Why government must invest in health sector, by Alasia
Dr. Datonye Alasia is the chairman of the Rivers State branch of the Nigeria Medical Association (NMA). In this interview with ANN GODWIN, he urges government to see the fund spent on the health system as investment.
What can be done to discourage medical tourism?
If political office holders have faith in the system they lead and manage, there is no way they would seek medical attention abroad. For them to continuously travel abroad for medical care is an indictment on their performance as leaders. Yes, we agree that people have choice to go where they want to go with their own money, but not with public funds. If you have to go with public funds then, you are wrong and what that tells us is that we have not given prior attention to the health system as a whole to the extent it deserves. And that is why we are rated very low in terms of health care delivery.
There is need for better investment in the Nigerian’s health system, especially in human resources and infrastructure, and also create a system whereby anybody can have access to quality health care. So, we need to do better with financing and better health insurance.
For instance, these hospitals that these people go abroad for medical care, how much did they spent to set them up? But here in Nigeria, it is difficult to get the required fund to set up such health facility. So, this is one of the challenges. What about cost of drugs, the government has recently imposed a 20 percent tariff on imported drugs. There is no special concession for drugs imported under the present high exchange rate. So, the cost of drugs is going up. What about investing in the people that render this specialised service.
Are you satisfied with the present funding of the health sector?
The issue of funding of the health sector has been a recurring one, because the sector has been largely left unfunded. We rely on foreign donor funds and thus most of the programmes ranging from Human immunodeficiency Virus (HIV), tuberculosis, and some non-communicable disease like hypertension; there is no adequate budget for it. So, all these explain why the health system is weak. In this year’s budget, the Ministry of Information and Communication had a bigger chunk than the health, so that is what we are saying. It will be difficult for the health sector to work without funds. These are all the challenges.
Another biggest challenge is that we do not have enough human resource. There must be a clear plan to grow it and government must put the necessary incentives in place. So, when you see situations where health workers are agitating, some, their wages not paid, some are being owed for months, so, morale goes down and who will be willing to come into a system like that. Nigerian doctors abroad are doing great. In fact they are seen as the best. What is wrong with the system here is that human capacity development is poor. Doctors in this country are doing their best; there are many public hospitals that are doing heart transplant, kidney transplant and heart surgery in spite of these challenges. If you want a general hospital to be very effective, you must have all that is necessary to make it run well. You cannot keep one doctor in a general hospital and expect it to work, that hospital must have at least four to five specialists manning the vital areas, and good accommodation must be provided for them.
Now, what can be done to improve the system?
One of the things is that government should see every kobo they put in the system as an investment. I am sure once government realises that any money put into health is a huge investment, the approach to it will change. There is the need to ensure that the health insurance scheme works, so that many people can have access to medical care without the fear that they will pay from their pocket. But in doing that, you must also ensure that the appropriate value is placed on it. Let the health insurance system work and make sure that the pricing and everything is done appropriately. And when these are done, there will be competition and quality will now be what will determine where people go.