Public officials and overseas medical treatment
The simmering debate on the propriety of public officials travelling out of the country for medical treatment reached a crescendo recently, when President Muhammadu Buhari left Nigeria on a 10-day vacation to London to rest and also see an ear nose and throat (ENT) specialist for a persistent ear infection.
In an attempt to douse the furore generated by the president’s decision, his special adviser on media and publicity, Mr Femi Adesina, explained that the president had been examined and treated by his personal physician and an ENT specialist in Abuja, following which he had been recommended to see an ENT specialist in London for further evaluation. The recommendation, he said, was purely precautionary.
Still, many public commentators flayed the president’s action, describing it not only as an indictment on the country’s health system but also a needless waste of time and resources, especially at a time when the country is enmeshed in economic turmoil and violent agitations, among many other pressing issues. Vice President of the Commonwealth Medical Association, Dr Osahon Enabulele described it as a national shame of immense proportion that the president had to be recommended for foreign medical care, despite the presence of over 250 ENT specialists in the country.
We believe that the outrage trailing the president’s decision is justified, considering that it was this same government of Mr Buhari that banned medical travels for public office holders, except in cases that cannot be handled in Nigeria. There is no substantial evidence that the president’s condition fits into this exempted category. There is also mounting concern over the unacceptable capital flight of billions of naira siphoned yearly from the country’s coffers by public officials for treatment of all sorts of conditions abroad.
The disdain Nigerians had always harboured for medical tourism by public officials was apparently responsible for the elation that greeted the then declaration by President Buhari that he was ending the practice. For this same president, barely one year into his administration, to be seen as breaking his prescribed code of conduct is a sad commentary not just for the new administration, as most of the critics have argued but the state of health care in the country.
It is indeed an open secret that hundreds of Nigerians who have the means, not just government officials, travel out daily to Europe, America and even Asian countries like China and India for medical treatment. According to the 2014 NMA Annual Report, the Indian High Commission confirmed that Indian hospitals received 18,000 Nigerians on medical visa in 2012 alone and they spent about 260 million dollars for their medical trip. There is indeed an urgent need to curtail this anomaly.
The truth however remains that to holistically address the challenge of huge capital flight from Nigeria as a result of medical tourism, drastic steps must be taken to tackle the cankers troubling the nation’s health sector, improve health care delivery, and ensure our hospitals have the capacity to provide quality medical care for Nigerians.
That the health sector has for several decades suffered serious neglect, is overstating the obvious. It is no news that our teaching hospitals are apex centres of medical excellence in name only. A visit to most of the teaching hospitals clearly shows palpable infrastructural decays. It is thus not surprising that any Nigerian with the means would rather seek alternative institutions abroad to tend to his or her health conditions rather than these hospitals.
We call on the Nigerian government to, as a matter of urgency, come up with, and implement a blueprint that will transform the nation’s health sector. The federal government must demonstrate the required political leadership to positively turn around the nation’s public hospitals by tackling the challenge of infrastructural decay. These facilities must be re-equipped with modern diagnostic and treatment apparatus as it is the case in the countries Nigerians are trooping to for health care. Moreover, adequate attention must be given to the welfare and working conditions of health workers to ensure they are well-motivated to give their best at all times.
Another fundamental issue that must be addressed is transparency in the management of funds for the health sector. It is really disheartening that while there have been repeated complaints that budgetary allocation to the sector is paltry, there are reports that even this meagre allocation is being embezzled and diverted. Only recently, the Economic and Financial Crimes Commission (EFCC) commenced investigations into allegations of financial mismanagement by the health ministry. According to a letter recently addressed to Amina Shamakin, permanent secretary, Federal Ministry of Health, “The commission is investigating a case of criminal conspiracy, embezzlement, abuse of office, diversion of public funds and money laundering…”
Additionally, there is a paramount need to audit the nation’s medical care processes to bring them in line with contemporary global best practices. Many Nigerians have lost confidence in the health sector’s capacity to provide the care that they need and deserve and regaining this confidence is crucial.
It is our view that if the challenges confronting the health sector are conscientiously addressed, not only would Nigeria end medical tourism for public officials and citizens, but the nation would be able to attract huge inflow of foreign exchange from patients that would come from outside Nigeria to access our hospitals for treatment. When we achieve this, it is the Nigerian nation, not just the heath sector that will ultimately enjoy the benefits.