Critical medical services and other operations of university teaching hospitals in Nigeria have suffered major setbacks since the Nigerian Electricity Regulatory Commission (NERC) increased the electricity tariff for customers under its Band A category from N66 per kilowatt to N225 per kilowatt in April this year.
A nationwide investigation conducted by LEADERSHIP into what the tertiary hospitals pay for electricity supplied to them by the various distribution companies (DisCos) in the new threshold and its impact on their services and operations revealed that their monthly bills have either tripled or quadrupled.
The worst-affected teaching hospitals are in the first-generation category. These include University College Hospital (UCH), Ibadan in Oyo State; Ahmadu Bello University Teaching Hospital (ABUTH), Shika, Zaria in Kaduna State; Bayero University Teaching Hospital, Kano, and the University of Nigeria Teaching Hospital (UNTH), Ituku Ozalla in Enugu State.
Others are Abubakar Tafawa Balewa University Teaching Hospital, Bauchi (ATBUTH); University of Maiduguri Teaching Hospital (UMTH), Maiduguri in Borno State; Jos University Teaching Hospital (JUTH), Jos, Plateau State, and those owned by state governments.
The case of UCH, Ibadan, is more pathetic. Even before the new tariff regime, it was indebted to the Ibadan Electricity Distribution Company (IBEDC) to the tune of N495 million and had its power disconnected.
At the going rate, ABUTH pays N75 million monthly, which translates to N2.5 million per day. Aminu Kano Teaching Hospital (operated by BUK) pays N119 million per month (approximately N4 million daily). ATBUTH pays N50 million monthly (N1.66 million each day). JUTH pays N31 million or N1.03 million daily, and UNTH parts with N50 million monthly, or N1.66 million daily.
Details of ABUTH's power expenditure showed that the hospital paid between N20 million and N25 million for electricity monthly before the tariff hike. Now, it coughs out N75 million monthly and another N47 million on diesel (due to epileptic power supply), bringing the total to N122 million monthly.
For hospitals that cannot pay their bills, the DisCos instantly disconnects them.
That is the plight of the Chukwuemeka Odumegwu Ojukwu University Teaching Hospital (COOUTH), Amaku-Awka, Anambra State, which the Enugu Electricity Distribution Company (EEDC) cut off its power supply for two weeks because its management was unable to pay its bill.
The CMD of the hospital, Dr Joe Akabuile, who disclosed the development in an exclusive interview with LEADERSHIP, stated that the EEDC gave the hospital a whopping N19.8 million as its one-month bill for April 2024.
He stated that the teaching hospital is under the Band "A" grade in the electricity tariff regime, adding that before the April N19.8 million bill, the average monthly bill from the EEDC to the hospital was N4.55 million.
"We can't buy a car we cannot maintain," the COOUTH CMD said to explain why the hospital could not pay such a huge bill and allowed the EEDC to cut off its electricity supply.
He said that for the past two weeks, he had been running the hospital with generating sets, adding that the option had also not been easy.
ATBUTH officials told LEADERSHIP that the hospital receives a relatively stable power supply from the Jos Electricity Distribution Company (JED) daily, and that the bill rose from N11 million in April to N50 million in May 2024.
The management of Bayero University, Kano, said the recent outage at its College of Health Sciences, located at the Aminu Kano Teaching Hospital (AKTH), was caused by an unsolicited debt of N30 million imposed on the facility by the Kano Electricity Distribution Company (KEDCO). In May, the hospital got a bill of N119 million, translating to N4 million per hour for electricity consumed.
In his lamentation, the CMD of ABUTH, Prof Ahmed Hamidu, cited the high cost of running the institution, particularly the electricity bill payment, which he said costs the hospital N75 million monthly.
In an interview with journalists at his office in Zaria, Kaduna, he said, "Our greatest challenge now is energy. Last year, we paid around N240 million as outstanding payment to KEDCO, and by the end of the year, it accumulated to over N200 million again. With the current tariff increase, we paid N25 million last month, but the last bill brought to us was N75 million.
"We are disturbed and don't know where to get this money. So even if we take the whole of the money we have in the hospital and pay a huge amount, which is not even possible, that means we have to increase the cost of our services, and when we increase the cost of our services, patients will stop coming. So there is a problem.
"We spent N47 million on diesel last month. So, when you add everything, we're talking about over N100 million per month for energy; that is not sustainable," he said.
The CMD hinted that the hospital management was looking at renewable energy as alternative solution.
"In our 2024 budget, we have allocated about 15 per cent to provide renewable energy. For example, the Magnetic Resonance Imaging (MRI) suite requires a 24-hour power supply, and by the end of the year, we'll have renewable energy powering one building completely. We hope that within a few years, about 30-40 per cent of the hospital will be off the grid, reducing our energy costs," he said.
ATBUTH's management revealed that the hospital's monthly power consumption tariff increased to about N50 million in May this year.
The CMD, Professor Yusuf Jibrin, said that although the hospital had not increased its patient charges, the tariff rise is a huge economic burden on the facility and requires the authorities' intervention.
Jibrin said the hospital's monthly electricity tariff increased astronomically to N50 million in May, for just one month, adding that it came at a time when the price of diesel also rose, making it almost unaffordable to maintain power-generating sets during a supply cut.
LEADERSHIP learnt that the hospital has an 850kva generating set, which consumes about one and a half drums of diesel in three hours.
In an interview with LEADERSHIP, Auwalu Gajida, the CMD of AKTH, Kano, said that because of the essential services involved in caring for patients and the facilities used in the hospital, it cannot function without constant electricity supply.
He said the hospital, which is on band A, is finding it difficult to offset bills, which has recently led to a four-day power cut.
Gajida said that the hospital paid between N26 million and N31 million monthly in the past, but that the bill it received for May was N119,679,750 (approximately N4 million daily).
"It's difficult because we don't know how to handle the cost. This has raised a challenge for us regarding how to raise the money. First, it is good to know that a hospital is a social service sector, not a revenue-generating sector.
"Yes, we are charging for some little markup to cater for inflation and some consumables procured, but the rate at which we are going, if we have to pay for this, it means we have to transfer these bills to poor Nigerian patients," he said.
The CMD also lamented that the DisCos in Kano recently disconnected the hospital's power at 11pm, leaving it run on the generating set for four days, with a huge amount of money spent on diesel.
According to him, the management tried to mobilise N40.7 million and pay the electricity distribution company to show its commitment, in order to get electricity back to the hospital.
"After paying that amount, we came back to see how resources can be mobilised because the government's overhead is grossly insufficient to address the electricity bills. So, considering a review of patient charges is one option. Still, we are also looking at options to see where else we are not using the electricity judiciously, which we will address to reduce electricity consumption," he stated.
On whether the hospital is considering alternative sources of power generation, the CMD said solar can only be a backup, noting that some of its buildings are on solar, as the management had decided that such buildings should operate on it during the day time, except when it is necessary, to reduce electricity consumption.
He also pointed out that, with the hospital's infrastructure, it will be too expensive to go fully solar. He added that its attempt to switch to gas was thwarted after some companies came with proposals.
"We also discovered that Lagos University Teaching Hospital (LUTH) that opted for it has shut down because the price has skyrocketed. So I think hybrid is still the option, with solar back-up and generating sets," the CMD said.
He, however, called on the federal government and other stakeholders to intervene so that medical services would not become unaffordable to the common man.
Speaking on the effect of the recent hike in electricity tariff on the University of Maiduguri Teaching Hospital (UMTH), the chief medical director, Prof. Ahmed Ahidjo, said the hike is putting the hospital in a difficult situation.
The CMD noted that energy is one of the most important needs in a hospital setting required to sustain infrastructure.
"To ensure adequate water supply to all the hospital sections, a hospital must pump the water using energy. Our hospital has a centralised sewage system, which will spill if you do not drain the sewage with very big pumps.
"We need the energy to run the equipment. All the laboratory tests, all the diagnostic equipment, all intensive care units, oxygen production dialysis of patients, so many operating theatres, delivery equipment; all these require energy. Without energy you cannot run a modern hospital, " the CMD said.
He, however, said the power tariff hike had not yet affected the hospital's service charges due to the peculiarities of the state and region regarding the decade-long Boko Haram insurgency that had impoverished the citizens.
Adhijo added that with the epileptic power supply and the hike in tariff, the hospital is looking into solar-powered energy. The 12 megawatts power facility undergoing construction at the university will also contribute to the hospital's power supply.
The CMD of JUTH, Dr Pokop Bupwatda, appealed to the federal government to intervene to save public hospitals from total collapse due to the electricity tariff hike, which, according to him, is not sustainable.
Bupwatda stated this in an interview with LEADERSHIP in Jos.
According to him, JUTH has three sources of energy: Nigeria Electricity Supply Company (NESCO), Jos Electricity Distribution Company (JEDC), and a standby diesel generator.
He said the hospital's operations depend heavily on the power supply because most of it equipment, such as ventilators and incubators in the Intensive Care Unit (ICU) cannot function without electricity.
The CMD also disclosed that they paid JED between N11 million to N12 million monthly for electricity bill before the tariff hike shot up its April electricity bill to N31.5 million, whereas the hospital's total overhead is within the range of N12.5 million.
He said JED had placed the hospital on Band A with a 20-hour electricity supply per day, stressing that JED had written to it about a plan to disconnect it because of its inability to pay.
Dr. Bupwatda added that he had to plead with JED to give it time to source the money.
"The government needs to intervene, or we are in big trouble. As it is right now, we need to think outside the box for alternative power sources such as solar and wind energy because we will not be able to cope with the current electricity tariff.
"All the tertiary health institutions in the country are in a very difficult situation right now because we are all placed on Band A.
UNTH Commercialises Services Over High Tariff
Services at the University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu, have been commercialised because of the recent increment in the electricity tariff.
Our findings revealed that UNTH, which is currently in the Band A category, is in dire financial straits due to the high cost of electricity.
It was further gathered that the cost of drugs and other services has increased tremendously since the increment.
Sources said that despite the increment, UNTH has been experiencing power outages, negatively affecting the hospital's services.
Although the hospital's spokesperson, Mr Uchelue Boniface, refused to disclose what the hospital was spending before the increment in electricity tariff and what it was currently spending when our correspondent contacted him, a source said the hospital spent between N20 million and N25 million monthly on electricity, including payment to the EEDC and purchase of diesel, before the increment. The figure has risen to N50 million.
Meanwhile, the Association of Resident Doctors (ARD) at the Delta State University Teaching Hospital (DELSUTH) recently suspended a one-week warning strike over the state government's insensitivity to issues affecting optimal patient care.
The doctors said working in the hospital had become an extremely distressing experience due to issues like inadequate power supply and escalating costs of electricity from BEDC, compounded by insufficient financial support from the state government.
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Despite being the highest referral centre in Delta State, ARD, DELSUTH chapter lamented the deteriorating infrastructure and outdated and dysfunctional equipment essential for diagnosing and treating various medical conditions.
The hospital's CMD, Prof Emmanuel Okolugbo, appealed to the state House of Assembly Committee on Health to investigate the energy challenge bedevilling the hospital, among other issues.
Lagos Govt Insulates Own Hospitals With Independent Power Plant
LEADERSHIP findings in Lagos showed that private and federally-owned hospitals were the most affected by the hike in electricity tariffs, as most state-owned hospitals use electricity from the Lagos State-owned independent power plant.
The power plant, strategically located at the Lagos State Electricity Board, GRA Ikeja, and operated through an Independent Distribution Network, provides reliable and dedicated electricity to key Lagos State government facilities and infrastructure, including, but not limited to, Lagos State University Teaching Hospital (LASUTH) and Lagos State University College of Medicine (LASUCOM).
The CMD of LASUTH, Prof. Adetokunbo Fabamwo, told LEADERSHIP that the hospital had no business with the Ikeja Electricity Distribution Company (IKEDC), as it gets electricity from the independent power plant.
On the high cost of drugs and hospital services, Fabamwo affirmed that the state government was looking at how to support hospitals.
"Not all hospitals are tapping electricity from the project. Some are still paying electricity bills from their pockets. The government is already looking into augmenting their subvention so that they can pay their electricity bills.
"So, I do not think, in all sincerity, that the hike in electricity bills will translate to the increase in the cost of services in the hospitals," he stated.
A cross-section of patients who spoke with LEADERSHIP lamented their harrowing experience in terms of the purchase of drugs and other essential materials needed for their well-being.
An outpatient simply identified as Tola claimed that the electricity tariff hike had affected the cost of health care delivery in the hospital.
She blamed the removal of subsidy on petroleum products and the electricity price hike for the increase in the cost of health care delivery.
New Tariff Not Sustainable, MDCAN Warns
Similarly, the Medical and Dental Consultants Association of Nigeria (MDCAN) recently said the energy bill by the various discos to Public Hospitals is unsustainable and tends toward continuous dispute and potential service interruption.
MDCAN, in a communique signed by its president, Prof. Mohammed Aminu Mohammed and, secretary-general, Dr Daiyabu Alhaji Ibrahim, at the end of the National Executive Council (NEC) meeting, enjoined the federal government to urgently put in place a sustainable and holistic framework to ensure public hospitals have adequate power supply for effective delivery of optimal healthcare to citizens.
The doctors also lamented the recent disconnection of power supply to the University College Teaching Hospital (UCTH), Ibadan and called on the federal government to place public hospitals on subsidised special power tariffs as against the present commercial rates.
