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Editorial Opinion

Teaching hospitals: To be sold or not to be sold?



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THE ongoing furore over the sale or not of our teaching hospitals needs to be properly and sensitively addressed by all concerned. Nerves are yet to calm as opposing sides are articulating the merits and demerits of either outright sale or the purloining of our teaching hospitals onto the tempting embrace of PPP. In recent times, the idea of PPP (public-private-partnership) has been gaining ready converts who see in PPP the solution to most of our moribund institutions of which our teaching hospitals constitute a part of the whole.
PPP is the new management mantra that promotes the participation of the public and private stakeholders in the running of government institutions in order to cut wastages and return distressed institutions to efficiency and profitability. Public-private-partnership’s ductile strength include the promotion of efficiency in delivery, reduction of wastages, removal of blockages, injection of new ideas and technology, elimination of bureaucracy, ability to free federal resources to pursue other priorities, the encouragement of managerial independence, the enthronement of transparency and accountability and the power to generate multiple sources of funding.
Given the near paralytic gridlock of bureaucracy, corruption and inefficiency that define most of our public institutions, it is no wonder why PPP’s inherent benefits are being seen as the bookmaker’s favourite. The plan by the Federal Government to ‘sell’ public health institutions was confirmed in a document prepared by the Federal Ministry of Health (FMoH) in November 2014 titled “Recommendations for a National Policy on Incentivising Healthcare Investments.” President Mohammadu Buhari’s change-driven desire to eliminate corruption and cut out inefficiency in government institutions may find PPP a tempting experiment for implementation. This is where the President has to avoid walking on eggshells. Any sale or rendition of our teaching hospitals to private hands is nothing short of playing a reckless and dangerous game with the lives of millions of patients. PPP for teaching hospitals is dangerous because our lives and health are involved.
The teaching hospitals are medical institutions for the training of our future health personnel. By extension, a teaching hospital is the hospital to the University concerned.
Any partial or full privatisation of Ahmadu Bello University Teaching Hospital (ABUTH), Lagos University Teaching Hospital (LUTH), University of Ibadan Teaching Hospital (UCH), University of Nigeria Teaching Hospital (UNTH) and the University of Benin Teaching Hospital (UBTH) would amount to serious questions being raised concerning the role of government to the citizens. It is on record that Federal Government receives 54% of all national revenues. Where is this money going to? What is draining federal resources that it cannot defend its fundamental charter to Nigerians?
Why does Nigeria, the so-called giant of Africa, existing without a fully functioning rail system, a national carrier and a steady electric power supply such as we have even in less endowed countries of the world?
We recall here that ex-President Olusegun Obasanjo once bought a lot of medical gadgets for the teaching hospitals in the country. What happened to these equipments? According to our sources, they all rotted away. Why would the Federal Government abdicate its responsibilities to the teaching hospitals, and, therefore, to Nigerians, by encouraging commercialisation through investors? It has to be said that when entrepreneurs are brought in to run our teaching hospitals, the pursuit of marginal profit over medical humanitarianism would exclude millions of Nigerians who may not be able to afford these institutions any more. The old safety net of ready access to medical emergency would then be broken and millions of poor and excluded Nigerians will be lost to quacks, who may not have the same equipments as our teaching hospitals, in spite of their flaws and frailties.
Therefore, the Federal Government owes Nigerians a duty to inject money and resources into our teaching hospitals and also act as a gatekeeper of its performances from now on. If the necessary financial assistance is not deployed, this would amount to serious erosion and rape of every Nigerian’s right to healthcare as enshrined in the Chapter II of the 1999 Constitution under “Fundamental Objectives and Directive Principles of State Policy”. Affordable and access to health care is part of the social contract between the government and the governed all over the world and Nigeria should not be seen as deviating from this noble norm.
Indeed, President Mohammadu Buhari should seek to urgently galvanise support, money and resources, to at least build a world standard hospital in Nigeria to arrest the shameful practice of our elite who fly abroad for medical treatment. The estimated loss of this medical tourism malaise to places like the USA, South Africa, India, the UK, Germany, Poland and Russia amount to billions of naira annually. A widely favoured alternative to either outright sale or outsourcing to privateers is to resuscitate these moribund teaching hospitals through Federal Government capital investment and the maintenance of control, good practice and accountability from the bottom to the topmost management.
It is worth restating that the ceding of our teaching hospitals to the tempting arm of PPP is dangerous and reckless. We must not inadvertently or intentionally stratify our society and deny the weak access to medical care through PPP that seeks to protect investors’ profits over the doctor’s ancient canon to protect, save and care. If President Mohammadu Buhari’s body language, manifesting in integrity, honesty and efficiency, could make a dead PHCN roar to life, nothing then should be able to stop our teaching hospitals from being revamped and seen as citadels of true medical excellence and national pride. A troubled suspicion exists in the merits of PPP-driven agenda for our teaching hospitals and to believe it will usher in a life of medical ease to Nigerians is to ignore the argument that privatised teaching hospitals would deny millions of Nigerians the liberty of their health care social contract as enshrined in the Constitution.

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