Communiqué of the 41st Annual General Meeting of the Association Of General and Private Medical Practitioners of Nigeria (AGPMPN) Held on the 12th Day of April, 2019 at the Honni Hills Hotel, Yenagoa, Bayelsa State.
The Association marked her 41st Annual International Scientific Conference/Annual General Meeting in Yenagoa, Bayelsa State in April, 2019. The week long electrifying event began on BM April with pm-conference events and conference activities involving scientific lectures, seminars, symposia, equipment arid intellectual product presentations as well as product exhibitions. These culminated in the AGM on Saturday, 13th April 2019.
The theme of the conference was “The Health Implications Of Oil Exploration And Gas Flaring”. The lecture was very eminently delivered by no less a personality than Prof. P. J. Allagoa. The conference was richly attended as it drew members from all the states of Nigeria and the Federal Capital Territory, Abuja.
The event which had Prof. Tarila Tebepahas chairman, witnessed the assembly of great dignitaries prominent amongst whom were the Executive Governor of Bayelsa State, His Excellency, Henry Seriake Dickson ably represented by the state commissioner for health; the Hon. Minister for Health Prof. Isaac Adewole who was eminently represented by the Director of Hospital service at the Federal Ministry of Health, Dr. Omale Joseph; the Nigerian Medical Association President Dr. Francis Faduyile; President of the Nigerian Labour Congress as represented; President of the Pharmaceutical Society of Nigeria and a host of others.
The Andem Ewa theme lecture succinctly captured the mood of the national reality and the concerns of oil exploration and gas flaring in the oil rich Niger Delta zone of the country where we seem to experience the misfortune of disaster in benevolence and abject devastation of wealth. This is the picture of Oloibiri, the ancestral home of the oil of wealth of Nigeria where the first oil was extracted in 1969 but now lies waste and desolate in the midst of plenty. It told tales of extreme ecological degradation, occupational hazards and the economic down turn of the people. Apart from the recommendation that Oloibiri be steadily transformed into a world tourist location and heritage for our oil, a clarion call was put out for the observance of strict safety protocols by the oil companies in administering the process of oil exploration.
STATE HEALTH INSURANCE SCHBAES (SHIS)
We are proponents of health insurance and our desire is for universal health coverage to be achieved for Nigerians. Nothing can be greater service to a people than that. We are happy that the states are beginning to get involved in health insurance schemes at their levels. This is a prerequisite for Universal Health Coverage. We are however, uncomfortable with the conditions and standards the states are putting in place to try to achieve the objectives.
Health insurance is serious business. It is the life wire of the health system of any health insurance nation. If the system gets the standard right, it will achieve the cardinal objectives of health insurance which are embodied in patient satisfaction, provider prosperity and good governance. If the wrong things are done, the consequence is anarchy. the evidence of which will manifest in the ripple effects of patient dissatisfaction, a worsening disease burden and healthcare indices, exploitation and frustration of providers and a poor nation.
The states have proposed tariffs and covered services that can only bring poverty to doctors and expose patients to avoidable outcomes. Doctors have been sidelined in planning and formulating policies for the scheme.
In view of the calamity ahead and on the mandate of National Executive Committee of AGPMPN, an extraordinary summit of NEC held on 24 November 2018 in Port Harcourt. We resolved not to participate in any scheme that holds the potential of crippling our practices and compromising our professional obligations to our patients. We agreed to withdraw from or withhold participation in any state health insurance scheme until we have had the opportunity of engaging the state governments and establishing a scheme that is not only equitable but sustainable; a precondition for our participation. A communiqué was published in two national newspapers to that effect.
We noticed that some states have gone ahead to implement the health insurance scheme without the required input of doctors that will bear the operational burden. We resolved that all Commissioners of Health in all the states in Nigeria will be written to state the fact that we reject the states health insurance policy and guidelines the way they currently are. Doctors will not participate in the scheme until they (Doctors) participate in drafting the guidelines. Any doctor participating in the scheme against the decision of AGPMPN is on his own and risks being accused of infamous conduct. Infamous conduct is an offence the MDCN takes the disciplinary action against.
TREATMENT OF EMERGENCY
Article 20 (I) of the National Health Act provides that a healthcare provider, health worker or health establishment shall not refuse a person emergency medical treatment for any reason. It goes further in part 2 to declare that a per-son who contravenes this section commits an offence and is liable on conviction to a fine of N100,000 or to imprisonment for a period not more than six (6) months.
This law affects us in the private sector more as it impacts directly on our finances and performance. Nobody has been paying for those mandatorily treated and our health insurance system has not helped matters. If our health insurance worked, every Nigerian would be covered and no doctor will lose his money. Private doctors bear the bur-den of our healthcare delivery system because of this dysfunctionality.
The federal government through the national assembly has earmarked l% of the national consolidated revenue fund to health, under the Basic Healthcare Provision Fund. A ministerial committee has been set up to harness the management as well as remuneration for emergency treatment. This is a welcome development. The AGPMPN as a major stakeholder and the President represents its membership. By this development, the days of the horror of doctors, painstakingly committing their time and resources to treating emergencies and having no one talking about their payment is gone. Membership of AGPMPN and recommendation by us will be a principal criterion for eligibility to benefit from this and other projects.
Nigeria has about 75,000 registered doctors out of which over 35,000 are in the diaspora and many more are leaving. We are the largest affiliate of the NMA, there is no doubt that we have over 25,000 doctors in the private sec-tor. Many of them have not found need to affiliate with AGPMPN. Because of the overwhelming importance of put-ting a tag to our membership, we resolved to operationalize our identity which recognizes membership of the doc-tor employees of private hospitals. We resolved to build a national electronic database of members that will include facilities, the facility owners (Medical Directors/CEOs) and the Medical Officers (MOs). Medical Directors of facilities will enlist their doctors as members. Membership of AGPMPN will henceforth be part component of the terms and conditions of employing doctors in our facilities. We will liaise with the various state ministries of health in the spirit of Public Private Partnership to collaborate with the AGPMPN to fight quackery and guarantee efficiency, mon-itoring and evaluation as they pursue corporate governance in the healthcare system. AGPMPN will be part of the protocol of accrediting facilities for government license by screening and recommending doctor-owners of hospitals.
PRIVATE SECTOR PARTNERSHIP INITIATIVE (PSPI)
Our governments and the formal sector do things in the health system as though the private sector does not exist. Our lawmakers make laws that suggest that they are oblivious of the peculiar challenges in the private health sector. To make a law that demands compulsory treatment for emergencies in a country where health insurance has covered less than 3% of the population without clearly taking measures to ensure payment for the services is to suggest that such lawmakers did not consider the staggering difference between the public hospitals where salaries must be paid whether patients pay or not and the private hospitals which depend totally on what patients pay. We cannot afford the unpleasant irony of being the most significant workers in the field of delivering healthcare to Nigerians and yet be the least significant to the system. AGPMPN being a corporate entity listed with Corporate Affairs Commission is a legal personality. We resolved to open channels of discussion for collaboration with organizations such as Federal Ministry of Industry, Trade and Investment; Bank of Industry; Nigerian Maritime Administration and Safety Agency; Nigeria Agip Oil Company Ltd.; Nigerian Liquefied Natural Gas Ltd.; Ibeto Group; Dangote Foundation; Air Peace; Indorama Eleme Petrochemical Industries; the Media, etc. We resolved to develop a strong media/publicity unit with extensive corporate social responsibility mandates to collaborate with these various partners.
LAW ON TREATMENT OF GUNSHOT VICTIMS
The new law on gunshot victims provides that the doctor must accept gunshot victims and treat with or without police report and with or without money. This is acceptable and meets global best practice. The same law however demands that the patient must not die and prescribes that if the victim dies, the doctor will be liable to paying compensation and or a jail term. We think this is draconian. It is anti-doctor. It violates professional norms and values knowing that we care but God heals. The outcome of our efforts is beyond us. This component of the law is not acceptable. We resolved to consult our parent body, the NMA and other stakeholders including our lawyers on the approach considered best to expunge this malignant spot from the provision.
NON ELIGIBILITY TO SIGN MEDICAL REPORTS BY PRIVATE DOCTORS
We noticed that medical reports signed by doctors in private practice are rejected by government and the public sector. it is ridiculous and insulting that a senior medical doctor in private practice will write a medical report and it will be rejected on the basis that the doctor is in private practice. We resolved to commission a lawyer to investigate the authenticity, genuineness and veracity of the alleged law that makes private doctors ineligible to sign medical reports and its applicability. It violates the professional rights and liberty of the private doctor and should be abrogated if it exists or otherwise be declared a ruse.
A total of twelve doctors were conferred with the award of Distinguished Medical Practitioner (DMP). They are:
- Dr. EMUDAINOHWO Aye Ebi (Delta State)
- Dr. SAGBE Solomon Aye Ebi (Bayelsa State)
- Dr. AKPAN Petrolina Usoro (Edo State)
- Dr. OKPOKO Pius Izundu (Ekiti State)
- Dr. FAGBEMI Leonard Adegboyega (Lagos State)
- Dr. ESEGINE Jonathan Orji (Lagos State)
- Dr. AMBALLI Adebayo Adetola (Ogun State)
- Dr. KUSIMO Adeneye Rabiu (Ogun State)
- Dr. MADUAGWU Okezie Baldwin (Rivers State)
- Dr. OKOYE John Obiaghanwa (Rivers State)
- Dr. DIENYE Paul Owajionyi (Rivers State)
- Dr. OSENI Lawal Osikhuemhe (Sokoto State)
Another 15 doctors bagged the Fellow of General Practice (FAGP) award. They are:
- Dr. OKEKE Godwin Osita Chinonye (Kebbi State)
- Dr. OSUNDARE Ebenezer (Osun State)
- Dr. BENNIBOR John Amakiri (Bayelsa State)
- Dr. UBA Anthony Nwabueze (Bayelsa State)
- Dr. ANAMEZE Osita Joseph (FCT)
- Dr. FOLAJIMI Oluwarotimi Michael (Kaduna State)
- Dr. POPOOLA Fatai Olajide ( Lagos State)
- Dr. MBAMA Jude Pius (Lagos State)
- Dr. OYELADE Oluwakayode Olakunle (Ogun State)
- Dr. AJANLEKOKO Dolapo Richard (Ogun State)
- Dr. AJANAKU Olumuyiwa Samuel (Oyo State)
- Dr. ADEYEMI Taal ik Aderemi (Oyo State)
- Dr. 0 DOBEATU Ndubuisi !gym (Rivers State)
- Dr. OSSAI Festus Orie (Rivers State)
- Dr. IKHUORIAH Teddy Abdullahi Eguavon (Edo State)
OUR SENIOR CITIZENS
Some septuagenarians among us who have distinguished themselves in the practice and relationship with the Association were given special recognition. Members who are septuagenarians are now recognized as our senior citizens. They include so far:
- Prince Dr. ADEYEMI Taofik Aderemi
- Dr. KORUBO Bernadette
- Dr. (Elder) OBASI Basil Okeke
- Dr. ADJEKPEMEVOR Daniel Onoseware
STATE OF THE NATION
The AGM expressed deep concerns over the widespread reports of electoral violence across the country that greeted the just concluded national and state elections. It condemned in no uncertain terms, the ravaging state of insecurity in the country and called on the leadership of the nation to live up to their expectations and stem the ugly trend.
Amb. Dr. Ugwu Iyke Odo. MD.
MB,BS; PGD-FM; MBA; M.SC; DMP.
Dr. Augustine Aipoh. MD.
M.B.B.S; MPH; PGD-FM. FAGP.