HomeWorld NewsHealth sector crippled as Buhari delays major appointments

Health sector crippled as Buhari delays major appointments

Niyi Odebode, Olalekan Adetayo, Eniola Akinkuotu and Olaleye Aluko

There are strong indications that the delay by President Muhammadu Buhari’s administration in making major appointments in the health sector, two years after its assumption of office, is negatively affecting the sector.

Saturday PUNCH gathered on Friday that no fewer than 19 federal medical centres and other Federal Government-owned tertiary institutions do not have substantive chief medical directors. Also, while the Medical and Dental Council of Nigeria has an acting registrar, the National Agency for Food and Drug Administration and Control has an acting director-general.

Similarly, the boards of key health institutions such as the MDCN and the National Health Insurance Scheme have not been constituted.

It was learnt that the psychiatric hospitals in Benin, Lagos, Abeokuta, Maiduguri, Sokoto and Calabar; FMCs in Abeokuta, Owo, Ido-Ekiti, Lokoja, Lagos, Asaba, Owerri, Birnin-Kudu, Gombe; and the teaching hospitals in Kano, Abuja, Abakaliki and the orthopaedic hospital in Lagos do not have substantive medical directors.

Most of the hospitals do not have governing boards, thus making their acting medical directors to depend on the health ministry for approval of some of their actions.

According to the Federal Ministry of Health’s Hospital Services’ Department’s website, www.health.gov.ng/index.php/department/hospital-services, there are 21 Federal Government-owned teaching hospitals, 20 FMCs and 13 specialist hospitals.

A top Federal Government source, who confided in Saturday PUNCH, said many of the institutions had been without substantive chief executives for over one year.

It was learnt that one of the worst hit institutions was MDCN, as disciplinary measures against erring doctors were stalled because without a board, the Medical Practitioners Tribunal could not sit.

“Besides the issue of discipline of erring doctors, the accreditation of medical schools has been slow because of the absence of the board of MDCN,” the source, who confided in Saturday PUNCH, said.

Another source explained that although the acting medical directors could recruit staff, they were mandated to get approval from the parent ministry because the governing boards for their hospitals had not been constituted. The source added that such approvals were slow in coming, thus creating shortage of staff in the hospitals.

“Currently, many of the hospitals are facing shortage of manpower including doctors and nurses, which would have been better addressed if they have substantive medical directors,” the source stated.

The source also attributed the crisis in the NHIS to the non-constitution of the board of the agency by the present government.

The NHIS Executive Secretary, Prof. Usman Yusuf, is at loggerheads with health maintenance organisations, which had dragged him to a Federal High Court, Abuja for allegedly performing duties that only the board could do.

The source stated, “There is a limit to the funds these agencies can spend.  Anything above the limit, they must obtain the approval of the board.”

MDCN, others can’t function effectively without boards – NMA

The Nigerian Medical Association said it was concerned about the delay in making the appointments, saying it was affecting the agencies negatively.

The NMA President, Prof.  Mike Ogirima, in an interview with Saturday PUNCH, said, “The non-constitution of the boards is affecting all the parastatals negatively, particularly the MDCN because it cannot function properly without a council.

“Right now we have an acting registrar in place. The Act setting up the MDCN says they (the council) will approve the appointment of a substantive registrar.

“There are federal medical hospitals whose chief executives are in acting capacity. Of course, they are doing the jobs of the chief medical directors, but they are now under the supervision of the ministry. The ministry has a lot of work on its hands so there cannot be any adequate supervision of all by the ministry.

“There are purchasing powers vested in each level of administration. Of course, any purchase that is more than a certain amount has to be approved by the ministry. The difference between acting and substantive is obvious. The powers are not too different but an acting CMD cannot be fully concentrated on his duty because he is not sure of his fate.”

Many acting CMDs can’t embark on full staff employment, huge capital projects – Ogun NMA.

The Chairman of the Ogun State branch of the NMA, Dr. Abayomi Olajide, said the branch was highly disappointed that the two federal health institutions in the state had no substantive chief medical directors.

He stated that the acting chief medical director at the FMC Abeokuta had spent about one year, while the one at Neuropsychiatric Hospital, Aro, had spent six months.

Olajide said, “Acting chief medical directors have some limited capacity to function especially when it comes to making some decisions that have far-reaching effects. A good number of them could not embark on huge capital projects, full employment of staff, except for contract and locum appointments. Based on this, some of them have resorted to employing more locum appointments which NMA frowns upon.

“Psychologically, they are mindful of their actions because it may portend danger for their confirmation as substantive CMDs. It is actually difficult to holistically put on board their own developmental programmes for the institutions because of the uncertainty with the final outcome of appointments.”

“Another serious issue with this is that some of the candidates who participated in the CMD interviews are close to retirement as occasioned by the delay.”

Olajide urged the Minister of Health, Prof. Isaac Adewole, to appeal to the Presidency to expedite action on the appointments.

He added, “On the issue of the board of our regulatory body (MDCN), it is regrettable that despite all the entreaties from the NMA for the council to function, it is about two years now and most functions of council could not be actualised because of the non-constitution of the board.

“The issue of discipline of erring members, monitoring of facilities, accreditation of colleges of medicine and other related functions are largely affected. It is in the best interest of Nigerians that the board should be reconstituted to bring normalcy to medical practice regulations.”

Efforts to get the reaction of the spokesman for the Acting President, Mr. Laolu Akande, did not succeed as he did not pick calls made to his mobile phone nor responded to an SMS sent to him.

Acting leadership has not affected council – MDCN

The acting Registrar of the MDCN, Dr. Tajudeen Sanusi, said the council usually embarked on accreditation, but it could seem slow, because a lot of processes were involved.

He said, “On the absence of a substantive CEO and board in the MDCN, I do not think that is a problem.  I started in acting capacity on December 28, 2016, and the council is not the only institution that has its leadership in acting capacity. This has not affected the activities of the council in any way.

“It is true that the MDCN is involved in the accreditation of medical schools. But you see, accreditation entails a lot of things, and we do this as a regular activity. The degree that medical schools award is both academic and professional.

“But when people say accreditation is not regular, they do not know our inner workings. For any accreditation, we have to assemble professionals and academics, who are scattered all over the country. We pick people randomly from all parts of the country and they all have to be free at the period of accreditation. This is a problem on its own.

“Also, every year, we continue to improve on the method of accreditation. There is an information booklet that we receive from medical schools, which contains the names of all their lecturers and consultants. We also accredit by going in to their files and scrutinising the information. When we observe discrepancies, we call to question. Hence, accreditation might look slow, but in the long run; we cannot endanger the lives of people in the country.”

We are working on the issue – Minister

When contacted, the Minister of Health, Prof. Isaac Adewole, said the government was working on the issue (the appointments).

In a terse text message he said, “Thanks for your SMS. We are working on these and should be done soon.”

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