Challenges of health-care system and medical tourism by Polycarp Onwubiko

To say that the sustainability and viability of a country’s socio-economic growth and development depend largely on vibrant healthcare system is merely stating the obvious. Unfortunately, emerging challenges in the health sector have made medical tourism by public officials inevitable, which attract revulsion.
 Making allusion to President Muhammadu Buhari’s vacation-turned medical tourism in the United Kingdom, a prominent lawyer advocated that elected public functionaries who go on medical tourism should bear the cost of treatment.
Acho Orabuchi who bemoaned the unrealistic health-care system said that there would have been no cause to seek medical treatment abroad if things had been done rightly. He said: “Poor healthcare system is causing the deaths of people in Nigeria. The healthcare system is fundamentally flawed because of decades of neglect and absence of corrective measures.
“If the quality of medical care in Nigeria had been adequate, there would be no need for any medical tourism to India, America and European countries. Nigerian leaders go abroad for their medical needs because they don’t trust the medical care they would receive in their own country. Perhaps, since the leaders could afford the expensive medical trips to abroad, the neglect of the Nigeria’s healthcare system would continue regardless of the consequences to the nation,”
The seemingly intractable challenges in the health sector are worsened by incessant strike by the federal health workers who are mischievously joined by state workers; whereas the condition of service of federal workers is not the same with state governments’ services. The paralysis of healthcare delivery has compelled people resorting to unorthodox measures which invariably never worked. 
Faulty governance structure   
Dapo Fafowora attribued the deteriorating healthcare in Nigeria to faulty governance structure which equally affects other sectors whose combined effects engendered the crippling economic recession placing the country at the brink of a failed state. He said: “We have over 50 university teaching hospitals but they all lack the necessary medical equipment to function maximally. This situation applies to the private hospitals as well. Very often surgeries cannot be performed because of the irregular and uncertain power supply. In both urban and rural areas of our country, access by the poor to healthcare is very poor”.
In the same displeasure, a cross section of respondents were unanimous in asking recurring questions viz: what has become of billions of annual budgetary allocations to the Aso Rock villa medical institution?; what does it take to have a state-of-the-art hospital with specialist of diverse hue to minister to the health of president and top public functionaries?. Why would billions of public funds be expended in medical tourism abroad for minor ailments like ENT which President Muhammadu Buhari has gone on medical tourism which could have been treated by ENT specialists which abound in the country?
Writer Martins Ifijeh recalled that Buhari had declared that he would “discourage medical tourism through revitalizing the country’s healthcare system and putting stringent measures in place for government officials to travel for medical treatment abroad, except extremely needful”.
The vice-president, Commonwealth Medical Association, Dr. Osahon Enabulele described as “a national shame of immense proportion” for Buhari’s treatment of ear problem outside the country. The federal government should commence its plans to re-equip Nigerian hospitals with modern state-of-the-art facilities…President Buhari would save Nigeria the capital flight that would result from his foreign medical trips.
“His recent trip has again called for question over his government’s efforts towards prioritizing healthcare in the country and making the sector a world class. This is even as reports suggest over N1.3 trillion was being spent on medical tourism abroad last year, whereas the country’s entire health allocation in the 2017 budgetary allocation remains a paltry N304 billion.
“With the country’s health allocation placed at N304 billion for over 180 million Nigerians, it would mean the government would spend just N1,688 on the health of each citizen for 2017, an amount stakeholders say would not be enough to tackle even 25 percent of the healthcare needs of an average Nigerian for the year. Meanwhile, the WHO has stated that Nigeria needs to spend as least N6,000 per Nigeria this year if it must make strides in the health sector. It is also believed for Nigeria  to attain its goal of being a medical hub for its citizens and neighbouring  countries, the health sector must be well funded to achieve it”.
 Records show that Nigeria occupies the enviable position of 187 out of 190 countries in the World Health Organisation [WHO] health ranking. Only Democratic Republic of Congo, Central African Republic and Myaanmar are tailing behind Nigeria
Expressing fury at the mindless waste of public resources in health tourism, a national newspaper commented as follows: “We see no need for the hoopla that has attended the president’s medical vacation. Our grouse, if any, is with the continuing prostration of our medical institutions which made it necessary for the president to travel out for treatment.
“For how long will our supposed centres of medical excellence be unable to offer top grade medical services, thereby making the president and all other Nigerians who can afford it, medical tourists? Why can the nation not provide top graded medical services to the president in spite of the billions of naira voted for the medical centre at Aso Rock? These are questions that are crying out for answers”.
  Condemning medical tourism, Stephen Akpati, medical doctor and former chairman of Anambra branch of Nigeria Medical Association collaborate Fafowora’s views saying that the exclusive legislative list is loaded with sectors which state governments could conveniently formulate policies that conduce to the value system and aspirations of their people. He said:“Over-centralization and excessive bureaucratization led to paucity of data for proper planning for distribution of health institutions and manpower.” 
Recently, the management of Lagos university teaching hospital, Idi-Araba, Lagos ran out of essential medical supplies and consumables, which prompted a relation of a patience to say that if this could happen to a teaching hospital, then to what standards do we hold lesser public hospitals?
 Elochukwu Amucheazi, a professor of political science in a recent media interview also agreed with Fafowora on faulty federalism whereby the federal government makes policies in all sectors for the states to observe. He asked: “What business has federal government in running ministries of agriculture, housing, education, water resources, health, women affairs and social development, etc?  
New health policy 
 The minister of health, Professor Isaac Adewole who the new health policy declared said: “The policy initially approved by the National Council of Health, was extensively deliberated upon before the final approval. The policy is the third health policy in the history of Nigeria. The first national health policy was in 1988, while the second policy was produced in 2004. This new policy will provide directions necessary to support the achievements of significant progress in terms of improving the performance of the national health system
“It also lays emphasis on primary health-care as the bedrock of our national health system in addition to the provision of financial risk protection to all Nigerians particularly the poor and vulnerable population. This administration is committed to alleviating the problem of the poor Nigerians, the vulnerable, the unemployed and the disadvantaged.
“The ministry had constituted a technical working committee to look into the country’s context, the challenges, what went wrong in the past and how we can reposition the health sector. The policy captured the essentials of ensuring the reduction of maternal and child mortality, wider immunization coverage and better control and prevention of public health emergencies”. Chairman, senate committee on health, Senator Lanre Tejuosho, Ogun central endorsing the new health policy said that “the statistics of the rot in the health system provided are worrisome may be an understatement. How best to deal with the issues of access and quality of health-care, how to improve health facilities and services in the country and how to stem the disturbing and growing trend of medical tourism, is bothering the committee”.
“With the economic recession in the country, a practical way to walk the country out of the recession is by boosting investment in human capital, which in turn will stimulate growth. There is a strong link between health and wealth, indeed, between a healthy work-force and economic development.
“The National Assembly will ensure that the provision of the National Health Act, 2014, which stipulates that 1% of the Consolidated Revenue Fund be dedicated to the health sector, is adhered to in the 2017 budget. The National Assembly will improve its over-sight of the health sector and health expenditure spending and ensure judicious management of resources allocated to health, particularly given the decline in oil revenues. There should be greater political will to accelerate resource allocation to health and ensure that the sector is among the top five priority areas in the national budget.”
The APC-controlled federal government should recall its election campaign promise to restructure governance where the burden of the federal government will be reduced. For instance, in the absence of centralized policies, state governments can establish state-of-the-art health-care system to halt medical tourism.

Culled from Orient Daily
Challenges of health-care system and medical tourism by Polycarp Onwubiko Challenges of health-care system and medical tourism by Polycarp Onwubiko Reviewed by Odogwu Emeka Odogwu on Wednesday, March 15, 2017 Rating: 5

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