The Nation Newspaper

Tag: Physicians

  • Physicians call for collaboration

    Private medical practitioners have called for collaboration between government and private medical practitioners to restructure, rebuild and save Nigeria’s ailing health system.

    The President, Association of General and Private Medical Practitioners of Nigeria (AGPMPN), Dr Ugwu Odo, made the call at a news conference by the association and the World Organisation of Family Doctors (WONCA), in Lagos.

    The conference was to commemorate World Family Doctors Day (WFDD), to acknowledge the role and contributions of family physicians in health care delivery.

    The 2018 WFDD theme was: “Family Doctors: Leading the Way to Better Health’’.

    According to Odo, government’s collaboration with private medical practitioners is the only assurance for Nigerians to have affordable and accessible quality health care.

    “Family doctors are a very special group of doctors because they provide the most essential daily health care needs to the highest number of the population.

    “They are also the longest-serving, as well as the longest-staying doctors in the lives of people, especially because they provide comprehensive and continuous care.

    “On a day like this, family doctors across the world mark their great work in advocacy, clinical governance, health care development and promotion by way of corporate social responsibility to the society.

    “We are all encouraged to replicate this at state and individual hospital levels,’’ Odo said.

    “We commend our governments at the federal, state and local levels for what they have done in articulating a health system for Nigeria.

    “However, a lot still needs to be done in the health sector because our health care institutions are still very weak and unsustainable.

    “The determinants and indicators of a functional primary health care system, which account for over 80 per cent of the needs of the population, are not strongly in place.

    “Governments must budget more for health, at least 17 per cent of the annual budget is expected to go to the health sector but it gets less than five per cent presently.

    “Our health insurance scheme must be transformed by transparency, accountability and professional diligence, to enthrone universal coverage,’’ Odo said.

    Odo urged governments at all levels to invest in and also grow the private health sector by policy shift and system restructuring that were investment friendly.

    Dr Tunji Akintade, Chairman, AGPMPN, Lagos State Chapter, also drew attention to the need for private/public collaboration, which could help to deliver good health services to the people.

    “Public/private collaboration would address the challenges of lack of health personnel and brain drain in the health system.

    “Our major plan is to have a meaningful impact on health but governments need to employ more manpower than just restructuring health facilities.

    “There is a gap in human resource for health in Nigeria that is why we have doctor/patient ratio at one to 5,000.

    “We do not have more than 40,000 doctors in Nigeria; the main reason it is important for government to partner with private sector to improve primary health care services,’’ he said.

    Akintade said there was need for an inclusive health insurance system.

    “Health insurance scheme can also be used to improve the health system in both public and private sectors.

    “That is why we want government to consider the private health sector during budgeting and also reduce the multiple taxation in the health system,’’ he said.

    Also speaking, Dr Sylvester Osinowo, Former President of the World Organisation of Family Africa, said it was important to put the health sector in the right perspective.

    Osinowo said the only way this could be achieved was by planning and making sure every individual contributed to health according to their income.

    “This can be done through telecommunications, which is a meaningful way of funding health.

    “Government needs to establish a health bank to manage such funds, which will help everybody t

     

     

     

     

     

    o access health,’’ Osinowo said.

    AGPMPN offered free medical services to not less than 150 residents of Lawanson Community in Surulere, Lagos.

    The outreach comprised of series of tests, including malaria, diabetes and checking cholesterol level

     

  • When doctors need physicians

    Truth, however underdressed, will always be more magnetic than untruth, however overdressed. This truism will be put to the test in the governorship elections in Ekiti State on June 21 and Osun State on August 9. By logical extension, next year’s critical general elections will also provide an opportunity to observe whether the maxim can stand the test of time in the context of political contest across the country.

    Specifically on Ekiti, last week’s press release on the chances of the candidates in the approaching poll, issued by ANAP Foundation, was food for thought particularly because its appeal to objectivity seemed to contradict objective reality. It is worth mentioning that the body described itself as a “Non-Profit Organisation that is committed to promoting Good Governance”, with the elaboration that its formal statement on the June 2014 Ekiti election is part of its “Election Series which started in 2011.”  According to the communication, “ANAP Foundation has also been collaborating with NOI Polls Limited to help publicise and institutionalise a polling culture which helps political leaders to be aware and more conscious of the yearnings of the electorate.”

    In other words, the publicised result of the poll purportedly conducted in connection with the Ekiti election is possibly intended to encourage a front-runner mentality in the gubernatorial challenger and ex-governor of the state, Ayo Fayose, 53, of the Peoples Democratic Party (PDP)   who held the reins of power from May 2003 to October 2006 when his four-year term was abbreviated by impeachment. ANAP claimed that 31 percent of the electorate endorsed Fayose, while 29 percent backed the incumbent governor and second-term aspirant Kayode Fayemi, 49, of the All Progressives Congress (APC).  Three percent reportedly supported Opeyemi Bamidele, 50, of the Labour Party (LP); and Kola Ajayi of Accord Party (AP) had zero. With a trivial difference of two percent supposedly separating the leading candidates, the pollster portrayed the election as a “close race.”

    Significantly, the report said that 37 percent were “yet to decide.”   With just over one month to go, it is reasonable to reckon that those allegedly undecided about who to vote for are likely to decide the outcome of the election, if the survey is of unquestionable veracity. But is it? To start with, the methodology adopted by the polling group is unclear, just as the margin of error is uncertain. What is more, there are clear curiosities in the announcement; especially the fact that the female support for Fayemi was put at 24 percent against 34 percent for Fayose, which is strikingly implausible, given the state administration’s widely acclaimed feminine-gender sensitivity due largely to the activism of the governor’s wife, Bisi.

    To take the matter further, it is illogical that Fayose who conceded that he had a negative and unattractive track record in office without concrete evidence of reformation would gain acceptance so effortlessly. This is the character who said in a recent interview, ostensibly focused on the electorate, “I am assuring them that the Fayose they were afraid of is a better Fayose. He is more mature and more responsive. If you say I’m a bad man, I say I’ve changed. I am appealing to them that I am a changed man.”  ANAP’s portrayal suspiciously suggests that the electorate has had a change of heart, and Fayose is now in the good books of Ekiti voting population simply on the weak strength of his mere claim that he has improved, which cannot reasonably match Fayemi’s demonstrably persuasive governmental performance.

    These points will suffice to illustrate the immense possibility that the ANAP survey is an enlightening instance of hallucinatory realism; it is most likely the effect of a dream-state or fantasy rather than external reality. To put it more simply, it may well be wishful thinking, with the connotation of an agenda-setting venture without actual relevance to real life except perhaps as a lesson in politically motivated falsification. The exercise brings to mind the title of Darrell Huff’s 1954 book, How to Lie with Statistics, although this is not exactly the same thing as lying with cooked-up or doctored statistics.

    However, there is an unmistakable and potentially perilous dimension to the phoney -sounding poll result; namely, that it could well be a foretaste of a predetermined electoral outcome, meaning that it might serve as a way of preparing the minds of the people for an eventuality. The fact that the report was signed by Atedo Peterside, the president and founder of ANAP Foundation, whose association with President Goodluck Jonathan is beyond conjecture makes it understandably thought-provoking. It may not be without merit to imagine that a friend of Jonathan would be a partisan of PDP and an antagonist of APC. Furthermore, apparently informed assumption about the ownership of NOI Polls reinforces the possibility of the influence of agents of the PDP-constituted central administration on the survey.

    It is instructive that, by way of response, the John Kayode Fayemi (JKF) Campaign Organisation declared, through Dimeji Daniels, “We hereby urge Ekiti people to be vigilant. We wish to state categorically that NOI Polls is nothing but an acronym for Ngozi Okonjo-Iweala Polls, the real owner of the company who is Nigeria’s Minister of Finance and Coordinating Minister for the Economy.” The spokesman added, “Our people would recall that the All Progressives Congress (APC) at the national level has indeed challenged Dr. Ngozi Okonjo-Iweala to publicly deny her ownership of the company. Expectedly, she has kept mum on the matter. We again reiterate that challenge.”  According to him, “NOI Polls is nothing but a front organisation organising voodoo polls to achieve pre-determined ends for the PDP. Indeed, since these folk are the pollsters of the Jonathan administration, Nigerians can now understand why we are in this present mess as this same company organises monthly polls for the Presidency under the close supervision of its owner, Dr.Ngozi Okonjo-Iweala.” No doubt, clarification by the accused would be in order.

    It is an eye-opener that the release of ANAP’s statistics coincided with news of APC’s magnetisation of two former PDP members of considerable political stature, particularly a former governor of the state, Segun Oni, whose U-turn is remarkable.  His term was shortened by Fayemi’s victory in 2010 after a three-and-a half-year legal challenge. The other person is a lawmaker in the Ekiti State House of Assembly, Mrs. Bunmi Oriniowo. Oni put the defining desideratum in a capsule, saying, “We must ask ourselves who is in a better position to give Ekiti a better future, the kind of future that we want.”  Certainly, it will be a mission impossible for spin doctors to redefine this clarity for the people.

  • Why Nigerian physicians can’t heal themselves

    SIR: About three or four years ago, the British Royal College of Physicians was involved in a peer review process with one of her Nigerian counterparts, the West Africa College of Physicians. The objective was to assess areas of collaboration in medical education, evaluation and practice. The intent was also to evolve a new paradigm and approach to the training of doctors generally, bringing things to par with international best practices.

    The success of that mission would have meant that physicians trained and accredited here as specialists could simply pack their belongings and move to the United kingdom, Australia, Singapore or Ireland for practice and vice versa. It would have meant our qualifications are unquestioned and at par with other ones out there. It would have facilitated practice across borders, greater international recognition and acceptance, a fluidity of processes and perhaps a restoration of confidence in a sector since relegated to the fringes.

    It would have been an elixir of life in a sector bedeviled by all manner of ills, a lack of leadership (conceptual, managerial and innovative), loss of confidence by the populace, an obsolete approach to medical education, lack of general and human management approaches, inter and intra professional squabbles, this initiative would have done a lot to assuage some of these ailments.

    Unfortunately, as is typical for brilliant, well intentioned and novel ideas which go against well entrenched vested interests, the initiative came dead on arrival!

    A cabal that eschews public scrutiny and accountability presided over the death of the initiative.

    A few of us continue to aver that too much power, is vested in the post graduate Medical Colleges which remains both the judge and prosecutor in her own cases! It determines the standards of graduate medical education, determines the standards for residency programmes, determines the standards and formats for the examinations, administers these examinations and determines individuals it deems fit to qualify as specialists!

    She will also adjudicate in any appeals against it – an exercise in futility.

    The colleges are a law unto themselves with no external checks and balances. They are not accountable to the public. They carry on as though not answerable to anyone.

    The federal government which underwrites the salaries of these resource persons has never demanded results. No one has ever challenged their methods. They resist oversight from the National Universities Commission in a battle of egos and continue to inflict unimaginable pain on multitudes of wannabe specialists through their non evidence based methods. The tragedy is that no one is asking questions!

    Indeed, the thrust of the recommendations by the Royal College was precisely in the areas of planning, resource allocation, objectivity, standardization, transparency, accountability and international best practices. These recommendations were roundly dismissed by some of the faculties (Psychiatry) and selectively adopted by others.

    The developed countries adopt a process which matches supply of specialists with demand, which ensure outcomes for resource allocation and which lends little opportunity for manipulations, ensuring accountability from top to bottom.

    Transparency and accountability is often achieved by a process of quality assurance which articulates what the definitions, standards or measures of quality are, what needs to be done to achieve this quality and spells out the steps to achieve this end- in a dispassionate manner.

    Quality assurance in graduate medical education should begin with the separation of the bodies responsible for setting and upholding the standards for graduate medical education and the body that implements these standards. As in other spheres of the Nigerian existence, the tendency to resist change remains significant in the healthcare sector. The sector is arguably the most troubled, partly because of the conspiracy of its elites, its highly professional nature which renders it impervious to public scrutiny, failure of her utilisers to demand change and a government lacking in will to place demands.

    The sector will remain in its current sorry state unless the conceptual underpinnings of healthcare delivery is revisited, new mechanisms and processes engaged, accountability and transparency to the public made its cornerstone, and a more appropriate model for its delivery employed.

     

    • Timi Babatunde MD

    Lagos

  • Physicians advised to address health care problems

    For an effective medi care, physicians have been told to review their activities to improve access to health services.

    This, according to the Chief Medical Director (CMD), Lagos University Teaching Hospital (LUTH), Prof Akin Osibogun, will promote patient care, which is the nucleus of medical profession.

    He spoke as the guest lecturer at the yearly Faculty Day Lecture of the Faculty of Anaesthesia, National PostGraduate Medical College.

    The theme was: “The limitations and wonders of modern medicine”.

    Patient care, he said, should be accompanied by certain rights to enable the physicians give direction to their care.

    Osibogun said: “A well organised health care must be able to promote health, protect health and prevent disease and where disease has occurred, promote cure, limit disability and prolong life.”

    He said there is need for doctors to promote increase in education for health promotion and disease prevention.

    “Also important is the integration of technology that has evolved globally to help the patients locally,” he added.

    He charged physicians to address courageously the roles of historical antecedents, culture, training and retraining of doctors. Others are technology, financing and inter-professional rivalry.

    They should ensure continuous self-development to be ahead of those providing support services, Osibogun added.

    He enjoined physicians to abide by the Hippocratic Oath, saying young doctors must learn from the elderly ones so that profession doesn’t lose a lot.

    Physicians in Nigeria shouldn’t lose their skill in the management of diseases. This is because the country is undergoing an epidemiological transition, as such it is experiencing high rates of prevalence of communicable and non-communicable diseases, the CMD said.