Health insurance scheme for all is key–NMA President

Professor Mike O.  Ogirima is the newly elected President of the Nigerian Medical Association (NMA), President Nigerian Orthopaedic Association and  an expert in Orthopaedic and Trauma Surgery at the Ahmadu Bello University Teaching Hospital, (ABUTH), Zaria.  In this interview with LARA ADEJORO, he says there is need for a deliberate health intervention policy, government-driven health insurance scheme, among others.
As the new president of NMA, What would you do differently to give a face-lift to the Association?
Our agenda for NMA is to reduce the disharmony between various professionals and between many groups of Doctors in the health sector. To protect the most vulnerable among Doctors. These are: the House officers, the residents, the state and local government doctors and the doctors in private sectors. We would pursue the welfare of every doctor in a just, fair and equitable manner. We would fend for every group and affiliates within the NMA and by so doing, the affiliates within NMA would develop trust in the NMA leadership and would naturally surrender their agitations to NMA to pursue.

We need to lunch a programme of welfare package that will benefit all. Doctors must love themselves-this is the Oath. Confidence will gradually return. Strong advocacy on promoting Public–Private Partnership (PPP) and competition by the private medical practitioners. We shall advocate for single digit interest rates for medical industry and encourage multi-specialty hospital complexes-Mega Hospitals. I will bring in a lot of innovations with experience and maturity. The Secretariat of NMA shall be functional 24/7. Diplomacy shall be the guiding principle. Welfare of my colleagues shall be paramount, our pact with government shall be robust so that the populace shall once again enjoy holistically professional service at its best.

There is this issue of brain drain in the medical profession, what are the causes and what can be done to avert it?
Poor working environment, lack of job satisfaction. Strong advocacy on provision of appropriate equipment and sound maintenance culture of the equipment. Adequate remuneration of all professionals in medical industry and ensuring strict adherence to good work schedules and ethics.

Nigeria loose a huge amount of money to medical tourism, can we possibly make the country a tourist centre medically for other countries?
Many factors are responsible. These include the poor working condition (paucity of equipment and facilities), corruption within the government circles, and lack of awareness/illiteracy of the populace as well as attitude of the elite class. In most countries where health is very well developed, there is a more private sector participation than government and the possible cost burden of this on the populace is on the other hand cushioned by functional well packaged health insurance schemes. We believe there is need for a deliberate health intervention policy but not limited to low interest credit facility for health industries, import duty waivers for health care equipment, special tax regimes on tobacco, alcohol, GSM calls etc dedicated to improving public health facilities and PPP.

PPP will promote healthy competition by the private medical practitioners. This will lead to the emergence of Mega hospitals that can compete positively with the foreign hospitals. In order to cushion the effect that this might have on health access and pricing for Nigerians, government driven- health insurance scheme that is compulsory for every Nigerians and that will cover most of the health needs is key. NMA under my leadership is raising a strong advocacy team for both purposes. We shall also re-orientate Nigerians attitude towards indigenous health care service professionals and facilities. In as much as we now advocate patronage of local goods, we also need such campaigns in the area of health care. Perhaps an annual health/hospitals exhibition may be helpful to showcase the range of care that can be achieved in the country and NMA is championing the course.

We will also strengthen our clinical governance system that will guarantee quality assurance, clinical and strategic effectiveness and patient involvement in healthcare decision-making. The government is already doing a lot on corruption and NMA under my leadership shall collaborate with the government on this. The NMA under our collective leadership shall be a watchdog on the judicious use of resources in our hospitals and Ministries of Health. This we intend to do by independently monitoring the use of the resources allocated to each of the teaching hospitals and the ministries. We shall set-up an internal mechanism within the NMA to investigate and call to other any chief executive that is found wanting.

Ironically, India has the highest number of maternal mortality in the world yet Nigerians keep going there for medical treatment. What is it about India and what are we getting wrong?
India has the highest population on planet earth.  We expect them to have high indices both in positive and negative trends. Indians are focused, plan strategically, have good leadership, have moved to be a developed economy, and are patriotic. Nigerians attitude to government is not right. We need to be patriotic and be ready to sacrifice.  We need to change our attitude through rigorous national orientation programme. How much would Nigeria be saving if we put an end to medical tourism May be about 2billion dollars annually.

On the budget for the health sector. Whats your take on it?
The budget presented by the President of the Federal Republic of Nigeria to the National Assembly allocated N221.7 billion to the health sector. This represents about 4% of the budget far from minimum of 15% as recommended by WHO. This is a disaster but the NMA under our collective leadership shall be a watchdog on the judicious use of even this meagre resources in our hospitals and Ministries of Health. It is not how much is earmarked but how well the money is utilised at the end of the year. But NMA is thrilled by the plan of government to rehabilitate at least 1000 functional primary health care centres before the end of the administration. We call on the government to establish a emergency ambulance on our roads and functional resuscitation centres along our highways.  These will minimise the carnage on our roads.  As  I have said before, NMA is independently monitoring the use of the resources allocated to each of the teaching hospitals and the ministries. We have an internal mechanism to investigate and call to other any chief executive that is found wanting.

There has been incessant strike actions in the profession. Do you think going on strike is the best way to drive home your demands from the government?
Strike is a legitimate right of all workers and doctors are not exempted. Because doctors uniquely take care of lives and well-being that is why their welfare stands utmost as clearly stipulated in the physicians oath…’may they enjoy the good things of life.’ NMA will not abuse this right but shall engage the government diplomatically and making sure government honours agreements reached with our members to avoid strikes.

What quota would you contribute to revamp health sector?
To give a purposeful leadership and strong advocacy for good governance, universal applicability of welfare packages and auditing developmental health programmes as they are unfolded.