Resurrecting the National Health Bill

Prof Onyebuchi Chukwu, Minister of Health

by Sylva Nze Ifedigbo

The National Health Bill 2011 gathers dust in one of the Aso Rock’s cabinets, unsigned and thus not in effect, close to a year after the National Assembly finally passed it into law in May 2011. The passage into law, the climax of an over two years journey in the two chambers of the National Assembly was greeted with joy and high expectations that provisions of the new law once implemented will define, streamline and provide a framework for standard and regulation of health services in the country. The Bill was also expected to spell out the rights and duties of healthcare providers and health workers in the nation’s health system.

It is a known fact that there is an existing rivalry among the various professional groups in the health sector. The Doctors Vs Pharmacist Vs Nurses/Midwives Vs Laboratory technicians battle for equality or supremacy is an age old one and one of the contributory factors to the deplorable state of that sector and it is ironical that the very same reason, (one of the issues the Bill is to address) is the very reason why this Bill is yet to become law after such a long time.

No sooner had the National Assembly passed the harmonized version of the Bill that a controversy broke out from the usual suspects. The writers of the new law had in their wisdom created a new structure for the management of the Nation’s Tertiary Institutions which accounted for 80% of the annual budget to that sector. Instead of the existing structure where these hospitals were ran by an almighty Chief Medical Director, the new law introduced the “National Tertiary Hospitals Commission.” The mandate of the Commission as can be seen in the bill can be best described as laudable – all of it but one provision, that which states that the Executive Chairmanship of the proposed National Tertiary Hospitals Commission must be a; “Medical Director of the status of a Professor with a minimum of ten years working experience in a Teaching Hospital” 

This clause which made the executive chairmanship an exclusive right of doctors, as minor as it appears effectively prevented the immediate signing of the bill into law as the various health groups would have none of it.  One would have thought that in a few weeks of round table talks, the issue will be resolved and the necessary amendments made to the law in the overall interest of Nigerians but it’s almost a year now and we are still at that point. Indeed, the Bill seems to have been relegated to the back waters of national discourse.

While the professional health groups play out their politics, one cannot help but observe that the Nation and indeed Nigerians especially those in the more disadvantaged segment of society are the worse for it. Each passing day, we deny ourselves the benefits contained in the Bill as we continue to watch health indices nose dive annually. Among these benefits is Free Medicare for children under 5 years, pregnant mothers and the elderly as well as disabled people, a guaranteed basic minimum health package for all Nigerians, universal acceptance of accident cases by all health facilities both public and private, closer monitoring and enforcement of standards, better funding for the sector and a host of others.

If the protracted disagreement is worrying, then the seeming conspiracy of silence by we the people, the would be beneficiaries is even more worrying. Nigerians are just uninterested. Not too many supposedly informed, internet savvy Nigerians know of the existence of the Bill. Not too many, care. Ironically, these same set of people can effortlessly state the provision of the equally controversial United States Health Care Plan popularly known as ObamaCare and argue on end about what is right or wrong about it. And because we have remained silent, the bill slowly gathers dust.

Signing the passed Bill into law is now out of the question. The controversial provision certainly does not meet with the tenets of equity and fairness and asking the other professional health groups to accept it will be asking for quite a lot. Instead I call on the President to as a matter of urgency to send back this Bill to the National Assembly for the necessary amendments to the contentious area. Preceding that, I expect the Minister of health to bring the various professional groups under his ministry to a round table where they can jaw jaw and come up with a workable compromise. Above all, I wish to call on the Nigerian people to wake up and demand for this Bill, to make it a topic of discussion, to secure for ourselves and our children unborn, a better deal.

A copy of the bill can be read here

Sylva Nze Ifedigbo, a columnist with DailyTimes lives in Lagos, Nigeria.