Communiqué Issued By The Nigerian Medical Association (NMA) At The End Of Her First National Health Summit (NHS), Held At The Events Centre, Asaba, Delta State, From Sunday 20th January To Sunday 27th January, 2013
BACKGROUND:
The Nigerian Medical Association (NMA) held her 1st National Health Summit (NHS) at the EVENTS CENTRE, Asaba, Delta State, from 20th to 27th January, 2013. The Summit which had as its theme: ‘Repositioning the Medical Profession and Nigeria’s Healthcare System for National Development’, was convened to deliberate on the State of the Medical Profession, Medical Practice and Nigeria’s healthcare system. Over 1,300 participants from within and outside Nigeria (including other professional groups within and outside the health sector, as well as representatives of Nigerian medical professionals in the diaspora), attended the week long Summit which was formally declared open on Monday 21st January, 2013 by the President of the Senate of the Federal Republic of Nigeria, H.E. Distinguished Senator (Dr) David A.B. Mark, GCON, FNIM.
The opening ceremony of the Summit which was chaired by the President of the Senate of the Federal Republic of Nigeria, H.E. Distinguished Senator (Dr) David A.B. Mark, GCON, FNIM, had in attendance four State Executive Governors namely the Chief Host and Executive Governor of Delta State, H.E. Dr. Emmanuel Eweta Uduaghan,CON, H.E. Chief Theodore Orji of Abia State, H.E. Mr. Peter Obi of Anambra State and Comrade Adams Aliu Oshiomhole of Edo State.
Also in attendance was the Guest of Honour and Honourable Minister of Health, Professor C.O. Onyebuchi Chukwu, who delivered a keynote address at the Summit, as well as the Chairman of the Senate Committee on Health, Distinguished Senator Ifeanyi Okowa, Distinguished Senator Dr. Chris Ngige, the Deputy Governor of Delta State, Prof. Amos Utuama, the Speaker of the Delta State House of Assembly, Rt. Hon. Victor Ochei, the Secretary to Delta State Government, Mr. Ovuzorie Macaulay, the Asagba of Asaba, HRM Obi Prof. Chike Edozien, former Minister of Health, Prof. Adenike Grange, the Hon.Commissioner for Health, Dr. Joseph Otumara, the Chief of Staff to Delta State Government, Dr. Festus Okubor and other members of the Delta State Executive Council.
Amongst other eminent Nigerians and professionals who also took part in the Summit were Past Presidents of the Nigerian Medical Association, Medical/Dental elders and highly distinguished medical/dental practitioners of all cadres and age, Captains of the health industry, eminent public office holders (including but not limited to the Registrar of the Medical and Dental Council of Nigeria, Chief Medical Directors/Medical Directors, Commissioners of Health, Directors General of Government Parastaltals, Executive Secretaries and Directors of Government Agencies, Directors of Medical Services from across the States), President of the Medical Association of Nigerian Professionals Across Great Britain (MANSAG), Mr. Jacob Akoh, President of the Nigerian Bar Association, Barr. Okey Wali, SAN, President of the Medical and Health Workers Union of Nigeria (MHWUN), Mr. Ayuba Wabba, President of the Pharmaceutical Society of Nigeria (PSN), Pharm Olumide Akintayo, President of the Nigerian Veterinary Medical Association (NVMA), Dr Gani Enahoro, President of the Nigeria Society of Physiotherapists (NSP), Mr. Taiwo Oyewumi.
It is also worthy to note that members of the fourth estate of the realm and other members of the public from different communities also thronged Asaba for the historic National Health Summit.
Professor Isaac Folorunso Adewole, the Vice Chancellor of the University of Ibadan, delivered the Guest Lecture on the Summit’s theme: ‘Repositioning the Medical Profession and Nigeria’s Healthcare System for National Development’.
Aside from the Summit Guest Lecturer, there was a galaxy of eminent resource persons and discussants drawn from diverse professional fields and organizations including the Medical and Dental Council of Nigeria (MDCN), Medical Association of Nigerian Professionals Across Great Britain (MANSAG), Medical and Health Workers Union of Nigeria (MHWUN), Pharmaceutical Society of Nigeria (PSN), Nigerian Bar Association (NBA), Nigerian Institute of Public Relations (NIPR), Nigerian Institute of Medical Research (NIMR), National Universities Commission (NUC), National Postgraduate Medical College of Nigeria, West African Postgraduate Medical Colleges, Standard Alliance Insurance Ltd, National Primary Healthcare Development Agency, National Health Insurance Scheme (NHIS), International Institute of Leadership and Governance, amongst others.
NATIONAL HEALTH SUMMIT OBJECTIVES:
The key objectives of the National Health Summit were:
1) To develop strategic plans to reposition the Medical profession;
2) To produce actionable plans and practical framework for improving Nigeria’s Healthcare System;
3) To develop feasible and realistic plans to restructure relationships within NMA and her affiliates, the Medical Profession, and within Nigeria’s Healthcare System in general, with a focus on achieving better cohesion and relationships.
OBSERVATIONS, RESOLUTIONS AND RECOMMENDATIONS:
Following the thematic presentations and extensive deliberations at the panel discussions as well as the plenary and breakout sessions, the Summit resolved as follows:
- COMPLIANCE WITH THE CODE OF MEDICAL ETHICS:
The Summit emphasized the need for Medical and Dental Practitioners to adhere strictly to the professional Code of Medical Ethics as set out by the Medical and Dental Council of Nigeria (MDCN) and which is binding on all medical/dental practitioners.
Still on the issue of adherence to code of Medical Ethics and good conduct by medical practitioners, the Summit received the report of the investigation by NMA into the widely publicized case of one Salifu Odiba, a pipeline vandal alleged to be a Medical Doctor in a news story published by Punch Newspaper on the 25th of December, 2012.
In the said publication by the Punch Newspaper, the pipeline vandal was said to have claimed he was ‘admitted to study Medicine and Surgery at the University of Jos in 1996’ and graduated in 2004’.
As a result of the distressful news story and inquiries by several well meaning citizens home and abroad, the NMA painstakingly investigated the matter with a scrutiny of the faculty records of matriculated students from 1993-1996 as well as the MBBS graduates of the University of Jos from 2003 to 2005 and found no name as Salifu Odiba.
On account of the foregoing and the negative image the news story caused NMA and the medical profession, the Summit urged Punch Newspaper and other media outfits to always carry out proper investigation before reporting such a sensational new story. The Summit noted that improperly investigated cases such as that of Salifu Odiba by media outfits have contributed to the blacklisting of Nigerian Medical Schools and their graduates by Foreign Medical Bodies.
The Summit however enjoined practitioners, employers and members of the public to promptly report defaulters to the Medical and Dental Council of Nigeria (MDCN) and NMA (through the NMA State/FCT branch secretariats or the National secretariat of NMA at No.8 Benghazi Street, Wuse Zone 4, Abuja, or through the NMA hotlines: 098709249; 08055243259; 08035986601; 08036771113; 08033464867; 08053500246, for necessary investigation and actions.
- STRIKE ACTIONS IN THE HEALTH SECTOR:
The Summit took a critical look
at the alleged indiscriminate and incessant resort to strike actions by medical and health workers, and resolved that henceforth no Affiliate group or State/FCT branch of NMA shall embark on any strike action without clear approval from the national body of NMA, and that all such strikes, where extremely unavoidable after exploring all options at constructive dialogue, must conform to extant laws and the provisions of the code of medical ethics. Any violation of the foregoing shall be met with appropriate sanctions by the Association.
In the same vein, the Summit charged the leadership of the various health institutions to pro-actively prevent strike actions in their institutions by ensuring that appropriate working conditions are created for their staff and that disputes are sorted out before they snowball into strike actions or other forms of conflagration.
3. REVIEW OF NIGERIA’s HEALTH SYSTEM
The Summit observed that despite efforts being made by the current leadership of the Federal Ministry of Health, Nigeria’s health system was yet to meet the aspirations and expectations of Nigerians. This, the Summit further noted was traceable to several factors, including poor funding of the health sector, weak primary and secondary healthcare systems with poor coordination occasioned by an ineffective and inefficient referral system, absence of a legal framework for health, poor access to healthcare facilities and packages by Nigerians, Medical Tourism, etc.
a) Universal Health Coverage and Access to Health care by All Nigerians:
Convinced that Universal Health Coverage is critical to significant improvement of the health of Nigerians, the Summit harped on the need to accelerate all actions geared towards achieving Universal Health Coverage for all Nigerians. In this regard, the Summit resolved that efforts be stepped up at collaborating with all tiers and levels of government in the formulation of practicable policies and plans aimed at ensuring that every Nigerian, irrespective of place of abode or status, has access to affordable quality healthcare.
Of particular note, the Summit advocated the following:
a) the entrenchment of health rights as justiceable fundamental rights in the 1999 Nigerian constitution currently undergoing amendment;
b) the need to speedily pass the National Health Bill and enact a National Health Act to allow for the utilization of the 2% of the consolidated revenue fund provided in the National Health Bill to strengthen Primary Healthcare and boost access to healthcare facilities by Nigerians in rural communities.
c) The Summit also advocated the universal applicability of the NHIS and expansion of the Community Based Social Health Insurance Scheme.
d) Enforcement of a policy restricting foreign medical travels by public and political office holders at tax payers’ expense, especially for medical conditions that can be safely managed in Nigeria.
The Summit called on Nigerians to always look inwards as exemplified by Capt. Ichalla Idris Wada, the Executive Governor of Kogi State, for solutions to their medical problems as Nigeria is blessed with medical experts in virtually all fields of medicine.
The Summit also advised health practitioners who for reasons of financial returns have perfected the habit of referring patients abroad through Commissioned Agents, to turn a new leaf and be guided by the code of medical ethics and good clinical practice.
While offering to assist embassies in the scrutiny of referral forms, the Summit called on the Federal Ministry of Health and all embassies to set up effective modalities for scrutinizing all referral forms sent abroad.
As part of her contributions to improving access to healthcare by Nigerians, especially as Nigeria approaches her centenary anniversary, the NMA shall expand the scope of her four monthly health/surgical missions to various zones of Nigeria, with the hope that by 2014 no Nigerian shall have cause to harbour basic medical and surgical conditions such as inguino-scrotal hernias.
Still on Corporate Social Responsibility, the Summit while noting challenges being faced by Nigerians (especially on account of the economic hardship, the recent flood disaster, as well as the outbreak of cholera in some communities), charged members of NMA and other health practitioners to continue to robustly respond to emergencies.
The Summit also mandated members of NMA in communities with cases of Polio and Cholera outbreaks to demonstrate leadership and mobilize resources to put an end to such embarrassing cases in the 21st century.
4. INTER-PROFESSIONAL RELATIONSHIP AND HARMONY IN THE HEALTH SECTOR:
The Summit was pleased with the attendance and active participation of some health professional groups as well as their contributions on the issue of inter-professional rivalry and workplace harmony, and resolved to work with such like minds to restore teamwork and workplace harmony for the overall good of patients.
The Summit called on all members of the clinical health care delivery team to sheath their sword, drop all professional prejudices and adversarial approaches, embrace the spirit of dialogue and understanding (admirably exhibited by the health professional groups that participated in the Summit’s panel discussion on ‘Inter-professional rivalry: Resolving the conflicts and contradictions’), and join the train of progress now in motion.
5. MEDICAL AND DENTAL EDUCATION:
The Summit deliberated extensively on the state of medical and dental education in Nigeria, particularly the current curricula of Nigerian medical and dental schools and identified some deficiencies.
The Summit therefore resolved to actively work with the MDCN, the National Universities Commission (NUC) and all other relevant stakeholders to expedite the review of the curricula to bring them in line with current local and global necessities and realities.
It also enjoined the MDCN to regularly and frequently carry out inspection of accredited medical colleges to ensure that standards are not compromised or jettisoned after securing accreditation.
6. DISSOLUTION OF THE GOVERNING COUNCIL OF THE MEDICAL AND DENTAL COUNCIL OF NIGERIA (MDCN)
The Summit noted with dissatisfaction the frequent and premature dissolution of the Governing Council of the MDCN and the attendant impediment of its regulatory activities particularly in the critical areas of trials and sanctioning of erring medical and dental practitioners, regulation of medical practice and medical education, and delivery of quality health care to Nigerians.
The Summit, in noting the foregoing and the fact that Council by law, exist in perpetuity, calls on the federal government to, as a matter of urgency, restore the prematurely dissolved Council to run its full term and ensure compliance with the provisions of the law establishing the MDCN.
7. PUBLIC HEALTHCARE FINANCING
The Summit deliberated on the current level of public healthcare financing and concluded that, it has remained grossly inadequate with Out-of-Pocket/Household Expenditures accounting for over 70% of Healthcare expenditures.
As part of efforts to improve funding, the Summit submitted that other options of financing public healthcare services with well structured and acceptable guidelines, be explored. Options advocated by the Summit include Public-Private Partnerships particularly in the areas of infrastructural maintenance and other areas that accommodate shared responsibility and liability with the private sector or areas that can be outsourced to free up funds for deployment to improve the efficiency and effectiveness of other more critical services.
8. INDISCIPLINE IN THE WORKPLACE AND MANAGEMENT OF HEALTH INSTITUTIONS
While noting the difficult circumstances under which the management of most public health institutions/hospitals operate, the Summit urged the leadership of various health institutions to create opportunities for improved growth and development of their staff to enhance quality service delivery, while taking all necessary measures to ensure the activities and conduct of their staff are centred on quality patient care and guided by extant public service rules.
The Summit called for the speedy arrest of the rising spate of gangsterism in public health institutions/hospitals, with negative impact on health care delivery. The Summit urged the management of public health institutions to aggressively deal with such acts of indiscipline.
The Summit also urged medical and dental practitioners to be more assertive on issues bothering on quality patient care, and to defend the rights of patients at all times.
While it appreciated the concrete plans of NMA to introduce Clinical Governance arms to aid quality patient care in health institutions/hospitals, the Summit was harsh in condemning the situation where some medical and health practitioners inexplicably abandon their duty posts during official working hours and resort to self-serving engagements. The Summit resolved that such unpatriotic acts of impunity and lawlessness should not be tolerated or treated with kid-gloves but justly and promptly addressed with the extant public service rules.
9. RESEARCH ACTIVITIES:
The Summit in noting that Research drives quality in healthcare, decried the extremely poor funding of Research in Nigeria’s health institutions/hospitals which has impacted negatively on the overall quality of healthcare.
To reverse the trend, the Summit harped on the need for a National Research policy and also urged governments at all levels and the legislature, particularly the National Assembly, to allocate enough funds and resources for Biomedical Research in health institutions, research institutes and hospitals.
10. HEALTH LEGISLATION
a) National Health Bill
In the light of the potential benefits to be derived by Nigerians, particularly Women, Children, the elderly and rural Nigerians, from the provisions of the National Health Bill, the Summit while commending the leadership of both houses of the 7th National Assembly for representing the earlier passed National Health Bill for re-consideration for passage, fervently called for the quick passage of the National Health Bill so as to give legal backing to Health policies in Nigeria and expand access to healthcare services by Nigerians, particularly the rural poor.
b) Medical Negligence Bill
The Summit reviewed the Bill for an Act to provide for Medical Professional Indemnity, To Establish the Medical Negligence Complaints Committee, Repeal Section 45 of the National Health Insurance Scheme and For Matters Connected Thereto (otherwise known as the ‘Medical Negligence Bill’) currently being sponsored by Hon. Robinson Uwak, Member representing Oron Federal Constituency in the House of Representatives.
The Summit resolved as follows:
i) That the Bill defeats the very essence of professionalism;
ii) That the Bill is an unnecessary duplication of the functions of already existing Regulatory bodies/Councils;
iii) That rather than create new conflicting laws through the Bill, efforts should be made to strengthen existing laws. In particular, efforts should be made to restore the Medical and Dental Council of Nigeria (MDCN) which has been comatose following its unfortunate political dissolution about 15months ago. The MDCN Act empowers Council to take complaints on issues of misconduct and negligence by professionals and to prosecute non-criminal cases of negligence being the equivalent of a high court; all criminally-related cases are transferred to the police for prosecution at the civil court before Council acts on the outcome.
iv) That on account of the above, the Bill currently being sponsored in the House of Representatives is not only counter-productive, but extremely unnecessary and superfluous and should therefore be withdrawn.
c) Constitutional Amendment Process
The Summit commended the 7th National Assembly for their efforts at evolving a popular approach to amending the 1999 Nigerian constitution and prayed for the consideration and acceptance of the submissions of the Nigerian Medical Association before and during the public hearings organized by both houses of the 7th National Assembly.
11. THE LEADERSHIP OF THE FEDERAL MINISTRY OF HEALTH
The Summit reviewed the activities of the Federal Ministry of Health under the current leadership of the Hon.Minister of Health, Prof. Onyebuchi Chukwu and the Hon.Minister of State for Health, Dr. Mohammed Ali Pate, and concluded that the Federal Ministry of Health is on course with her programmes for better healthcare.
The Summit therefore commended the Hon. Minister of Health and the Hon.Minister of State for Health for their transformation programmes, and urged them to remain focused in the face of unhealthy political distractions.
APPRECIATION
The President of the NMA, Dr Osahon Enabulele, and the National Executive Council and entire membership of the Nigerian Medical Association greatly appreciate His Excellency, the President of the Senate of the Federal Republic of Nigeria, H.E. Senator David A.B. Mark, GCON,FNIM, for his physical presence and support for the Summit.
We are also profoundly grateful to Dr. Emmanuel Eweta Uduaghan, CON, the Executive Governor of Delta State for his immense contributions and unprecedented support that made the historic Summit a huge success. We also appreciate his positive transformation of the healthcare system in Delta State along with several other positive initiatives in various sectors of Delta State. We pray God to continually strengthen him, his family and his Executive Council as they seek to better the health and lives of Deltans.
We also appreciate H.E. Chief Theodore Orji, Executive Governor of Abia State, H.E. Mr. Peter Obi, Executive Governor of Anambra State and Comrade Adams Aliu Oshiomhole, Comrade Governor of Edo State, Capt.Ichalla Idris Wada, Executive Governor of Kogi State, and all other Governors who either sent representatives or sent goodwill messages.
The NMA is also indebted to the Honourable Minister of Health, Professor C.O. Onyebuchi Chukwu, the Chairman of the Senate Committee on Health, Distinguished Senator Ifeanyi Okowa, Distinguished Senator Dr. Chris Ngige, the Deputy Governor of Delta State, Prof. Amos Utuama, the Speaker of the Delta State House of Assembly, Rt. Hon. Victor Ochei, the Secretary to Delta State Government, Mr. Ovuzorie Macaulay, the Asagba of Asaba, HRM Obi Prof. Chike Edozien, former Minister of Health, Prof. Adenike Grange, the Hon.Commissioner for Health, Dr. Joseph Otumara, other Commissioners for Health in the various States of Nigeria, the Chief of Staff to Delta State Government, Dr. Festus Okubor and other members of the Delta State Executive Council.
We are also grateful to our Summit Guest Lecturer, Professor Isaac Folorunso Adewole, the Vice Chancellor of the University of Ibadan, and all our resource persons for their physical presence.
We are grateful to all Past Presidents of the Nigerian Medical Association, Medical/Dental elders and highly distinguished medical/dental practitioners of all cadres and ages, Captains of the health industry, the Registrar of the Medical and Dental Council of Nigeria, Chief Medical Directors/Medical Directors, Directors General of Government Parastaltals, Executive Secretaries and Directors of Government Agencies, Directors of Medical Services from across the States of Nigeria, President of the Medical Association of Nigerian Professionals Across Great Britain (MANSAG), Mr. Jacob Akoh, President of the Nigerian Bar Association, Barr. Okey Wali, SAN, President of the Medical and Health Workers Union of Nigeria (MHWUN), Mr. Ayuba Wabba, President of the Pharmaceutical Society of Nigeria (PSN), Pharm Olumide Akintayo, President of the Nigerian Veterinary Medical Association (NVMA), Dr Gani Enahoro, President of the Nigeria Society of Physiotherapists (NSP), Mr. Taiwo Oyewumi, Nigerian Institute of Public Relations (NIPR), Nigerian Institute of Medical Research (NIMR), National Universities Commission (NUC), National Postgraduate Medical College of Nigeria, West African Postgraduate Medical Colleges, Standard Alliance Insurance Ltd, National Primary Healthcare Development Agency, National Health Insurance Scheme (NHIS), International Institute of Leadership and Governance, NMA State branch Chairmen and Secretaries, Heads of Affiliate Groups of NMA, medical and dental practitioners from all the States of Nigeria and the Federal Capital Territory, the Chairman and members of the Presidential Summit Steering Committee and the Local Organizing Committee, as well as all our invited guests and members of the public.
We appreciate members of the fourth estate of the realm and the good people of Delta State for their unparalleled hospitality and tremendous support throughout our stay in Delta State.
While we thank all well meaning Nigerians for their prayers, we wish to firmly reassure Nigerians that the NMA will firmly implement all the resolutions taken at the Summit in a manner that will help improve the health and prosperity of Nigerians.
DR. OSAHON ENABULELE DR. AKPUFUOMA L. PEMU
PRESIDENT SECRETARY GENERAL
