President Muhammadu Buhari on Monday finally dismissed Usman Yusuf as Executive Secretary of the National Health Insurance Scheme (NHIS).
The director of media of the health ministry, Boade Akinola, said the termination of Mr Yusuf's appointment was based on the recommendation of a panel of inquiry which the Nigerian government asked to probe allegations of fraud and abuse of office made against the official.
The statement also announced the appointment of Mohammed Sambo as the new Executive Secretary of the scheme and the dissolution of its governing council.
The seven-man panel was set up last November after the president ordered Mr Yusuf to proceed on administrative leave, following his suspension by the NHIS governing council.
The president deployed Ben Omogo, the Director of Administration in the Office of the Head of the Civil Service of the Federation, to "oversee the affairs of the Scheme" pending the outcome of the inquiry.
The panel headed by Hassan Bukar, a retired permanent secretary, was given two weeks to file its report to the office of the Secretary to the Government of the Federation (SGF), Boss Mustapha, and make recommendations. According to Punch Newspaper, the report was submitted seven months ago.
The president, however, did not take any action on the report until Monday.
The panel report
A copy of the panel's report sighted by PREMIUM TIMES accused Mr Yusuf of breaching the Public Procurement Act.
It said the official flouted public service rules by refusing to carry out lawful instructions by superior authorities; namely, the minister of health Isaac Adewole and the NHIS governing council.
The committee noted that Mr Yusuf had an unhealthy relationship with members of staff of the agency, local unions, Health Management Organisations (HMOs), and Health Care Providers (HCPs).
This, it said, would further disorganise the scheme and the health sector if he was allowed to retain his position.
Mr Yusuf was also accused of "embarrassing" the government through "unguarded social media comments."
The committee said the NHIS boss deserved to be dismissed for failing to explore internal administrative remedies before suing the (then) Minister of Health, Mr Adewole; the (then) Attorney-General of the Federation, Abubakar Malami; and the NHIS last November.
Though the panel recommended Mr Yusuf's dismissal, it did not call for his prosecution.
President Buhari on July 29, 2016, appointed Mr Yusuf to take over from Femi Akingbade, who was the General Manager, Information Communication Technology (ICT) until he was appointed by President Goodluck Jonathan to head the agency in acting capacity following the sack of Olufemi Thomas.
There were hopes that Mr Yusuf would revive the NHIS which had been engulfed by allegations of corruption and controversies. Those hopes were, however, dashed as his reign stoked even more crisis at the agency.
Mr Yusuf, a professor of Haematology-Oncology and Bone Marrow Transplant, allegedly has a reputation for disrespecting laid rules and constituted authorities at the scheme.
He allegedly ran the scheme with an 'iron fist', flouting laws, and breaking protocols and financial regulations.
The professor who had at a time purportedly bragged to be 'untouchable' was said to have the backing of the president.
Last October's suspension of Mr Yusuf by the governing council was his second since he assumed office.Both suspensions were within one year.
The first was in July 2017 when the Health Minister, Mr Adewole, sent the official on an indefinite suspension over alleged gross misconduct and fraud.
In response, Mr Yusuf defied the minister by refusing to comply with the suspension order.
He was quoted as using swear words on the minister during an interview by Punch Newspaper.
Meanwhile, Mr Adewole, also a professor, had asked a panel to investigate the allegations against Mr Yusuf. Documents in possession of PREMIUM TIMES revealed that the panel indicted him and recommended sanctions.
In February 2018, however, without informing the minister and against the recommendations of the probe panel, President Buhari reinstated the executive secretary.
After his reinstatement, the agency was again engulfed in infighting as Mr Yusuf and some senior officials traded accusations of fraud.
The NHIS governing council which was inducted last March received piles of petitions against the official. The council repeatedly rejected the 2018 budget of the scheme over alleged 'padding' by Mr Yusuf.
Because of this, the council again handed him another indefinite suspension. Rather than obey, Mr Yusuf stormed the NHIS head office with a contingent of about 50 police officers, broke a barricade mounted by angry workers and forced his way into his office.
Activities remained grounded at the agency, with workers and management pitted against each other until President Buhari sent the controversial official on leave and eventually dismissed him on Monday.
Mr Buhari approved the appointment of Mohammed Sambo as the new Executive Secretary of the agency.
Overstepping Governing Council?
On Monday, the president also approved the dissolution of the Governing Board of NHIS as recommended by the committee.
The seven-man committee said it recommended the immediate dissolution of the Eyanatu Ifenne-led governing council for suspending Yusuf because "it clearly had no constitutional powers to do so".
The panel said it observed the role of the governing council in the "present imbroglio and noted from the interactions that the council has become factionalised and is incapable of providing the required leadership for the scheme.
"The governing council embarrassed the government by exceeding its mandate when it suspended the executive secretary," the report noted.
In place of the council, the committee advised the government to appoint an interim management team to avoid a vacuum and ensure the smooth running of the scheme.
It said the recommended committee would have a six-month lifespan and should be led by a "seasoned administrator with a health system experience and other technical members drawn from the offices of the Accountant-General of the Federation, Bureau of Public Procurement and Head of Civil Service of the Federation."
The question on whether the council had powers to suspend the executive secretary became rife especially after Mr Yusuf ignored the sanction as he previously rebuffed a similar order by the health minister.
"The governing board has no right to suspend me as the Executive Secretary", Mr Yusuf had explained to BBC Hausa as his reason for brushing aside the sanction.
"I notified them in a written document that they lack constitutional rights to suspend or even block me from entering my office."
The Act governing the NHIS is not clear on the issue of suspension of the Executive Secretary. The word, "suspension", does not appear anywhere in its laws, much less in relation to the head of the agency.
Meanwhile, Part 3 section 8 (3) of the Act states that the Executive Secretary is "subject to the general direction of the Council." Perhaps, this is the part that the council latched on to suspend the executive secretary.
NHIS Act Conundrum
Players in the health sector have for long linked the poor structure of the NHIS Act as the major cause of various crises that have trailed the scheme over the years.
Mr Adewole, the then health minister, in an interview with PREMIUM TIMES in January alluded to loopholes in the Act. He said the body of laws gave enormous powers to the governing council but failed to be specific on sanctioning the executive secretary.
"The governing council, by that Act, was given the power to do whatever is necessary to keep the scheme running. If the council now thinks it is important to do anything to keep the scheme running, nobody can say no," Mr Adewole highlighted, during the interview.
"That is why we say the Act needs to be revised and be more specific. If you look closely, it is as if the council does almost everything there. The Act is one of the major issues with the scheme."
There has been a concerted effort towards repealing the old NHIS Act.
With a new Act, practitioners in the health sector believe functions of the scheme will be clearly stated.
Titled "National Health Insurance Act (Repeal and Re-enactment) Bill 2019", a new bill was proposed and when made law is expected to invalidate some aspects of the old law (2004).
The bill passed third reading at the Senate about two months ago. It now needs presidential assent to become law.
It is not clear yet whether the bill was transmitted to President Buhari for assent before the transition of the National Assembly last month.