Iyabo Obasanjo, veterinary doctor, daughter of our former president and former senator of our Federal Republic famously lost her seat in the Nigerian Senate in last weekend’s elections. What has this got to do with our health sector you might be wondering? Well, the former senator was the Chair of the Senate Committee on Health. Those of you that have kept faith with this blog for the past 4 years will notice our recurrent referral to the National Health Bill that has been stuck in our legislative system for 6 years (previous posts here and here). Iyabo Obasanjo had a unique opportunity to take on this cause and drive the health bill to passage. She had an opportunity to be a real advocate for the health of the Nigerian people and a hero to many of us. She controversially took her committee on health on controversial retreats to the serene environments of Ghana to discuss our health bill eluding EFCC’s investigation. But sadly, she had little time for the bill in her last few months in the Senate, when it needed one final push to get it through during this legislative period. So, our National Health Bill remains paralysed and will await the next cohort of senators. Dr Iyabo Obasanjo will be remembered by many in the health sector as the Senator that failed to pass the health bill as Chair of the Senate Committee on Health. What a missed opportunity.
Why is the Health Bill so important? One of the critical factors holding the development of our health sector is blurred responsibilities for providing for our health care across the various arms of government. The bill, in its present format is not perfect by any means, but anything is better than the impasse the sector is currently in. Without a legislative framework to make progress, the sector has remained in the dark. Contained in the health bill, in between the legal speak are the following critical innovations.
1. The establishment of a National Tertiary Hospitals Commission, a corporate body which will among other things establish minimum standards to be attained by the various tertiary health facilities in the nation and also to inspect and accredit such facilities, set standards and criteria for allocation of funds from the Federal Government, monitor their utilisation, collate, analyse and publish information in relation to tertiary health.
2. The establishment of a National Primary Health Care Development Fund that will be be financed directly from the consolidated fund of the Federation, with 2% cent of its value, with 50% earmarked for the provision of primary care via the National Health Insurance Scheme and the other 50% for drugs, infrastructure and human resources for primary health care to be managed by the National Primary Health Care Development Agency through State Primary Health Care Boards.
3. Legal duties on a health care provider: A health care provider, health worker or health establishment shall not refuse a person emergency medical treatment for any reason. Making this explicit by law means that I can sue any health care provider that fails to provide care in an emergency. This that can lead to a fine of N10,000.00 or to imprisonment for a period not exceeding three months or to both fine and imprisonment.- and of course a criminal record and its consequences.
The biggest risk to the National Health Bill at the moment is that a huge amount of funds have been earmarked for management by the NHIS, an organisation that has failed in its mandate in financing the provision of health care for the Nigerian people and is currently embroiled in a leadership quagmire as the Executive Secretary sued the Federal Government of Nigeria for allegedly retiring him prematurely. The Federal High Court in Abuja granted the current Dr. Waziri Dogo Mohammed, the current Executive Secretary of the NHIS an interim injunction restraining the previous Minister of Health, Professor Osotimehin from interfering with his job as Executive Secretary, pending the determination of a motion he filed challenging his removal from his tenured appointment as Executive Secretary of the NHIS. While this is going on – the NHIS has remained another part of the Nigerian puzzle.
In all the excitement of the elections, we had a short bout of hope when it was intially annouced that Dr Ibrahim Oloriegbe had defeated Dr Olusola Saraki in the senatorial elections in Kwara, Ibrahim will be remembered as the first executive secretary of HERFON that drove the development of the National Health Bill to its present state. Sadly, this was not to be. We hope that Ibrahim continues to seek the opportunity to serve his people.
Finally, lets see what the elections hold for the Nigerian people. Maybe, just maybe we will elect a leader that will give the health sector the priority it deserves….and a new group of senators that will take our health a little more seriously.
Never doubt that a small group of thoughtful committed people can change the world; indeed it is the only thing that ever has…Margaret Mead