Expert advocates primary care-based hospitals

Prof. Rotimi Jaiyesimi

Prof. Rotimi Jaiyesimi

To boost healthcare delivery in the country, an associate medical director for patient safety and consultant obstetrician and gynaecologist at Basildon & Thurrock University Hospital NHS Foundation Trust England, United Kingdom (UK), Prof. Rotimi Jaiyesimi, has called for the establishment of more primary health care-based hospitals since over 70 per cent of the population need the services.

Jaiyesimi who is also the Chairman of the Board of Bright Hope Specialist Hospital Agidingbi Ikeja, Lagos, and Visiting professor of Applied Sciences at University of Sunderland, England, decried the absence of political will and accountability and safety framework to monitor the performance of doctors, nurses and allied health workers.

Jaiyesimi in a chat with journalists in Lagos said: “I am passionate about primary care because that is where most of our problems lie, seventy percent of Nigerians require primary healthcare and what are the diseases, malaria, diarrhea, anemia in pregnancy. You do not need to go to University College Hospital (UCH) Ibadan, Oyo State; you don’t even need to go to general hospital to have those thongs treated, they can be dealt with in primary care. Bright Hope is new and we opened in June and the vision is such that we want to reach out to primary care as well. A little bit similar to a novel idea in the United Kingdom (UK) where the bigger hospitals now want to buy General Practitioners (GPs), so that there is a flow between the primary care, secondary care and tertiary care.

“I will start on the positive note. Nigerians are brilliant people. We are intelligent people. What is happening is that there is a huge gap in terms of investing in infrastructure. Secondly, what is happening in the health sector is there is no framework to monitor the performance of doctors, nurses and other allied healthcare workers. You could have doctors who are called but you don’t see them, you could have surgeons who are supposed to be operative and they do not even operate for a year and nobody within the health system holds them accountable.

“So what we need is a frame work to help us make sure we deliver what we promise, good quality care, safe care, here we do no harm to the patients we look after. I mean as a doctor he very first thing they will tell you is ‘do no harm’ but in Nigeria we know a lot goes wrong in hospitals and nobody says anything and so we would like to see this new government delivering accessible care, affordable care to all Nigerians and that is what we need to put in place.

“At the moment, we have the Medical and Dental Council of Nigeria (MDCN), you have the Nigeria Medical Association (NMA), and we have so many organizations. There is relatively a new one called society for quality health care in Nigeria. Now they are looking for good accreditation, good standard, so we are beginning to look at safety issues in health care and I think this new government, if they have good proper framework including primary, secondary and tertiary healthcare, we will get there. Not overnight but a step towards improvement on what we want, called ‘quality care’- Primary care.

“Primary care has to be looked out in primary areas, the rural areas the smaller cities, that is where most Nigerians live, die and nobody wants to go serve there, doctors, nurses, so we need a well established, well run, well equipped primary healthcare system but having a primary healthcare system as a ‘stand alone’ if something goes wrong, we still need secondary care like a referral part way to secondary care and to tertiary care.

“Nigeria is not short of policies, various past governments have written on policies but the problem we have is on the delivery of the policies. Now why do we have the problems? Again there is no accountability, nobody. Now people have got to be held accountable for their actions. If I am to be employed as a doctor, I should be held responsible, if as a minister should be held accountable for what they do, politicians as well maybe four years we go to the ballot box, again we thought what have you done in four years is about accountability, so that’s what I will like to say is, political will.

“We spent about three percent of the Gross Domestic Product (GDP) on health, that is inadequate. We need about six percent I will even like to recommend about ten percent if we are serious on health care issues in Nigeria.”

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