During a discussion about Nigeria’s healthcare sector, the Chairperson of the House of Representatives Committee on Health, Amos Magaji, proposed the privatization of the country’s university teaching hospitals as a means to enhance efficiency and elevate healthcare delivery standards.
This recommendation, however, has faced widespread criticism from stakeholders within the health sector, who have deemed it unfeasible given the current socioeconomic circumstances.
Critics of the privatization plan have raised concerns about the potential ramifications, highlighting the probability of job losses for healthcare workers and the risk of rendering medical services unaffordable to numerous Nigerians, especially those who are economically disadvantaged.
Naijatraffic learnt that, these stakeholders advocated for alternative approaches such as increased government funding, collaborations between the public and private sectors, and broader health insurance coverage as more viable avenues to fortify the nation’s healthcare system without resorting to privatizing its core establishments.
Dr. Dele Abdullahi, the President of the Nigerian Association of Resident Doctors, strongly opposed the idea of privatizing teaching hospitals, deeming it impractical in the current Nigerian context.
While acknowledging the potential cost-related benefits of privatization for the government, Abdullahi emphasized the importance of considering the impact on healthcare accessibility and affordability.
He questioned whether privatization would truly enhance hospital efficiency or aid the government in fulfilling its healthcare obligations to the populace.
Abdullahi underscored the substantial healthcare costs even when under governmental management, expressing concerns about the likelihood of increased expenses and limited accessibility if medical facilities were transferred to private control.
He stressed the need to prioritize universal healthcare access before contemplating privatization, noting the prevalent lack of adequate health insurance coverage among a significant portion of the population, resulting in substantial out-of-pocket expenses for medical services.
Additionally, Abdullahi highlighted the disparities between public and private healthcare delivery systems. He cautioned that privatizing teaching hospitals might compromise patient care quality due to differing operational standards and priorities.
The concern was raised about the potential financial barriers faced by many Nigerians if specialized healthcare services were privatized without subsidies, making them financially unattainable for a considerable segment of the population with limited resources.
He stated, “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 said, “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
Professor Tanimola Akande, a former National Chairman of the Association of Public Health Physicians of Nigeria, cautioned that privatizing federal teaching hospitals could restrict access to quality healthcare for many Nigerians.
He argued that privatization would primarily benefit those who can afford expensive medical services, neglecting the broader population that relies on subsidized care.
Akande emphasized that these hospitals, funded and operated by the federal government, play a vital role in providing essential healthcare services to local communities through skilled professionals.
He noted that even in developed countries, government-run hospitals remain public, and healthcare should be a fundamental right accessible to all citizens.
Akande advocated for public-private partnerships and expanded health insurance coverage instead of privatization, warning that it would hinder access to healthcare for poorer Nigerians and lead to job losses among healthcare workers.
He believed that increased government funding, transparency, accountability, and motivation for healthcare workers could achieve quality improvements without privatization, which could exacerbate financial barriers and worsen Nigeria’s health indicators.
Ultimately, Akande stressed that the government must ensure healthcare accessibility for all citizens.
He further stated, “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.”
