CMDs bemoan poor funding of teaching hospitals
NEWS DIGEST–Some Chief Medical Directors of federal universities’ teaching hospitals have lamented the underfunding of the tertiary health institutions in the country.
This, they said, had been stifling their operations. However, some of them said their health facilities had been relying on donations from foreign donors, alumni associations, well-meaning Nigerians and organisations.
Some of the CMDs, in separate interviews with The PUNCH, said despite the underfunding of the teaching hospitals, patients, who should be attended to at primary and secondary health institutions, had been besieging the tertiary hospitals for the treatment of common ailments such as cold and malaria.
The Chief Medical Director of the Obafemi Awolowo Teaching Hospital, Ile-Ife, Prof Victor Adetiloye, in an interview with one of our correspondents, said the hospital had been surviving on donations from well-meaning Nigerians, alumni of the institution and foreign donors.
Adetiloye stated, “You may not have a perfect idea of what we are going through if you look at what we used to be and what we are now. We have recorded improvement not because we are well-funded but because of the resolve of the management to succeed. We have been surviving through donations from well-meaning Nigerians, alumni and foreign donors.
“We have N8m statutory allocation as running cost monthly. We may not get this money more than once in four months. We pay on average about N13m to the Ibadan Electricity Distribution Company.
“Also in a month, we spend around N5m to buy diesel for our generators. Apart from providing power, there are other things that we will have to do. If you observe, buildings in our phase one are old. We spend a lot maintaining them. We are expanding too in our phase four.”
He said the OAUTH was lagging behind in personnel, overheads and capital funding, adding that the hospital had not completed many of its projects because of inadequate funding.
We can’t open two children wards for lack of funds – OAUTH CMD
He stated, “There was a time our personnel cost was reduced by 24 per cent, which means our workforce must also be reduced by that percentage. This is a hospital where the ratio of personnel to patient is already far from normal. We don’t have enough in all categories of workers. Because of shortage of staff, we can’t open two wards.
“These are the children wards. I have been to the National Assembly to complain and they promised to do something about it. Till date, we are still expecting. All the facilities are there in the wards, but we can’t open them for use because we don’t have enough medical staff.
“We did open heart surgery for about 70 patients but they paid at a subsidised rate. We took out of our IGR to offset the cost. We have a cardiac centre project going on. Work commenced on it since year 2011, till date, the project is still under construction.”
Funding by govt, fees paid by patients haven’t increased – LUTH
On his part, the Chief Medical Director of the Lagos University Teaching Hospital, Prof Chris Bode, who spoke with one of our correspondents through the Chairman of the hospital’s Medical Advisory Committee, Dr Olufemi Fasanmade, said the patients in LUTH had increased without the corresponding increase in funding from the Federal Government.
He said, “In terms of the numbers of clients we see, there has been a steady rise, every year the number increases, the number of schools within LUTH has increased, the volume of traffic has increased, the number of buildings has increased and some of them have come with their own challenges.
“For instance, the amount of land has not increased, and the funding from the Federal Government has not increased either, neither has the fees charged patients increased in proportion with the higher demands.”
We have been relying on foreign assistance – UNTH CMD
However, the CMD of the University of Nigeria Teaching Hospital, Enugu, Dr Christopher Amah, said the hospital had the capacity and manpower to tackle so many health care problems in the country if it was adequately funded.
He stated that the UNTH, one of the foremost teaching hospitals in the country, would have been in a sorry state if not for donations from foreign countries, which assisted the institutions in the provision of infrastructure.
Amah stated, “In terms of infrastructural facilities, they are not adequate. You know the government has several challenges that take a lot of attention, but I still think we can do better in the area of health. As far as our hospital is concerned, infrastructure wise, if not for the assistance we get from a number of foreign collaborators from the United States, the United Kingdom, Italy, Sweden among other countries, I don’t know what we would have done. We get a lot of support from them and that is what has been helping especially in the cardiac programme and recently in neurosurgery.”
UNTH spends N18m on electricity gets N5.5m for overheads monthly
According to him, the hospital spends between N15m and N18m every month to provide electricity, but receives only N5.5m for overheads to run the entire hospital including the old site, three rural comprehensive health centres and the federal secretariat.
He stated, “Our energy expenditure per month is between N15m and N18m. This includes what you pay to the EEDC (Enugu Electricity Distribution Company) , cost of diesel and cost of maintaining generators every month. We receive N5.5m as overheads to run the entire hospital, including the old site and three rural comprehensive health centres and the federal secretariat. In 2018, we only received this for seven out of 12 months.”
We can’t meet demands of our catchment states – ATBUTH CMD
Also, the CMD of the Abubakar Tafawa Balewa Teaching Hospital, Dr Alkali Mohammed, said the 700-bed hospital attended to patients from Bauchi, Gombe, Yobe and other neighbouring states.
Mohammed lamented the overcrowding of the hospital, saying “We cannot meet the demands in the state. The catchment population is not only Bauchi State but neighbouring states. We receive patients from Gombe, Plateau, Jigawa and largely from Yobe. Bauchi State alone has a population of about 4.9 million, and you can calculate what we get from the other states. You cannot get a 700-bed hospital serving this population.”
In a telephone conversation with one of our correspondent, the Chief Medical Director of the Federal Teaching Hospital, Gombe, Dr Yahaya Alkali, emphasised the fact that the Federal Government was trying.
“The government is doing well in funding the hospital, but it can do better,” he added.
‘JUTH cannot afford an ECT machine for now’
However, patients at the Jos University Teaching Hospital said the health facility did not have an electro-convulsive therapy machine, which is commonly used in the treatment of patients with severe major depression or bipolar disorder.
The Chairman, Medical Advisory Council of the hospital, Dr Pokop Bupwatda, when contacted said, “I agree with you that the hospital doesn’t have a functional ECT machine at the moment but we do our best to attend to patients using other available equipment.
“The cost of acquiring an ECT machine is capital intensive and the hospital for now cannot afford the amount given the limited resources at its disposal. You know that JUTH was not established as a profit-making venture and that is why we cannot charge patients unlike what the private hospitals charge those seeking medical services.”
Efforts on Sunday by one of our correspondents to find out the challenge of funding of the Usman Dan Fodio University Teaching Hospital, Sokoto were not successful as the CMD, Dr Anas Sabir, could not be reached.
But an insider, who spoke to our correspondent on the condition of anonymity said, “funding has usual, as been our perennial problem.
“Whatever amount that is given to the hospital is not near what is enough to sustain the running of the tertiary hospital that handles what ordinarily, the primary and secondary health facilities should have handled.”
Though he did not disclose the amount earmarked for the hospital on monthly basis, the source hinted that the amount was barely enough to provide electricity and buy diesel for the need of the hospital.
Adequate funding of teaching hospitals will reduce medical tourism – NMA
Corroborating the CMDs, the President, Nigerian Medical Association, Dr Francis Faduyile, in an interview with one of our correspondents, lamented the underfunding of the teaching hospitals.
Faduyile said the problems of most teaching hospitals in Nigeria were inadequate infrastructure, lack of enough skilled manpower and inadequate funding.
He said, “If teaching hospitals are well funded, it will reduce medical tourism; once patients begin to get better service from the public facilities, there will be improved patronage and medical tourism out of the country will crash.”
FG budgets N475.3bn to hospitals in three years
However, the analysis of the 2017, 2018 and 2019 budgets showed that the Federal Government allocated N475.3bn to its 21 teaching hospitals in three years.
A breakdown of the N475.37bn allocated to the Federal Government-owned teaching hospitals showed that N140.68bn was allocated to them in 2017, while in the 2018 and 2019 fiscal years; they were allocated N158.24bn and N176.45bn, respectively.
Further analysis showed that during the three-year period, the University College Hospital, Ibadan was allocated N37.12bn; LUTH, N20.96bn; Ahmadu Bello University Teaching Hospital, N21.19bn; UNTH, N32.09bn; while N24.92 was allocated to the University of Benin Teaching Hospital.
Others are OAUTH, N25.59bn; University of Ilorin Teaching Hospital, N23.38bn; University of Jos Teaching Hospital, N21.26bn; University of Port Harcourt Teaching Hospital,N6.91bn; University of Calabar Teaching Hospital, N27.34bn; University of Maiduguri Teaching Hospital, N21.23bn; Usman Dan Fodio University Teaching Hospital N19.48bn; and Aminu Kano University Teaching Hospital, N22.16bn.
Also, the Nnamdi Azikiwe University Teaching Hospital was allocated N23.94bn; University of Abuja Teaching Hospital, N17.02bn; ATBUTH, N12.15bn; Federal Teaching Hospital, Abakaliki, N36.53bn; Federal Teaching Hospital, Gombe, N11.09bn; Federal Teaching Hospital, Ado Ekiti, N17.65bn; Federal Specialist Hospital, Irrua, N17.24bn; and the University of Uyo Teaching Hospital, N18.37bn.
However, it was not certain that the amounts released to these hospitals during the period under review were in tandem with what were allocated to them.
The paucity of funds at the teaching hospitals is coming against the backdrop of the recent revelation by President Muhammadu Buhari that the country spent N400bn annually on medical tourism.