Private – Public Overlap: Why is The Government Against this Practise in Hospitals ?

THE Nigerian medical space is in dire need for restructure as it is with the other sectors of the economy. In a move to curb the worrisome trend of  public–private overlap in the country’s medical sector .The Federal Government has announced a ban for medical doctors working in public hospitals to engage on private practice, a move that would see the resident doctors show more commitment to their work. A statement that stakeholders has frowned upon and might commence another stage of industrial actions.

 

Medical practice is all about life and sacrifice, the ability to sacrifice gratifications, wealth and money for the upkeep of the patient is Paramount and it has been said that majority of the medical doctors in the public hospitals in Nigeria has or engage in one form of private practice. A situation that has undermined their productivity and loyalty. Combining both private and public practise as it is done in Nigeria would affect these above mentioned ,such as sacrifice and efficiency. And the Federal Government of Nigeria is trying to correct this anomaly.

Medical practise is a highly demanding job, that is why medical practise are regulated by calls ,which is time a doctor would be on duty. Bearing in mind the demanding nature of this profession, it is always required that a doctor must rest. Combining private and public practise exposes the fractioned to fatigue. This would heighten the tendency to make wrong judgement , as it is always the case in Nigeria or treat patients with levity.t

The good books, the Bible said that ” No servant would serve two masters at the same time ” and even in the secular world, no employer would accept an employee working for two different organisations in the same industry. The Federal Government had been magnanimous, kind and understanding to the medical doctors over the years. No reasonable government would allow such to happen…and this time, the Nigerian Government has demonstrated that they are reasonable.

According to BMJ.com, In Spain, in the 1980s exclusive dedication to public hospitals was introduced. Doctors who welcomed it, with the same working hours, had better pay. The fundamental reason that was exposed by the then health minister was that the doctors under exclusive contracts consecrate their free time in the afternoon to study the problems of their patients, however, those working in private medicine in the afternoons could not. This never happened. Most doctors who were exclusively dedicated, then and now, for the evenings were dedicated to their hobbies and favourite sports, to be with their family or out walking. The other, without exclusive dedication, devoted the evening to work and study to compete with other doctors to have more patients (clients).

According to Paulo Ferrinho, a medical doctor in a report , he noted that ;

“Doctors and nurses in government employment are labelled “unproductive”, “poorly motivated”, “inefficient”, “client-unfriendly”, “absent” or even “corrupt”. These labels are often associated with coping strategies associated with widespread “demotivation”, due partly to “unfair public salaries”. These are presented as the de facto justification of “inevitable” predatory behaviour and public-to-private brain drain ” .

A report by Human Resource for Health puts the public-private overlap in this way. A sample of 40 developing countries, an average of 55% of physicians worked in the private sector and an average of 28% of health care beds were private beds (21% private, for profit).

Though, to compensate for unrealistically low salaries and we know that Nigerian doctors are lowly paid, we have seen them leave the country to practise in countries like USA and arabia, health workers rely on individual coping strategies. Many clinicians combine salaried, public-sector clinical work with a fee-for-service private clientele. This dual practice is often a means by which health workers try to meet their survival needs, reflecting the inability of health ministries to ensure adequate salaries and working conditions. For the Nigerian government to bite not only bark, they must make public practise attractive and this is by having good renumeration, good work conditions that is at par with the global best practise and finally equip the medical facilities. It is only when this is done, then the government would be taken seriously. No doctor wants to practise in a facility that can’t boast of syringes as was eluded by a wife of a government functionary, lately.

There is a fine line separating coping strategies, including dual practice, from corruption. The difficulty in differentiating between the two starts with the definition of corruption. The definition of corruption as the “private use of public goods” and we know that majority of the doctors in public service use their time that would be used in public practise for private work, if this can be defined as corruption. What would you say about the poor remuneration that the dude in public practise recieve on a monthly basis. As we know of the evolution theory of Darwin which recognises that the fittest must survive, as it is with the first law if nature – self preservation. The average medical doctor in that public health Care facility is always on the lookout out for the private practise, assuming he doesn’t have his two bedroom “hospital ” tucked in some obscure corner of the town. The inability of the Nigerian Government to remunerate the doctors well has encouraged this trend. To curb the private – public overlap,there must be a middle ground and intervention on the side of government. It isn’t what can be achieved by fiasco or policy statement .

 

By

Anthony Emeka Nwosu

 

 

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