â€?It is wrong for doctors to divert patients to private hospitalsâ€™
‘It is wrong for doctors to divert patients to private hospitals’
Dr Jude Osayemere Omoroge, is an obstetrician/ gynecologist and Medical Director, St Jude Hospital and Diagnostic Center, Auchi. In this interview, he speaks on the state of the country’s health system and proffers solutions.
What is your assessment of healthcare delivery in the country?
It depends on the level of healthcare one is looking at, whether at the primary, secondary or tertiary level. But if we are to take it in totality, I think there is room for improvement because we are yet to reach the peak. It is in the crucial areas that the public suffer the inadequacy of our healthcare delivery system.
In the area of primary healthcare, we have inadequate staff to man the centers, there is poor referral system between primary, secondary and tertiary healthcare centers, and as a result of this, it is not possible to acquire or seek 24 hours service in most primary health centers in the country today. And any healthcare facility that does not run 24 hours service whether at primary, secondary or tertiary level cannot function effectively.
At the secondary healthcare level, the main bane is lack of man power as well as non-availability of equipment. But at the tertiary level the man power may be there but because it combines providing healthcare with training of specialists, there is a disconnect as to which is more important to the institutions. So the problem at the tertiary level is the ability to have a good synergy between training and care for patients. Basically that is the problem with our healthcare system in the country today.
What is your take on the allegation that doctors in public hospitals divert patients to their private hospitals instead of attending to them?
In the early 70s and 80s, only few medical practitioners own private hospitals. As at then, the remuneration was good enough for healthcare providers to provide qualitative education for their children, take care of their immediate family and to once in a while embark on holiday with his family.
Unfortunately with the down turn in the economy, the take home pay of the doctors became so meager that they have to seek alternative means to augment their incomes and the most appropriate ways available to doctors was to own a private establishment so that when he or she closes from his work in the government facilities, he or she goes there to attend to patients who seek his help.
They saw it as a means of making ends meet and sustaining themselves in the rat race in which the Nigerian society was now involved. For those who felt the need to remain in the country, they remained but the majority of healthcare practitioners migrated abroad and nobody who practiced abroad would like to come back.
We lost good brain in the country, an entire department in a teaching hospital was empty due to the migration. The situation is that the government at a certain stage allowed doctors to practice privately after they had spent sometime in government hospitals.
However, it is ethically wrong for doctors to divert patients from public hospitals to their own private hospitals but unfortunately it still exists because of the teething problems in public hospitals. Sometimes there is no light, water and emergency care could not be provided because of the non-availability of auxiliary staff, drivers and nurses are not available.
This is not so in private hospitals as such facilities are made available hence the patients choose private hospitals even if the doctor did not cajole him or her to go there. That is the problem we face in public hospitals and it can be solved through a practice whereby doctors can be encourage to come to work in public hospital and be paid a honorarium for doing that.
Doctors who are working in public establishment should have their take home pay enhanced in such a way that they can meet their basic needs. Secondly, Public Private Partnership should be adopted in providing the basic facilities in public hospitals. Our people are suffering and emergency care in public hospitals sometimes is something to be pitied because you see an emergency patient being rushed to hospital but there is no water, and what do you want the doctors to do in such circumstances?
What is your take on the rivalry between medical doctors and other health workers?
There is no need for the rivalry between doctors and other members of the healthcare team. Provision of healthcare is a team work because if a gardener who is to clear the field leading to the hospital refuses to do his job and a cleaner fails to clean the wards, doctors would not be comfortable to work.
Everyone has a role to play but however, there must be a leader in the healthcare team. When a patient comes to the hospital, he or she is coming to see the doctor. And on the case file of every patient it is written this is your doctor.
They are not coming to see a nurse or lab scientist, everybody has his job and in the team there must be a leader and the doctor happens to be the leader. It is like that all over the world, hence I see no room for rivalry and I don’t think it is rivalry but some people do not know what is proper and that is why there is continuous bickering between doctors and other members of the health team.
In what ways can the high rate of maternal mortality in the country be addressed?
Well, it is reducing, the last National Demographic Health Survey shown that it is reducing. Sometimes ago, we had the midwifery scheme which was established as one of the ways of tackling maternal mortality rate in the country. So I think it has reduced from the very high figures which it was because of the availability of more trained midwives and hospitals.
People are becoming more aware that there is need to tackle maternal mortality.
So I think it has reduced but not to such a low level as we would desire it. It is rather unfortunate because we heard that the scheme is going to be scrapped because it is a source of cheap labour to primary health centers and many secondary health centers in some states in the country.
How do you think government can improve on our health system?
The federal government can improved on the health system through training of staff at all levels, and bringing healthcare closer to the people and make it affordable. It is unfortunate that the National Health Insurance Scheme (NHIS) has not been properly embraced by everybody. I think if it is properly embraced ,healthcare delivery would be taken down to the grass root.