FG to bar doctors from private practice

     

   The Federal Government is considering barring doctors in public hospitals from private practice, Minister of Health, Professor Isaac Adewole, has said. The minister told State House correspondents that the idea was discussed yesterday at the weekly cabinet meeting presided over by President Muhammadu Buhari.

     According to the minister, the only thing the nation’s law permits a public officer to do is farming. Adewole said a committee had been set up to look into the matter and make appropriate recommendations to the government. “The council decided to look into the issue of private practice by medical doctors in the public sector, and a committee has been set up to look extensively into that issue because we want to resolve the issue of what does the law of the land state and what the rule of professional ethics says.

  

   “The law of the land does not allow any public officer to do anything other than farming. So, that committee will make appropriate recommendations to government on these important issues which is of considerable interest to quite a number of Nigerians,” he said. The minister said the government would also look at the report of the Presidential Committee of Experts on Inter-Professional Relationship in the Public Health Sector which was chaired by a former Secretary to the Government of the Federation (SGF) Yayale Ahmed.

    

   Yayale had, while submitting the report to then President Goodluck Jonathan, said the committee identified 50 areas of conflict after receiving memoranda and interacting with about 40 professional bodies in the Public Health Sector and members of the public. Prof Adewole said the Office of the SGF had been mandated to forward a white paper on the report to the cabinet so that the government could restore harmony to the health sector. The minister said the FEC also decided that the residency training programme should last for a fixed term of seven years, adding that “after training for seven years, individuals should exit from the programme so that other people can come into the programme.”

   

   He said in considering a memo on industrial relations in the public sector, the council stressed the need to do a comprehensive job evaluation and set up a committee that would “evaluate what exactly we should do as individuals, how much should we be paid in a way that we can really pay appropriately across board through the entire country”. The Nigeria Medical Association (NMA) described the benefit of the federal government’s planned ban as a double edged sword and a ‘50 -50’.  Dr Roland Aigbovo, Public Relations Officer of NMA, Federal Capital (FCT) Territory chapter, said the federal government should have consulted the Medical and Dental Council (MDCN) before coming up with the announcement.

  

    He described it as a misnomer because there was already an existing law, a Code of Medical Practice which says that one can actually run a private practice, but not within working hours at a public hospital, “and secondly that you cannot also run inpatient care that is seeing the patient and admitting them while working in a public hospital.”  While saying that the ban when implemented could help improve efficiency in patients care in public hospitals, the move would also cause a lot of job dissatisfaction and increased quackery in the health sector. He said doctors spend their hard earned money acquiring additional skills or developing themselves, while some cannot practice their skills in some public health institutions because of lack of requisite facilities and equipment. Dr Roland Aigbovo said it was important for government to be willing and able to fund and equip the health institutions because no doctor will be happy for his skills to go to waste because of a ban on private practice.

      “On the other hand it will also increase quackery because there are so many rural areas that even the Ministry of Health doesn’t go to. There are lots of quackery going on there. So it’s a 50-50 thing,” he said. Dr UgochukwuEze Public Relations Officer/ spokesman of the National Association of Resident Doctors (NARD), said "Firstly, the NMA is the umbrella body for doctors. NARD is just an affiliate so I believe NMA has a position on this and shall be made public. “Secondly, there is a code of ethics governing Nigerian doctors and its provisions on the issue are clear. However, there is a regulatory body for activities of medical doctors in the country which is the Medical and Dental Council of Nigeria(MDCN).

   

    “MDCN presently has no board and thus not exerting her regulatory role fully. NARD is aware that NMA has been advocating for FG to constitute the MDCN board. If government places high premium on the work/activities of doctors, the board of such an important regulatory body should not be dissolved at will. One is really baffled as this tops the head line of FEC meeting today,” he said.  Dr Frank Odafen, National President, Association of General and Private Medical Practitioners of Nigeria (AGPMPN), said the private medical practitioners support the Federal Government’s move because it will improve health care delivery in the country and stop the unethical practices of some doctors who divert patients and medical students from teaching hospitals to their private hospitals.

   

     He said the primary focus of doctors should be the interest of patients, adding that one cannot serve two masters as there will be disloyalty to one and favour for the other. He said: “If you are for private, be for private; if you are for government, be for government. Can you drive two cars at a time and you think there will be no accident? You must drive one and park one or you go to the other. The choice is for the doctors. So we private practitioners support government in that regard, because we have discovered that some of our colleagues abandon the government hospitals and divert patients to their practices.” For Dr Stephen Kitchner, a former president of the Nigeria Medical Association (NMA) and one of the prominent medical practitioners basedin Zaria, the federal government needs to define what it means bythe policy, because it would be a difficult one to implement.

   “For me we need not rush to pre-empt what the government means. It would be difficult for the government to determine what people would do with their private hours. If they are saying that adoctor would not be allowed to use his official hours to attend to hisor her private clinic this would be a good decision. This is becauseit would make the doctors to fully concentrate during their working hours. “However, if they are saying that a doctor cannot engage in private practice even during his free hours; I think this would be difficult to implement. A doctor using his free hours to do other things I think is the same thing with a civil servant that engages in farming or other activities during his free time. By and large, the government needs to define what it means before we can assess the impact that the policy would make.” A consultant at the Ahmadu Bello University Teaching Hospital (ABUTH), who craved for anonymity,supported the government’s move, describing it as a well-thought out one.

   

    “It would curtail most of the sharp practices that are taking place in private hospitals. Some of these private hospitals are not owned by doctors. A businessman would just build a hospital using the licence of a doctor. Because he is just after the profit he would make, this hospital owner would employ quacks and because these people are not qualified, they end up killing innocent lives. Even the hospitals owned by doctors are usually run by nurses or even midwives, because they don’t want to spend much in employing doctors.  “Again, the policy would allow us to concentrate fully on our work. It would bring to an end a situation where a doctor is attending to his official patients and at the same time rushing out to attend to his private patients. Generally, this policy would enhance the proficiency of doctors towards their official duties and Nigerians would be better for it.”