ADDRESS BY DR FRANCIS A FADUYILE, PRESIDENT NIGERIAN MEDICAL ASSOCIATION DURING THE CONGRATULATORY VISIT TO HIS EXCELLENCY, MUHAMMADU BUHARI, GCFR, PRESIDENT, FEDERAL REPUBLIC OF NIGERIA AT ASO ROCK VILLA ON TUESDAY 16TH JULY, 2019.
On behalf of the entire Medical and Dental Practitioners of Nigeria, we are delighted to be granted this courtesy visit despite your very tight schedule. We heartily congratulate you on your victory at the recent Presidential polls which is an indication of the good work of the present administration.
Your Excellency Sir, the Nigerian Medical and Dental Practitioners wish to appreciate your government for the numerous achievements recorded during your first tenure in office, particularly in the health sector. We note with excitement, the appointment of our members as cabinet ministers; the enactment of the Medical Residency Training Act; the release of Basic Health Care Provision Fund, the approval of the theme for the Senior Executive Course 41(Universal Health Coverage in Nigeria), and the reintegrating Nigeria back to Global Alliance for Vaccine and Immunization (Gavi), amongst others. Your keen interest in immunization and improvement of immunization coverage in the country; and the overall turn around to some of the Nation’s health facilities most recently the opening of world class Cancer Centre in LUTH, Lagos cannot be overlooked. We appreciate your Excellency Sir. Medical and Dental professionals will continue to partner with you in your administration’s quest to improve the lot of the masses of this country.
Your Excellency, as you start the second tenure in office, we want to assure you that the Nigerian Medical Association is a partner in progress for the improvement of the health of Nigerians and other laudable programmes of your administration. In doing this, we wish to proffer some suggestions as part of the roadmap for the “NEXT Level”.
1. Universal Health Coverage (UHC)/National Health Insurance Scheme (NHIS):
The NMA wishes to appreciate you on the appointment of a competent and highly suitable substantive Executive Secretary for the NHIS. We therefore solicit your support to make it a duty for every citizen to enroll including the informal sector. It has been proven that out of pocket expenditure or health cannot provide adequate and qualitative healthcare for the populace. We are advocating for a review of the NHIS Act to make enrolment mandatory for all Nigerians. This will have positive effect by giving adequate care and treatment to the enrollees. It will also ensure availability of funds to purchase the needed equipment and improve health infrastructure. Moreover, specialized treatments like cancer care and diagnostic equipment can be purchased; and the government can subsidize the treatment of cancers for the citizens as is obtainable in developed countries. The NMA is also throwing its hat into the ring with its Social/Health Safety net initiative tagged “Project 5×3” which seeks to provide basic health coverage for Five million Nigerians over the next three years.
2. National Health Summit
We wish to bring to your attention the organization of the 2nd edition of the National Health Summit slated for 4th to 8th November 2019 here in Abuja FCT by the Nigerian Medical Association. The Summit will play hosts to all professionals related to health as well as international delegates from Africa and Commonwealth Nations. The summit is expected to set the health agenda in key areas and develop a blueprint and practical framework for reforming/improving Nigeria’s Health system. Key areas to be considered includes stemming the tide of brain drain, ensuring harmony within professional groups in health, reversing the medical tourism and make Nigeria a medical tourist destination with the overall impact of improving the National health indices and social safety net. It is also heartwarming to inform you that a Nigerian for the first time will become the President of Commonwealth Medical Association (CMA) at the end of the Summit. We are aware of the enormous strides your office had made through the various social intervention programmes and we kindly invite you as Special Guest of Honour and to declare the National Health Summit open on Tuesday 5thNovember 2019. We seek the participation and support of the government in ensuring the success of the Summit.
3. Strengthening Primary Healthcare (PHC) And States’ Participation:
NMA appreciates the Federal Government for the improvement in the facilities in the PHC centres nationwide. PHC facilities are expected to cater for up to 75% of the populace mostly in the rural areas. However, these facilities need the corresponding improvement in complement of staff mix (doctors and other health workers) as this will address a lot of illnesses and disease burden. Medical and Health personnel retention at this level has been low as a result of very poor remuneration. This has caused brain drain of health personnel between the state government and Federal Government (internal brain drain) on the one hand and outside the country (external brain drain) on the other hand. We have always advocated for uniform remuneration for all Medical and Dental Practitioners irrespective of their employer. This we believe will retain professionals in the rural areas.
We plead with the Federal government to put pressure on States to prioritize health with adequate funding of the primary and secondary health care facilities and proper staffing of the PHC centres.
4. Health Bank:
NMA appeals and requests the government to establish “Health Bank” to provide health fund, akin to Bank of Industries (BOI) and Bank of Agriculture(BOA). The Health Bank will allow the Medical and Dental practitioners to obtain loans to improve their facilities with single digit interest and at least a 10 year moratorium. This will afford practitioners to improve their practice and will in turn lead to a better health care for our citizens and encourage our diaspora doctors to come back and build world class facilities thereby changing brain drain to brain gain (reverse brain drain). This is what was done in India that led to the expansion of medical management with attendant medical tourism seen in that country. Examples are Apollo and Fortes Hospitals in India. We also seek for a special intervention fund for our Government Tertiary Health Institutions to strengthen their practice, as has been done in the intervention fund for Nigerian Universities (TETFUND).
5. Import Duties On Medical Equipment
Technology drives medical services the world over today and technology (Medical Equipment) is a very expensive component of healthcare development that has to be imported. One way of reducing cost of Medical services is to reduce the cost of providing care and one way is to reduce the cost of Medical equipment by removing import duties on these critical equipment. Since Health is a social service and not a profit enterprise it should be accorded all necessary exclusive consideration such as this.
6. Health Funding:
We wish to remind your Excellency of one of the items of the manifesto of the APC, which is to increase funding to Health. Your promise to sequentially increase the percentage is not lost on us. Although the Basic Health care intervention fund was for the first time inserted in the 2018 budget and cash backed (part of which is to offset cost of emergency services across the nation), the budget for health in 2018 and 2019 is less than 4%, which is a far cry from the 15% agreed in Abuja by African Heads of States in 2001(Abuja Declaration). You also requested us, which we had kept, to seek dialogue in resolving conflicts rather than strike actions. However, there is an impeding agitation among our members which we wish to bring to your attention, we have explored all avenues to seek payment of all accrued arrears of our corrected salaries since 2014 but agencies of government have continued to hold us to ransom. We request you to direct payment of the arrears. We also note that despite your assent of the Residency Training Act, the Ministries of Health and Budget/National Planning did not make provision for the funding of the only program geared to produce world-class specialists.
7. Curbing drug abuse especially amongst youths in Nigeria:
The menace of drug abuse is on the increase among the youths of this country. The NMA believes that if the youths are well engaged in gainful employment this menace can be reduced drastically. In this wise, we commend the efforts of government in the massive employment of our teeming youth through the N-Power and other programmes. We also wish to request for full enforcement of the prescription rights for medical and dental practitioners is urgently put in place and stringent control of handling of drugs as well as strengthening the nations security apparatus so that the perpetrators and smugglers of these substances can be put in check and made to face the full wrath of the law. The NMA is ready to work with the necessary Ministries, Agencies and Parastatals of Government towards curbing this menace.
1. We wish to sincerely appreciate this administration for the reconstitution of the Council of the Medical and Dental Council of Nigeria after over three years of its dissolution. The council led by its Chairman, Prof Abba Hassan has constituted the relevant committees and we have once again have adequate regulation of medical and dental practice, the medical tribunal has in recent times been able to conclude over 25 cases out of over 120 pending cases, some over 5 years. We plead that the council be immune from dissolution without immediate reconstitution as this has a long lasting effect on medical and dental practice regulation.
Finally Your Excellency, we congratulate you for all efforts at repositioning the country and call on you to give more attention to security of lives and property, and many untoward and unwholesome human behaviour that have continuously threatened the peace of the land.
We wish you more success as you continue to render services to our great nation.
Long live Nigerian Medical Association
Long live Federal Republic of Nigeria.
Thank you and God bless.
Dr. Francis Adedayo Faduyile