Making National Health Bill acceptable for Nigerians

interest group protesting recently at Abuja to protest the non passage of the National Health Bill

Over the years, the nation’s healthcare has been plagued with lots of challenges stemming from worrying health indices on infant and maternal mortality to poor infrastructures at the various healthcare levels and lack of confidence to administer quality of healthcare to Nigerians, to name but a few.

These issues have in the sector has not only positioned the nation in bad light, it has also impeded the achievement of the MDG goals. Hence in a bid to reform the sector, the National Health Bill was passed by both arms of the National Assembly.

The National Health bill, first introduced to the National Assembly in 2005, was designed to provide a framework to regulate health services as well as clarify roles and responsibilities for various stakeholders in the health system in a country certainly in need of helth system strengthening.

Aside removing bottlenecks for emergency medical treatments, the bill seeks to provide for the statutory utilisation of not less than 2 percent of the Consolidated Revenue Fund for the provision of healthcare across the country. This does not take away the burden of paying for healthcare services from Nigerians.

 

While the bill still awaits President Jonathan’s assent, there have been heated debates within the health circles over the need to revisit certain issues aimed at addressing efficient healthcare delivery for Nigerians.

Medical Laboratory scientists, under the auspices of Association of Medical Laboratory Scientists of Nigeria (AMLSN) have called for the amendment of Section 1 of the National Health Bill, as the bill in its present state took no cognisance of existing professional regulatory laws and statutes in the health industry.

Speaking to newsmen in Lagos, Toyosi Raheem, National Secretary, AMLSN, disclosed that the bill would do more harm than good as it did not foster the interest of the multi-professional teams within the health sector. While Section (1) of the Bill, which is the establishment of National Health System, defines and provides a framework for standards and regulation of health services, Raheem explained that section 1 of the bill had already disdained and prejudiced various relevant existing professionals.

Raheem argued that the sub section which set out the rights and duties of health care providers, health workers, health establishments and users was not only ambiguous and irrelevant but also conflicts with and turns a blind eye on the existing laws that established the National council on Establishment whose functions and powers are by law to prescribe duties and responsibilities for all cadres of workers in the public service through their various scheme of service.

“The bill will not only conflict with the existing regulatory laws and statues, but will increase the crises in the health sector in Nigeria. Therefore, the victims of this crisis shall be the innocent patients, healthcare professionals and the larger society that visit and patronise our healthcare facilities,” Raheem added.

Members of the 6th National Assembly during a legislative session

 For Azubike Okwor, Pharmaceutical Society of Nigeria (PSN), the Health Bill is vague in its provisions for representation in a number of sections where it refers to representative of medical services of institutions.

In his words “An example is in Section 6 where references are made to representative of each of the Armed Forces Medical Corps. This is a cumbersome and potentially explosive situation as Section 62 under interpretations does not define persons who constitute medical services in these institutions. It is pertinent to make references to the contentious Section 1(1) of the Health Bill which declares that the National health System shall define and provide a framework for standards and regulation of health services.

"In order to allay fears of care providers and to prevent mischief making or even legal tussles in the near future, we implore the National Assembly to draw a parallax from Section 42(d) of the same Health Bill which takes cognisance of conflicts with existing legislation,” Okwor concluded.

In a different reaction, Olarenwaju Ekujimi, National President, National Association of Resident Doctors (NARD) disclosed that if the bill is assented to by the President, it will surely address identifiable gaps in the health sector with good governance and focused leadership devoid of corruption.

He warned that apart from children and women who had lost their lives due to preventable deaths, many more Nigerian children would die any day that passes without the bill becoming law.

"Many people with disabilities and the elderly will continue to lack access to qualitative health care while the bill still awaits the President’s assent," Ekujimi noted

In his view, the bill addresses the core issues that have bedevilled healthcare delivery in Nigeria since independence. While the nation’s infant and maternal mortality rate still remains alarming, the average life expectancy in Nigeria is 48-54 years compared to 60 years for Ghana, 63 years for Senagal, 58 for Sudan, 57 for Benin Republic, 82.6 years for Japan and 71 years for Egypt.

At the meantime, a report by the World Health Organization in 2000, ranked Nigeria’s health care system performance 187th out of 191 countries.

While stakeholders in the health sector believes that the sector needs to be strengthened to better meet the needs of Nigerians and that implementation plans are critical to the success of the National Health Bill, so far, none of the contending factions have softened its position over the health bill.

Many are of the view that for the bill to bring about the much touted transformation to health sector, all professionals must agree to it, rather than the situation where some perceive that the bill as marginalising their profession.

While fears have been expressed from various quarters that if nothing is done to make the health bill acceptable to all, war of words will not abate with patients suffering from the continued rivalry among health care professionals. Time will tell if the President will sign the bill.