National Health Bill: Health Workers Want Contentious Issues Addressed

On 05/Jun/2014 / In Medical News

Nigerian health workers have urged the House of Representatives to urgently intervene in resolving controversial issues of the National Health Bill by calling for a public hearing to ensure meaningful and fair contributions from all concerned persons in the sector, describing such move as a way forward.
Making the call today, were representatives of Assembly of Healthcare Professional Associations (AHPA) in the health sector, who were on a courtesy call to the Hon. Aminu Tambuwal, Speaker, Federal House of Representatives to complain about what they termed as some ‘distortions’ in the existing National Health Bill.
“We strongly urge the House of Representatives to call for a public hearing to afford all stakeholders have robust interactions to redress the contentious areas of the National Health Bill as a prelude to moving forward,” they said.
Among the health workers and other professionals who were present include: Olumide Akintayo, President, Pharmaceutical Society of Nigeria (PSN); Dr. Godswill Okara, President, Association of Medical Laboratory Scientists of Nigeria (AMLSN) and Chairman, Assembly of Healthcare Professional Associations (AHPA) and Mr. Abdulrafiu Adeniji, President, National Association of Nigerian Nurses and Midwives (NANNM)
Others are; Mr. Wole Ajayi, President, Health Information Managers Association of Nigeria, Comrade Wabba Ayuba, Chairman, Joint Health Sector Unions (JOHESU); Mr. Taiwo Oyewumi, President, Nigeria Society of Physiotherapy and Dr. Mark Okeji, President, Association of Radiographers of Nigeria.
The issues presented to Tambuwal, were classified under the following sub-topics: National Health System and Regulation of Health Services; Secretaryship of the National Tertiary Health Institutions Standards Committee; Powers of the Health Minister in Section 10 (2) and Issuance of Certificate of Standards.
On the crux of the various issues raised, Akintayo, President, PSN, who spoke for health workers noted that AHPA is of the view that the proposed Health Act will be a General Act of Parliament with regards to the regulation of health services, while the various Acts which regulate the different professions in healthcare are Specific Acts of Parliament, which ordinarily should take precedence over contending legislations.
He made references to the potentially controversial Section 1(1) of the Health Bill which declares that National Health system shall define and provide a framework for standards and regulation of health services.
Policymakers often bend over to pressures from powerful interest groups which facilitate mischief making in execution of statutes in our country based on recent experiences.
Concerning the Secretaryship of the National Tertiary Health Institutions Standards Committee, the PSN president said that AHPA wants an amendment of the clause which vests the Secretaryship of the proposed National Tertiary Health Institutions Standards Committee in the Director of Hospital Services at the Federal Ministry of Health.
He said: “In one of the major provisions of the Health Bill, Section 9(2) (g) vests the Secretaryship of the proposed National Tertiary Health Institutions Standards Committee in the Director of Hospital Services at the Federal Ministry of Health.
“The Assembly of Healthcare Professional Associations seeks an amendment of this clause which remains unconstitutional because of the equalization principle entrenched in the 1999 constitution which normally should guarantee equal rights and privileges for all citizens of Nigeria.
“The same 1999 Constitution rejects discrimination on the basis of social, religious, cultural and sex of citizens. It therefore cannot be justifiable to restrict a statutory privilege to a category of health providers on the basis of belonging to a particular profession, the PSN boss said.
“Specifically Section 42 (1) (a) and (b) declares inter-alia “(1) A citizen of Nigeria of a particular community, ethnic group, place of origin, sex, religion or political opinion shall not, by reason only that he is such a person: Be subjected either expressly by, or in the practical application of, any law in force in Nigeria or any executive or administrative action of the
government, to disabilities or restrictions to which citizens of Nigeria of other communities, ethnic groups, places of origin, sex, religions or political opinions are not made subject; or  be accorded either expressly by, or in the practical application of, any law in force in Nigeria or any such executive or administrative action, any privilege or advantage that is not accorded to citizens of Nigeria of other communities, ethnic groups, places of origin, sex, religious or political opinions,” Akintayo noted.
He further observed that the process of appointing the Secretary of the National Tertiary Health Institutions Standards Committee should therefore logically follow the conduct of a competitive selection process from a pool of professionals who have competent skill and cognate experience, insisting that such expertise is not confined to doctors.
“We maintain with strong emphasis that such skills are not only found in medical doctors contrary to the provision of the Bill,” he said.
“Powers of the Health Minister to give directives of a general nature not relating to particular matters with regard to the exercise by the National Tertiary Health Institutions Standards Committee is a direct invitation to commit acts of impunity in a democratic dispensation, the PSN boss observed.
According to him, the Assembly of Healthcare Professional Associations therefore strongly demands that this provision be deleted outright.
Akintayo noted: “Section 13 of the National Health Bill advocates the issuance of certificate of standards to establish, construct, modify or acquire a health establishment, health agency or health technology and provide prescribed health services. Ironically, the bill does not prescribe the licensing/authority which are most appropriate to carry out this statutory function.
He further said that AHPA is recommending that “the regulatory agencies which regulate and control each of the various health professions be statutorily backed to carry out these functions.
“Any attempt to place these functions under the ambit of another agency will be in conflict with existing legislations,” he warned.
“Specifically the Pharmacists Council of Nigeria regulates and controls the practice of Pharmacists and Pharmacy facilities in Nigeria. The Medical Laboratory Science Council of Nigeria does same for Laboratory Scientists, while Medical and Dental Council of Nigeria handles the licensing of Medical Practitioners.
“It will not be in order to rely on the provision of Section 13(2) which suggests that facilities may apply for registration from the appropriate body of government where the facility is located. For professions like pharmacy which are on the Exclusive List by virtue of being listed as item 21 of Part 1 in the 2nd schedule of the 1999 constitution (Drug Matters), it is unconstitutional, unlawful and ultra vires for an organ at State or Local Government level to attempt to register such facilities,” Akintayo said.
“The Assembly of Healthcare Professional Associations therefore proposes that Section 13(2) should read “The certificate of standards referred to in subsection (1) of this section may be obtained by application in prescribed manner from the relevant regulatory agency which regulates and control facilities in professional practice. In the case of tertiary institutions the appropriate authority shall be the “National Tertiary Hospital Commission”.
The Assembly of Healthcare Professional Associations therefore implored that the House of Representatives amends the provisions of Section 1(1), Section 9(2) (g),   Section 13 and also delete Section 10 (2) as suggested in this memo to make room for a statute that protects the interest of all stakeholders  in healthcare and ultimately serves the public interest.
Akintayo said: “In the light of this, the proposed amendments will read thus: Section 1(1): “There is hereby established for the federation, the National Health system, which shall define and provide a Framework for standards in health services.
“Section 9 (2) (g): “The Secretary of the committee who shall be a person with vast knowledge and experience in health service delivery of at least fifteen (15) years. Section 10 (2): Outright deletion of section 10 (2).
“Section 13(2): “The certificate of standards referred to in subsection (1) of this section may be obtained by application in prescribed manner from the relevant regulatory agency which regulates and control facilities in professional practice. In the case of tertiary institutions the appropriate authority shall be the “National Tertiary Hospital Commission,” he concluded.  

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