Professor Tanimola Akande Sodiq Ojuroungbe Rcently, the Chairperson of the House of Representatives Committee on Health, Amos Magaji, while x-raying the challenges plaguing Nigeria’s health sector, suggested that Nigeria’s university teaching hospitals be privatised to enhance efficiency and improve healthcare delivery. However, his suggestion has been widely condemned by stakeholders in the health sector, who said the idea was unrealistic in light of present socioeconomic realities. They noted that privatisation could lead to job losses for health workers and capable of making healthcare unaffordable for many Nigerians, particularly the poor and vulnerable.
Speaking exclusively with PUNCH Healthwise, they advocated for alternative solutions such as increased government funding, public-private partnerships, and broader health insurance coverage to strengthen the healthcare system without privatising its core institutions. The President of the Nigerian Association of Resident Doctors, Dr Dele Abdullahi, insisted that it is not feasible for Nigeria at the moment, to privatise teaching hospitals. Dr Dele Abdullahi While acknowledging the potential relief privatisation could provide to the government by shifting the financial burden of hospital management, he highlighted fundamental concerns regarding healthcare access and affordability.
The NARD president raised critical questions about whether privatisation would improve hospital efficiency or help the government fulfil its healthcare obligations to all citizens. He pointed out that healthcare delivery remains costly even under government management, let alone under private entities where costs are typically higher and are bound to increase astronomically. Abdullahi emphasised that before considering privatisation, Nigeria must ensure universal access to healthcare, lamenting that a significant portion of the population lacks adequate health insurance coverage and still pays out of pocket for medical services.
The NARD president also highlighted the disparity between public and private healthcare operations, noting that privatising teaching hospitals could jeopardise patient care due to operational standards and priorities. He expressed concern that specialised healthcare services if privatised without subsidies could become financially inaccessible to many Nigerians, who ordinarily cannot afford such high costs. He said, “I won’t say privatisation of teaching hospitals is a wrong idea, I will just say it is an idea that is not viable for our society as of today.
It’s one thing to see what works in other spheres and it is another thing to domesticate it in your society. “The ideology of privatising the federal teaching hospitals will help governments by taking the burden of running those hospitals off them. But, will it make the hospitals more efficient? “Also, will it help the government to actualise its obligation of efficient health care delivery to every citizen? Those are the points that we need to look at.
And in this case, both answers are no. As it stands today, healthcare delivery is expensive, even when government is the one running it. Talk more of when the private hospitals are the ones running it.
“We have a country that even though NHIA is an act. And by that, every citizen of Nigeria must have health insurance. But health insurance doesn’t also cover up to 20 per cent of the total population of Nigeria.
Most Nigerians still pay out of pocket.” Abdullahi added, “Even a lot of people who are already on health insurance still pay out of pocket. So, there are so many other things to achieve before you bring up the idea of privatising our teaching hospitals in the spirit of universal health care coverage.
“I will not say that what they suggested is totally wrong. I will just say that Nigeria is not in any way prepared for that kind of idea. And it will be best not to be brought it to the fore at any point in time now.
” Regarding the impact on medical training, the NARD president acknowledged that residency programmes might continue under privatisation but anticipates a drastic increase in training costs, potentially straining government finances further. In terms of improving healthcare delivery and efficiency, he advocated for increased government funding to enhance hospital infrastructure, equipment, and healthcare worker remuneration. He stressed that strengthening funding for federal institutions is crucial, especially in light of inadequate staffing and functionality issues plaguing many primary and secondary healthcare facilities across Nigerian states.
Abdullahi concluded by urging for the prioritisation of universal healthcare coverage before exploring options that could potentially increase the financial burden on hapless patients and compromise healthcare accessibility for the broader population. “To state clearly, the ideology for you to improve healthcare in all facilities is to increase funding to provide equipment in the facilities and improve on the remuneration of the labour workforce. “But in the spirit of universal healthcare coverage, if you privatise your hospital, that means the hospital will have to recoup the funds used to buy equipment and all from the patient’s care.
The basic strategy the government can adopt is to find ways to improve funding for our federal institutions. Currently, most state primary and secondary healthcare facilities are not functional and lack the basic labour force needed.” “So, what they need to do is find ways to improve the funding of these federal teaching hospitals, and find ways to support the primary and secondary facilities.
And once universal healthcare coverage is achieved, then, they can now think of other ways of cutting the cost of governance,” he suggested. On his part, a former National Chairman of the Association of Public Health Physicians of Nigeria, Professor Tanimola Akande warned that privatisation could potentially limit access to quality healthcare delivery for many Nigerians. Professor Tanimola Akande The Professor of Public Health argued that privatisation might cater primarily to those who can afford high-cost medical services, thereby, neglecting the broader population in need of subsidised care.
The physician insisted that the idea of privatising federal teaching hospitals was not suitable for Nigeria, adding that these hospitals, funded and operated by the federal government, play a crucial role in providing essential healthcare services to the local population through highly skilled healthcare professionals. The don pointed out that even in developed countries with better economic conditions, government-run hospitals are not privatised, stressing that healthcare as a fundamental right should be accessible to all citizens. He also affirmed that privatisation would hinder access to healthcare for poorer Nigerians when they need it most.
The don said instead of privatisation, the government should explore an alternative option like public-private partnership and expand health insurance coverage to address funding challenges faced by federal teaching hospitals. While acknowledging potential quality improvements through privatisation, he maintained that similar outcomes can be achieved through increased government funding, greater transparency, accountability, and better motivation for healthcare workers. Akande expressed concerns over potential job losses among healthcare workers under privatization, referencing the current low-efficiency levels in the hospitals.
He argued that while privatisation may reduce medical tourism, it could worsen financial barriers for the poor, thus, aggravating Nigeria’s already challenging health indicators. The professor noted that it is the government’s responsibility to ensure that healthcare is accessible for all citizens, and advocated for measures that will enhance efficiency without compromising services. He further said, “Federal teaching hospitals are run and funded by the federal government.
They provide medical care to people in their catchment areas through highly skilled health workers. The suggestion for privatisation is ill-conceived for a country like Nigeria. Even well-developed nations with citizens who have better economic status still don’t privatise their government-run hospitals.
“It is the right of every citizen to have access to quality health care at all levels. It is the social responsibility of the government to provide this access to health care. Privatisation of federal teaching hospitals is an inappropriate option that will deny poor Nigerians access to health care when the need arises.
“There are several other options to address the issue of funding for federal teaching hospitals. This includes public-private partnerships and high health insurance coverage, among others. “Privatisation will improve the quality of healthcare; however, this can also be achieved with increased government funding, ensuring transparency and accountability, and motivating health workers to provide quality care.
” “Privatisation will certainly lead to job loss among health workers as the owners would like to be more efficient in service delivery. Currently, efficiency is low. However, retained health workers may be better motivated.
” On how privatisation would affect attitudes to work, the physician said, “In addition, health workers’ attitudes towards work and patient care, as well as productivity would need to be improved and well-monitored along with effective supportive supervision. “Public-private partnership will significantly improve efficiency in service delivery. Improved technology and the use of ICT will help improve efficiency.
“The idea of privatisation of federal teaching hospitals should be discouraged. Rather, other measures to improve efficiency should be considered. If allowed, it will certainly affect financial access among the poor.
“This can further worsen the already poor health indices in Nigeria. While privatization may reduce medical tourism, only the rich will be able to access services in those facilities. “However, the government has the social responsibility to make healthcare accessible to its citizens, which will help towards achieving Universal Health Coverage.
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