During what could be described as one of his last public events as health minister, Prof Isaac Adewole noted the collapse of Nigeria’s primary and secondary healthcare facilities as the many reason why Nigerians don’t have confidence in the healthcare system.
“Nigerians have no confidence in the Primary and secondary healthcare facilities, because they have collapsed,” Adewole said.
Addressing senators, Adewole said that the Tertiary hospitals (the apex of the healthcare system) which were expected to manage complicated cases were doing well despite the extra burden of healthcare delivery, forced on them, due to the near collapsed Primary and secondary healthcare centres.
Likening the three (3) levels of the healthcare delivery to a building comprising of a foundation (Primary health care centres), the walls (General hospitals) and the roof (Teaching hospitals), Adewole declared that ‘’the foundation is weak, the walls are also weak, yet we are only concerned about the roof.’’ This, he maintained was an error, rather, the country should invest in PHC’s because ‘’it is closest to the people.’’
The Minister explained that the Primary and Secondary healthcare facilities needed to unburden the Teaching hospitals by playing their parts, which was, to provide basic health care services: treating malaria, rash, simple infections and others, while critical cases were referred to Teaching hospitals.
According to the Minister, if this was done, the Primary and secondary healthcare facilities would have handled 70% and 20% of healthcare service delivery, respectively, while only 10% of the burden would be left for the Teaching hospitals. Unfortunately, the Minister regretted, ‘the reversed is the case.’’
He therefore noted that, for the health sector to function optimally, the country needed to restructure the pyramid and begin the task of confidence building; because ‘’Nigerians have no confidence in the Primary and secondary healthcare facilities, because they have collapsed.’’
To remedy the situation, the Minister said, the health sector had introduced the Basic Health Care Provision Fund (BHCPF), which he tagged, ‘the game changer’’.
When the fund is injected into the various PHC’s, the facilities are expected to begin to operationally function, optimally, as such, Professor Adewole advised the country to ‘’own the PHC’s, invest in them and if this is done, people will not have reasons to travel out for medical care,’’ he underlined.
Adewole also said that functional PHC’s would reduce the problem of overcrowding in Teaching hospitals, which was caused by non-functional, State-owned, general hospitals. If this is done, the Minister assured that the Tertiary health facilities would be unburdened and they would be able to function as referral centres, as originally, intended.
He also tasked the distinguished Senators to assist by engaging their State Governors, especially, Governors of the 14 States, yet to implement the BHCPF programme, on the need to key into the programme and also invest in the secondary health facilities under their care, ‘’if we don’t do this, we will be scratching the surface of the problem. ’We also need the support of the Senate to appropriate budgetary funding for the health sector.’’
He further appealed to State Governors to partner with the Federal government by employing more medical personnel and making adequate budgetary allocation to the health sector.
More so, he added that the Teaching hospitals could not function in isolation, as such, there was need to partner with States as it was being done at Maiduguri Teaching hospital, Sokoto Teaching hospital and other ‘’star’’ hospitals like Obafemi Awolowo Teaching hospital, LUTH, Port Harcourt Teaching Hospital, Aminu Kano hospital and FMC Umuahia, who were doing well in various aspect.
Speaking on Power and water supply in health facilities, the Minister solicited for support from Ministries of Power, Works and Housing and Ministry of Water resources.
In his words ‘’Water supply is a challenge in University of Nigeria Teaching Hospital, Enugu; as such we need to partner with relevant Ministries. Collaboration in these regards would provide needed volume of water. It would also improve power supply at our health facilities and reduce dependency on diesel.
The Senate President, Abubakar Bukola Saraki in his remarks, said that there should be a better way to work with the States in order to reposition the Health system.
We must look at budgetary releases to fund our Primary health care facilities because if we get the foundation right the basic healthcare needs would be provided; this includes payment of Doctors and other healthcare workers allowances.
Commending the senate for their support for the sector, Saraki said, ‘’the Senate should be applauded for passing the Bill for the funding of the BHCPF towards improving healthcare service in Primary and Secondary health facilities.
He urged, Professor Adewole, to ensure that the fund is prudently managed.