 Welcome back at time to have a next conversation right here on the breakfast on plus TV Africa. I'm glad to say we have standing by the president of the National President of the Nigerian Medical Association, Dr. Uche Ojima. Hope you join us pretty shortly, but let's go to, you know, quickly inform you that the Nigerian Medical Association has rushed the federal government to consider privatizing the nation's public hospitals. The association's national president, Dr. Uche Ojima, who joins us this morning, had spoken to the news agency of Nigeria, adding that the boosting of the National Health Insurance Authority will bring more people into the health insurance net and give them better service at reduced costs. So we're glad to have the national president of the anime with us. Good morning to you, Dr. Uche Ojima. Good morning, sir. Good to have me. Good to be here. Yes, good to have you. Good to have you, sir. I'm privatizing the public hospitals in the country. Why? You say what? Yeah. Why are you calling for the privatization of the nation's public health facilities? Well, thank you for giving me this opportunity to hear this view. You see, for a while now, there has been this particular rhetoric that our public hospitals are not doing well because doctors are running there. There has been this consistent call for administrators to take over running the hospitals. But you and I know that the fundamental truth is that no matter the level of skill and specialization you bring to running our private public hospitals, if there is no financial backing, all your plans will end up in naught. It will not work. Therefore, the Nigeria Medical Association, which is the body that represents all doctors in Nigeria, having aggregated the view of Nigerian doctors, believe that it is time we put back the blame to the government. You cannot give me peanuts and expect me to build a skyscraper with it. So to us, having analyzed the situation of our public hospitals, it is our belief that privatizing it will give us two perspectives, which is having a properly run institutions with a positive balance. So let government take their hands off these public institutions and they will get the best of them. The work-hands that are needed will be properly paid. The institution will be properly funded and the patients will have the best. Even though we all know that the charges will go up, the net benefit of increment in pay and having a state of the art hospital is better than what we have today, where government is not funding them and all the blames are being heaped on the chief medical directors and the medical directors. This is our perspective. There's a lot to talk about here. Give me so many talking points at which you had an hour to discuss this. You've said that the blames need not be heaped on the chief medical directors and medical directors. You've also said that funding is a major issue and once that is sorted out, you don't need administrators to run the hospitals. You've also said that since government can't fund them, the private sector should come in, the hospital should be privatized, the costs will go up for the average person out there. So wouldn't this therefore make, you've already said that to that, wouldn't this therefore make healthcare out of reach to the most vulnerable Nigerians? Thank you. So you see, I don't like people approbating and reprobating. Approbating and reprobating. If you want to make an omelet, you must break an egg, sincerely speaking. I'm sure you saw the hospital that the vice president had his treatment at. That's the state of the art hospital. We don't really care who will run it. What I'm saying in essence is this, if we want what is obtainable in Europe, America, India, it has to be privately run. Because as far as Nigerian government and today's policy is concerned, health is a social service for them. It is not all about the financial bottom line for the current Nigerian situation. People are giving healthcare as a political dividend. And that means that if you really want to charge properly to run it properly, you're going to have problem because the patients cannot afford it. But what we're saying now is let us reposition this system properly. You may not privatize it all at once. You can start from privatizing the laboratories. There are a lot of multi-analysers and automated equipment that can take a lot of space and make it run faster. It can come in from the privatization of laboratories, can go to privatization of pharmacies. What I know you cannot privatize in the hospital is the nursing service and the doctor service, the medical service. So we can start by bringing in private sector into the laboratory and have faster results and have less bickering. And we can go on to lizard the pharmacies for the pharmaceutical industries or companies to run. Now, when you talk about increasing costs, let us channel all these budgets that we are going to save into the health insurance such that when we capture many Nigerians into the health insurance, no matter the marginal increase in price, the health insurance will take care of it. And we still have a good hospital. I do get where you're coming from. You've basically just said it all because I was going to talk about the fact that the hospital the vice president went to. In this old dichotomy or this debate between medical administrator and chief medical director is almost like the one between them, the members of the lab scientists and the medical doctors. That's why they've been having it. That particular hospital has a chief executive officer and it has a medical director. For the media appearances made, the chief executive of that spoke generally about the business and all that, you know, non-medically. And then the medical director spoke on the medical aspects. So it was clear that this place has been run by administrator while the medical aspects has been headed by medical director side by side. To make address that, I told you that as far as a public health system is concerned, it is a social service and it is not business driven. The fundamental thing is that the government of Nigeria is trying to make sure that the healthcare of Nigeria is taken care of. That is the basic issue as the concerns the public hospitals today are part of campaign promises and therefore if you bring in a CEO even though he believes the public will suffer. Because we are going to go strictly for the funds. But Doc, is that not what you're saying? Doc, but is that... Yeah. But Doc, is that not what you're saying? Privatization, look at the NMPC is privatized. We have CEO or group managing director. Is that not what you're saying? Of course. If you privatize it, it's business driven because the privatizes are going there for profit. So is that not what you're proposing? See, let me tell you, what I'm proposing is this instead of blaming the chief medical directors when you are the one not funding the hospital instead of blaming the chief medical director when you are the one limiting the charges for patients who you have promised democracy dividend will benefit then go through blast. If they want a CEO let us go through blast privatize it. Let the government hands off we are not afraid of facing purely medical practice but what we are seeing is that within the system of today the blame is not on the chief medical director the medical director. The blame is on the government who will decide to privatize it and the owner of the institution says he wants a CEO and the chief medical director so be it. So doc, if not satisfied my curiosity as to how the most verbal Nigerians who probably are expected to be covered in the current circumstances even if you don't have money you go to a teaching hospital to get attention you pay for everything from experience you pay by your card when you buy your card you have to even if you are rushing an emergency to the accident emergency ward they would not attend to you you have to get your card once you get that card anything they need if it's a catheter you have to go and buy it if it's any of the infusions you have to buy if it's saline if it's even bleach to clean the toilet you have to buy a lot of things you have to get every single thing for yourself so even under the current circumstances it's hard for the poorest of the poor and even the average civil servant out there to afford health care that's how many of them stay home or resort to self-medication so with this privatization one could argue it would get worse that you're proposing where people would not be able to afford health care in public institutions that is what see what I'm saying is this if you want to continue giving out health care as a social service and you are continuing to understand it what are you achieving you are not achieving benefit what we are saying is this we are talking about the things you have to buy go to a private hospital the catheter will be 10 times the cost of the catheter you get in a public hospital the card you are going to buy is 10 times the cost of the card you buy in a public hospital and you see in a private setup nobody breaks it down for you to get this, get this, get this and follow you as you go in a private setup they tell you the total cost and what you must deposit for them to take care of you by the time you come in and charging you 10 million Naira I would not ask you to get a catheter for God's sake, I would have a catheter for you, I would not ask you to get a card I would bring the card to you but when you go to a public hospital you are paying 10,000 Naira as your charge how can you not be expected to get a catheter and everything see this government of Nigeria with all the African government have agreed since 2001 that the health sector requires 15% of the budget to function very well but they have consistently refused to give the 15% for the health sector to function well so the stress you get in the public health sector is precedent upon the fact that there is no money to give you maximum support but the chief medical directors and other hospital workers are trying to break it down for you to make it easy for you to pick up the bills as you go on but if you go to a private hospital nobody has that time you either pay or you don't pay and you get out that is the truth of what we are saying so for today the public hospitals is still better for you if you don't have the money at the cheap rate but there are some stress you have to pass through that is in reality but for when you privatize it the vulnerable group will benefit from the new national health insurance authority act there is even a vulnerable people's fund that they take care of those that cannot afford it so with increased culture from national health insurance privatizing the public hospitals will become beneficial to everybody and the patient will get a better care and pay less out of pocket expenses is what is killing our patients the government needs to push the health insurance privatize the health sector and the patients will be better for it that's what I position you agree that the public hospitals like the teaching hospitals you pay for everything although you are saying it will be more expensive in the private hospitals I agree with you but I think this also points to the fact that the public hospitals especially the tertiary ones are making money doc where is the money going to the money goes back to government because you know where they got GSA since they established GSA it makes it difficult for even the the directors of the hospital to have access to fund any money you raise you pay to government basically and for you to get you have to explain what you did with the last one you were giving that is how GSA functions and you know that there is budgeting when you make your budget you spend your budget if your budget runs out ask anybody you will be in trouble and you have to justify the budget before you get it but if there is money coming in it goes to government so let us ask the government where the money is not us doc you've talked about politics I have you mentioned that so let's look at that you seem to be absorbing the medical directors in the public health institutions in the country of any responsibility in this problem in the health sector that you are proposing a solution to fix but it could be argued that some chief medical directors have become political medical directors they are there for political purposes some even engage in political campaigns and political rhetoric political speeches in the media so I will mention names some have become a stumbling block to the progress of their institutions to the extent that the members of the health workers they jubilate, they call brass band to come and play when the medical directors or CMDs are either fired or they resign some have been so so hard to deal with for the members of their of their staff some of them when they come there is a difference between one that was there themselves so this collusion between the political actors and then the medical directors is also a problem what do you say to this well the fundamental truth is that being appointed a chief medical director is a political appointment as of today in Nigeria if you allow the people who know the doctors within the institution to do the nomination like they do for vice chancellors I'm sure you can notice that since vice chancellors slots have been given to ASU or the institution not ASU by saying it is not the responsibility of the institutional congregation and seniors to produce the vice chancellors therefore when they produce the vice chancellors it sucks the people but as long as we continue with governments being solely responsible for appointment of chief medical directors it is a political appointment and he who plays the paper will dictate the truth that is the truth and let me also point out that there are some bad and there are good medical directors I'm sure you are aware that two medical directors this year a chief medical director and a medical director we are giving national productivity merit award this year that of University of Medjugorje and the Federal America we are giving natural productivity merit award which means that this government agrees that they are productive but you see even presidents that we have had compare them some of them are more difficult than others so you cannot have a standard for all the chief medical directors some are highly loved some are not loved that is Nigeria and that is life I would like to thank you for your honesty Doc and you have given some very interesting suggestions and even a breakdown of how this relationship between government and the private sector can work and let's see how it goes and also you shared your thoughts on the National Health Insurance Authority so let's see if the government will borrow a leaf from your suggestion but thank you so much for joining us Dr Uche Ujima thank you, it was nice to be here I hope to have you soon that's the president national president of the Nigeria Medical Association that's the size of our package right here this morning on the breakfast my name is Kofi Bartels, thank you very much for your time we are at Plus TV Africa across the social media platforms on YouTube you can check out our two accounts Plus TV Africa and Plus TV Africa Lifestyle, see you tomorrow good morning