues relating to location of the services, ease of access, responsibility for payment, quality of staff, standard for workforce training and development and protection of employee rights and responsibilities to the public etc.
I am of the opinion that our politicians charged with the responsibilities for making laws would be wise, patient and courageous to consider the options available to them and the alternatives and consult adequately across several stakeholders, particularly the teams of management and clinical experts, excluding Nigerians in Diaspora who could add extra value to the direction the legislation might go for the betterment of Nigeria and the entire population.
David Eboh BA (Hons) Health Services Management, MBA, PgDipHE, MIHM, AfCIPD CEO Mebod Management Ltd, England. +44(0)7956378017