The suggestion by the Chairman of the House of Representatives Committee on Health, Amos Magaji, that Nigeria's university teaching hospitals should be privatised has been roundly condemned by Nigerians, including leaders of the country's trade unions.
Mr. Magaji was reacting to the challenges of lack of funds reflected in deteriorating infrastructure, overstretched facilities, poor power supply and severe staff shortages faced by all tertiary hospitals scattered across the country.
The lawmaker, who represents Zangon Kataf/Jaba Federal Constituency in Kaduna State, north-west Nigeria, made the suggestion when he recently visited the Ahmadu Bello University Teaching Hospital (ABUTH) in Zaria, Kaduna State.
He said Parliament would be willing to support the drive to privatise hospitals to make them more efficient and effective.
Mr Magaji, however, acknowledged the hardships the initiative could impose on Nigerians if carried out now, though he suggested a critical review of the country's health insurance system by increasing its capitation.
He acknowledged that there is a huge burden of out-of-pocket health expenditure at the moment and that commercialising teaching hospitals would be akin to “giving death sentences to Nigerians”.
He said: “Governance is a system for the people and as such, government policies must have a human face and be aligned with the aspirations of the people.”
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Reaction trace suggestion
Reacting to the development, President of the Nigerian Medical Association, Bala Audu, said history has shown that privatisation of public institutions in the country has never yielded good results for the good of the people in the past.
Bala Audu, National President of NMA
He said massive investments in primary and secondary healthcare institutions will automatically reduce the burden on tertiary healthcare institutions and thereby improve their efficiency and productivity.
Mr Audu, who spoke to Newslodgein a telephone interview, said that by reducing public dependence on teaching hospitals, they will focus on their triple mandate of training, research and service delivery.
He said: “Take the case of the defunct National Electric Power Authority (NEPA) for example. NEPA was privatised to improve the quality of power generation, distribution and utilisation by Nigerians. I don’t think we have achieved that.
“The public has lost its property. Workers have lost their jobs and we have not yet achieved the goal. From this you can see that NEPA was better than what can be achieved today.”
He urged the Nigerian government to encourage medical professionals by creating an enabling environment for them to deliver quality service.
Let hospitals be built only with taxpayers’ money – NLC
Reacting to the development, the Head of Information Unit at the Nigeria Labour Congress (NLC) headquarters, Benson Upah, said there would be a nationwide revolt if the Nigerian government continues with the commercialization of teaching hospitals.
Mr Upah said the NLC is “firmly against the privatisation of teaching hospitals”, saying doing so will only make healthcare unaffordable rather than improve the system.
NLC Spokesperson
He said: “We are opposed to the privatisation of tertiary healthcare institutions. We are strongly opposed to the privatisation of public healthcare institutions. Our reasons are simple: it will put healthcare out of reach of citizens. The contribution of private institutions to healthcare service has not been spectacular. Even when it comes to salaries, public hospitals pay better than private institutions.”
He argued that private investors should create their own hospitals and oversee management.
“Leave alone the hospitals built with taxpayers' money,” he said.
NARD speaks
The second vice president of the National Association of Resident Doctors (NARD), Kefas Wida, urged the authorities to address the existing problems in the system, noting that privatization, “although a good initiative, would not offer the necessary solutions.”
National Vice President II of NARD, Kefas Wida
Mr. Wida called for better remuneration for medical professionals based on the quality of service provided, suggesting that remuneration should be based on the quality and quantity of services that health workers provide to the system.
“The government has commercialized certain institutions in the past, so this is nothing different, but we need to look at how this will affect citizens,” he added.
The Director General of the West African Institute of Public Health also speaks
For his part, the Director General of the West African Institute for Public Health, Francis Ohanyido, said that the current situation in the country makes the privatisation of tertiary health institutions a bad option.
He said the country still needs to address the numerous challenges affecting the sector, such as access to healthcare, brain drain and the provision of functional primary and secondary healthcare.
“Privatisation of hospitals is not a problem if it is done correctly, but it can be very risky. The fact that it is being done at this time is also very risky because we are in a fragile phase given the state of the country’s economy,” he said.
Mr Ohanyido noted that most of the health policies initiated by the current administration have not yet been fully implemented, “so the idea of privatisation represents a huge leap from the immediate needs of the sector.”
The brain drain will worsen
Mr Ohanyido also noted that the idea would also worsen the brain drain crisis in the health sector.
While affirming the need to properly implement the insurance scheme, the director general said the policy would create uncertainty and tension among health professionals and thus force many to seek better opportunities abroad.
The country is currently facing an increasing exodus of health professionals to developed countries. In 2023 alone, more than 900 resident doctors left the system and another 1,417 professionals showed interest in leaving.
Coordinating Minister for Health and Social Welfare Muhammad Pate said there is a problem of uneven distribution in the ratio of workers to population which is getting worse.
In this regard, Mr. Ohanyido revealed that the situation will only get worse with the commercialization of tertiary hospitals.
“Privatisation will not necessarily eliminate the problem, but it will put it in the hands of the private sector,” he said.
Similarly, Development Research and Projects Centre (dRPC) Project Director Stanley Ukpai said that with the rising cost of inflation and the increasing population of people facing multidimensional poverty, privatisation of tertiary institutions will only make things more difficult.
He said the privatization plan is likely to fall short of its goal of providing equitable distribution of health care resources and financial protection by reducing the burden of out-of-pocket expenses.
“If we are not careful, we will be pushing more people away from healthcare. At present, the other levels of the healthcare institution are not functioning properly, which jeopardizes universal basic healthcare,” he said.