The National Health Insurance Scheme NHIS is supposed to be a shining beckon of hope in a heavy mist of expensive healthcare bills. The laws establishing the Scheme assured Nigerians of a commitment to securing universal coverage and access to adequate and affordable healthcare in order to improve the health status of all Nigerians.
However, with so much in-house fighting and leadership tussles in the NHIS, the Guild of Medical Directors have expressed their position concerning the NHIS problems. Obviously, the Guild of Medical Directors does not see any wrongdoing from the Health Maintenance Organizations or from the Healthcare Service Providers.
Below is the full communique of the Guild of Medical Directors;
1: There is an urgent need to review the leadership of the NHIS
2: Primary health care should be left to the Primary health care centers: government and private
3: The government should mandate compulsory enrolment of all eligible Nigerian families.
4: Accredit and include more private hospitals in the scheme to improve and ensure nationwide coverage
5: Engage private hospitals in the enrolment of Nigerians into the scheme
6: There is a dire and long overdue need for yearly monitoring, evaluation, and review of guidelines, standards, tariff, and operations of all stakeholders to ensure strides are taken towards Universal Health Coverage in Nigeria.
The GMD would like to note as follows:
1). The GMD is not happy with the current fractious leadership of the scheme. The continued and repeated unrest in the scheme is not in the interest of the enrollees (Nigerian citizens), for whom the scheme was set up in the first place. The government should seriously consider a review of leadership in the interest of peace and harmony.
2). The GMD is not happy with the current situation which affects the smooth running of the scheme and thus leads to negative consequences for enrollees of the scheme. It should be noted that the primary focus of the scheme is to service the health needs of the enrollees and to improve the health indices of the country.
3). The GMD opines that the current structure of the scheme involving the NHIS, the Health Management Organizations (HMOs), the service providers (Hospitals) and the enrollees can be significantly improved upon. This is to ensure the statutory role of each stakeholder is optimized in the process of healthcare delivery. Thus, there is a need to fine-tune the relationship between these organizations in such a way that high-quality service is delivered to the enrollees.
4). The GMD is worried about the abysmally low coverage of the scheme in our country. Other African countries such as Ghana and Kenya have embraced a similar scheme and have enrolled up to 69% of their populations while here in Nigeria, we have enrolled less than two percent of our population. We therefore strongly advocate for the introduction of mandatory enrolment by all eligible families in the country.
5). Health Insurance should be devolved rapidly to the states to ensure that all Nigerians benefit from the lofty goal of Universal Health Care in the foreseeable future.
6). Secondary (General hospitals) and tertiary care providers (teaching hospitals, specialist hospitals, and Federal medical Centers) are overwhelmed with cases that can easily be taken care of at the primary care levels and are unable to concentrate on their core assignments and to handle cases on referrals that are beyond the scope of Primary health care centers. Primary health care should be left to the Primary health care centers: government and private.
7). These lives need to be re-distributed. A patient should not need to travel more than 5 KM from his home in order to access Primary care. The enrollees need to be rightly guided as to their choice of primary care center which should include all accredited health care institutions (public and private) within their catchment areas.
8). There is a need to accredit more private institutions in anticipation of the increased load of enrollees. GMD hospitals account for about 60% of all health care in the country, and it is unfortunate that the GMD is not even in the National or State Health Council. This should be looked into by the appropriate authorities.
9). Ultimately, we are urging the implementation of the National Health Act and its domestication at the State level.
In conclusion, the Guild of Medical Directors is not content with the fractious leadership of the NHIS and we believe that the Government should move speedily to ensure industrial peace in the organization. The Guild stands ready to play its part in the delivery of quality health care for all Nigerians.
Prof. Femi Dokun-Babalola
National President, Guild of Medical Directors
Date: 15TH November 2018
About the GUILD of MEDICAL DIRECTORS
Guild of Medical Directors is a registered corporate body with the Corporate Affairs Commission of Nigeria as a body of medical doctors who own and run private hospitals and clinics in Nigeria providing through our network, 60% of quality medical care for all residents of Nigeria.
Our Mission is the provision of quality health care with compassion, using appropriate technology and ensuring affordability to all citizens of our great country.