Five states lock horns with FG over health care fund

The Minister of Health, Prof Isaac Adewole, has blamed the deplorable state of tertiary health institutions in the country on the inability of state governors to fund basic primary and secondary health facilities under their respective care.

Adewole, who stated this at the Senate plenary on Tuesday, said state governments had “literally abandoned” health care.

He also accused 14 states including Sokoto, Ogun, Cross River, Benue and Rivers of refusal to embrace the Basic Health Care Provision Fund which would have enabled them to access the N55.15bn earmarked for primary health care in the country.

The National Assembly had earmarked N55.15bn in the 2018 budget as one per cent of the Consolidated Revenue Fund for the BHCPF.

Health experts have lauded the National Assembly’s approval of the BHCPF in the 2018 Appropriation Act.

But to access the fund, state governments must deposit N100m in a dedicated account at the Central Bank as counterpart fund and must have their own health insurance scheme law among other conditions.

But Sokoto, Cross River, Ogun and Benue states said the Federal Government’s alleged politicisation of the health policy was responsible for their inability to access the fund.

They argued that the choice of beneficiaries for the health care fund was allegedly skewed in favour of states in the good book of the Federal Government.

At the plenary, Adewole explained what his ministry was doing to address the terrible conditions of the Federal Government-owned teaching and specialist hospitals across the country.

The minister, who answered questions from the senators, however, said the inability of the state governments to pay adequate attention to health issues had overwhelmed the federal health institutions and the specialists there.

He lamented that Nigerians no longer had confidence in the primary and secondary health care centres, hence their preference for tertiary facilities which were set up to take care of referral cases only.

Adewole commended the federal lawmakers for approving the BHCPF which he described as a game changer in the nation’s health sector.

He, however, regretted that about one year after the 2018 budget was signed into law, 14 states had yet to embrace the BHCPF which would have enabled them to access the N55.15bn earmarked for primary health care in the country.

The minister stated, “The states have literally abandoned healthcare such that everything is handled by the Federal Government. We cannot succeed with this.

“What we have done through your support, and I must commend you for approving the healthcare basic fund, it is a game changer. We have spent almost a year developing the guidelines and over the last weeks, we have started a roll-out and as at the last count, 22 states have registered for the basic healthcare provision fund.

“What we have done with the fund is to structure it in a way that money will flow from the Central Bank to the primary health care facilities bypassing all obstacles. Last week, we succeeded in moving out funds from the Central Bank to the agencies and from the agencies, it will go to the primary health care centres.

“As of today, 14 states are yet to show interest in the basic health care provision fund and because senators represent the entire country, I want to quickly seek your permission to list the 14 states that have yet to register – Kebbi, Jigawa, Akwa Ibom, Cross River, Gombe, Rivers, Borno, Zamfara, Ondo, Benue, Taraba, Nasarawa, Ogun and Sokoto.

“It is unfortunate because this is a game changer. There will be free ante-natal care, free delivery, take care of malaria, screen for tuberculosis, hypertension and diabetes.”

While also admitting that tertiary health institutions required adequate funding, Adewole said only the National Hospital, Abuja and the Lagos University Teaching Hospital had cancer treatment machines in the country.

He said the two hospitals had capacity to treat 300 cancer patients successfully every day.

Adewole said, “If we invest in primary health care, people’s rush to seek treatment in tertiary health institutions will reduce. Only 22 states have so far registered for the BHCPF while 14 had yet to register.”

He said if all the states embraced the BHCPF initiative, the nation would be able to reach 10,000 places and over 100 million Nigerians with basic health care.

The minister said for the country to come out of its current health crisis, the governors must without further delay, set up health care development agencies, institute the health insurance scheme and pay their counterpart fund of N100m to access the BHCPF.

He said the federal tertiary teaching health institutions were carrying out innovations including open heart surgery and separation of conjoined twins.

Adewole told the senators that his ministry had commissioned a team of consultants to carry out a comprehensive diagnosis of all tertiary and teaching hospitals across the country with a view to identifying the real challenges facing them.

The minister said the initiative would deliver basic health care services to all Nigerians through the primary health system.

He said he had used the Nigeria Governors’ Forum and engaged in personal interactions with the defaulting governors on the need to key into the fund but to no avail.

The minister said the collapse of primary and secondary health care centres had led to patients visiting tertiary health institutions for ailments including headache, malaria and high blood pressure.

He said Nigeria currently had 59 tertiary institutions which included 22 teaching hospitals, 20 Federal Medical Centres and 17 specialist hospitals.

Adewole identified epileptic power supply and inadequate water supply as the major challenges consuming the funds allocated to the nation’s tertiary institutions.

The Health minister was accompanied to the Senate by top officials of his ministry and chief medical directors of the various teaching hospitals across the country.

He said the Federal Government through a former health minister; the late Dr Olikoye Ransome-Kuti, invested in the primary health care institutions but that the system collapsed after the exit of the military dictator, Gen. Ibrahim Babangida.

He said, “There were a series of complaints under (former President Olusegun) Obasanjo and he decided to invest heavily in tertiary health institutions to the detriment of primary and secondary health institutions which obviously collapsed due to poor funding.

“The development overwhelmed the tertiary health institutions who started treating cases especially malaria instead of attending to referral cases.”

The Senate Leader, Ahmad Lawan, urged the minister to use his good offices to talk to the governors to embrace the laudable effort made possible by the federal parliament.

Also, the Deputy Leader, Bala Ibn Na’Allah, said the Federal Ministry of Health should dismantle bureaucratic bottlenecks preventing the citizens from accessing health care.

He urged the minister to ensure that no citizen was left behind in accessing health care.

Senator Sam Egwu asked whether the minister was aware that some medical students were still roaming the streets because they had nowhere to carry out their housemanship before they could go for their youth service.

The minister acknowledged the problem of inadequate placement for medical students but noted that the Federal Government had provided 4, 000 spaces. He encouraged affected medical graduates to contact his ministry to address the problem.

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