Healthcare practitioners, under the aegis of the Healthcare Providers Association of Nigeria (HCPAN) Lagos State Chapter, have tasked the new administration of President Bola Ahmed Tinubu on unwavering political will to drive the new health insurance and Universal Health Coverage in the country, insisting that the Federal Government must throw it weight behind it to work.
Rising from the association’s Mid-Year Meeting and Capacity Building with the theme “Operationalising the NHIA Act 2022: The actuaries wiewpoint”, which was held at the Lagos Chamber of Commerce and Industry (LCCI), Alausa, Lagos, the Chairman of the association, Pharm. Abiola Paul-Ozieh, noted that the goal of Universal Health Coverage in Nigeria through the window of health insurance as the financing option is feasible if well coordinated.
According to her, everything falls and rises at the table of leadership, therefore the new government must have a strong political will and commitment to the NHIA act, ensure transparency, keep the public abreast of the happenings and what its intentions are and as well bring everybody on board, adding that those sitting in the driver’s seat of NHIA at the national level and those working at the state level must be on the same page, so as to be able to convince the populace to enroll, and get assured of optimal service delivery.
While calling for the separation of professional roles among healthcare providers, she noted that for optimal healthcare service delivery, there must be strict adherence to stratification as primary, secondary or tertiary healthcare facilities, adding that the basic healthcare provision should be done by primary care providers which comprise of public primary healthcare centres and numerous independent standalone clinics and hospitals spread across the states.
“An effective referral system must be put in place. Under no circumstances, must teaching hospitals, specialists hospitals and general hospitals be providing primary care services”, she noted.
Speaking further, the HCPAN boss stressed that healthcare providers must be remunerated according to their services adequately and promptly, adding that the two payment mechanisms of capitation for primary care providers and fee-for-service for secondary care providers should be upheld.
“Under no circumstances should a primary care provider warehouse the funds for secondary care providers. Block capitation to primary care providers as practised under NHIS should be unbundled such that the fee-for-service components can be paid directly to the secondary care providers viz specialist centres, laboratories, radiographic centres, pharmacies, physiotherapy, optometric centres, as this will assure a sense of inclusiveness and efficiency in the system”, she advised.
Her words, “Healthcare providers in the private sector provide over 60 per cent of healthcare in Nigeria, especially in Lagos State, so because of that, we must be carried along in whatsoever policy the government is making. Without private healthcare providers, public providers can go fast. Still, they are not likely going to go far, but for them to go far, regarding the implementation of the NHIA, 2022, we must carry the private healthcare providers along, and those terrible healthcare indices we see would change”.
Speaking in the same vein, Dr Austin Aipoh, national president, HCPAN stressed that the government must have the right political will and also put the required structures and funding in place as obtained in other countries for Nigerians to enjoy UHC.
“For us to enjoy the new act, the government would have to show political will and the political will is to be able to implement the new act to the fullest. The new government should be able to release the fund when due, the budgetary allocation for health that we see on paper should be released truly, and once there is budgetary allocation, there should be budgetary implementation, and even increase the allocation”, he said.
In his remarks, the Chairman of the Occasion, Dr Umar Oluwole Sanda, noted the need for the providers to come together under a common interest, and in compliance with the decree, 35 of 1999 setting health insurance scheme with particular reference to part 1, section 11, subsection 2c and 2d, which enumerated the role and place of healthcare providers in the country necessitated the establishment of HCPAN, adding that the association was officially launched on 12 August, 2004, in Lagos.
Sanda, a former president of HCPAN, noted that health insurance is the future of healthcare in the country, adding that a workable, affordable health insurance scheme that will be inclusive and lucrative to all healthcare providers is achievable.
He however noted that the Ilera Eko Scheme which was designed to provide access to effective, quality, and equitable healthcare services, while providing financial protection from the cost of healthcare to all residents of Lagos State, was not living up to expectations and not satisfactory, adding that it is rather more of a political programme, than a genuinely established healthcare scheme.
His words, “We need a robust debate to move the scheme forward, and we must be ready to engage the government on this. I however want to appeal to fellow providers not to be deterred by the rough terrain we are passing through, as our journey to our destiny and destination has started well and should be sustained by all”.
In her speech, titled “Overview of the Lagos State Health Scheme (LSHS): The LASHMA Update and Providers”, Dr Emmanuella Zamba, general manager, LASHMA, explained that the Lagos State Health Scheme is mandatory for all residents of Lagos State, and all employees in the public and private sectors, including the self-employed and the unemployed, adding that the overall goal of the LSHS is to ensure that all residents of Lagos have unhindered access to quality healthcare services in an efficient, sustainable, and equitable manner.
“Providers are identified as a key structure in community dynamics. In Ideal community settings, the hospital is a symbol of hope and care; the community members also trust the healthcare leadership. Also, the providers have a key role in achieving UHC, not only by providing quality care but also service to enlighten, educate and inform people in the community about the scheme and follow-up on premium payments”.
The high point of the event was the panel discussion on health insurance scheme, implementation, regulatory framework and collaboration, which had Dr Austin Aipoh; Dr Leke Oshunniyi; Mr Emeka Okoji; Mr Abiola Oshunniyi as panellists, and Dr Raymond Abiodun Kuti, as the moderator.
During the discussion, other stakeholders present at the programme such as operators of Health Maintenance Organisations (HMOs), medical practitioners, pharmacists, and laboratory scientists, among others, called on the Federal Government to address the bottlenecks that prevented the NHIS from working, so that NHIA, won’t end up the same way.
A cross -section of healthcare providers at the programme
L-R: Dr Aipoh Austin, president, HCPAN; Pharm. (Mrs) Abiola Paul-Ozieh, chairman, HCPAN, Lagos State Chapter; Dr Umar Oluwole Sanda, chairman of the occasion; and Dr Raymond Abiodun Kuti, at the Mid-Year Meeting and capacity building organised by the HCPAN, Lagos State Chapter at the LCCI, Alausa, Ikeja.