[OPINION POST]: GREEDY MEDICAL DOCTORS CAUSING HEALTH SYSTEM COLAPSE IN NIGERIA: THIS MUST NOT BE ALLOWED BY NIGERIANS – HUMPHREY ELENDU.

Who is a greedy person?

“…someone who wants more and more of something he doesn’t have the right to possess”; “A person at work who takes credit for the hard work of others…”

Richard F. Taflinger in his presentation: “Taking Advantage, The Sociological Basis of Greed” emphasized that: “unrestrained greed in an individual (or group) can lead to callousness, arrogance and even megalomania” (Taflinger, 1996:1).

Consequently, Nigeria Medical Doctors are very GREEDY because they qualify for the definition of a greedy person described above.

2. A system has been defined by many scholars as “a set of rules, an arrangement of things, or a group of related things that work towards a common goal” For example: the laws and procedures of a democratic government, the engines of a vehicle or aeroplane, the human body system, etc. When any system part presents with a problem, every other part of that system suffers according to the principles of the systems theory.

3. Ferlier & Shorter (2001) in clarifying the structure and dynamics of a health system and it’s division of labour (specialized areas) and interdependence, reported the four-level model of an ideal healthcare system components viz:

i. INDIVIDUAL PATIENT; (at the center of the system).

ii. THE CARES TEAM (Medical Laboratory Scientists, Medical Doctors, Nurses, Pharmacists, Radiographers, Physiotherapist, Dentists, Dental Therapist, Dental Technologist, Nutritionists, Health Record Officers, Environmental Officers, Engineers in Works and Maintenance, etc). That is, from the Chief Executive to the cleaners, security team, etc.

iii. THE ORGANISATIONS (Management, infrastructure)

iv. THE POLITICAL & ECONOMIC ENVIRONMENT (Regulatory, finance, payments and health markets).

4. Therefore, in a system, when any single unit or group is not considered or relegated, such a system like the health system cannot function uptimally and a BIG PROBLEM occurs. If this PROBLEM is managed or not rectified at all, the health system will definitely COLAPSE! THIS IS THE SCENARIO IN NIGERIA HEALTH SYSTEM. ASK ME WHY??

5. Absolutely unrepentant GREED amongst some analogue and archaic minded Medical Doctors in Nigeria is the BIG PROBLEM causing the colapse of the Nigeria Health System. YES! Go round and see for yourself.

6. THE BIG PROBLEM CAUSED BY THESE GREEDY MEDICAL DOCTORS IN NIGERIA include but not limited to:

i. As a problem in the health system, the Medical Doctors as a group in the care team as in (3ii) above, since 1985 have continued to lay-siege to the headship of ALL other professional groups in the health system in Nigeria mostly since 1985 – Whereas they lack the reqisite qualifications to do so by their training-THIS IS ROOT CAUSE/FATHER OF ALL THE PROBLEM IN NIGERIA HEALTH SYSTEM!

ii. These Greedy Medical Doctors, head and control: Works & Maintenance Department, Nutrition Department, Environmental Health Department, Public Health Department, Medical Laboratory Department, Pharmacy Department, Nursing Department, Physiotherapy Department, Records Department, Dental Department, Radiography Department, etc. Can you put a squared peg in a round hole? NO! These Greedy Medical Doctors, as a single group in the care team, kidnapped the Nigeria health system administration, relegated other care team professional groups in health sector, continued to milk recklessly, the available finances/ budgets provided for rendering patients services delivery to a colossal colapse of the Nigeria health system.. Consequently, Nigerians and the world at large have no confidence on Nigeria health system. This is because these Medical Doctors lack the standard required trainings/knowledge/skills/abilities, registration certifications, to head and control the other health professionals. This MUST NOT BE ALLOWED in this 21st century judging by World Health Organisation Standards.

iii. How can someone lead or head a profession where he lacks the reqisite qualifications??? YES! These Greedy Nigeria Medical Doctors seek to determine the grow/ specialization of other health professionals in the health. Moreover, ALL (including the Medical Doctors, Medical Laboratory Scientists, Pharmacists, Radiographers, Physiotherapist, Nurses, Dentists, etc) studied their various courses in a University (a place where the HIGHEST manpower is produced). Each care team has the needed capacities to oversee its team. YES! ALL the varying component care team in the health system studied their various courses or professions with a peculiar dedicated curriculum designed by their various professional bodies /regulations under one Nigeria Universities Commission. So, why the trespass by these greedy Medical Doctors in Nigeria? ???

iv. Nigeria Health System’s ranking has continued to fall since 1985 when a Medical Doctor, Professor Olukoye Ransome Kuti became the Minister of Health in Nigeria. Before 1985, only Hospital Administrators are in charge of health facilities in Nigeria. Presently, with estimated 23,640 health facilities in Nigeria with Medical Doctors as the Chief Executives in a three tiered governance structure, Nigeria is ranked 187th out of 195 member states on health matters globally by World Health Organisation.

v. Go round most private hospitals owned by Medical Doctors in Nigeria, they assume a health worker training institutions churning out quacks in the form of laboratory assistants, auxiliary nurses, radiograper attendants, etc. In some cases, they employ secretarial staff and unqualified persons to churn out Laboratory results, dispense drugs or perform health related activities/duties. These are lawlessness in the highest order and remain another BIG PROBLEM CAUSING THE COLAPSE OF THE NIGERIA HEALTH SYSTEM.

vi. This global ranking of Nigeria Health Facilities of 187/195 by WHO is a sound evidence that these greedy Medical Doctors as the Chief Executives of Nigeria Health Facilities, lack the team spirit and leadership qualities required for a standardized health services delivery in Nigeria. It is a proof that the Medical-Doctor-Chief Executives or leadership has failed Nigerians. Henc, the time to deploy seasoned Hospital Administrators as Chief Executives of Nigeria Health System is now! #ENOUGHISENOUGH!!!

vii. In Nigeria, the most lawless system, is the Nigeria Health System. ASK ME WHY? These sets of Greedy Medical Doctors heading Nigeria health facilities do not obey court judgements and always work in ocean of elitism against the principles of egalitarianism. A recent example is the Nigeria Senate Committee on Heath Public Hearing on some health related bills on 01 February, 2021 headed by a Medical Doctor. There are numerous other court judgements for establishing of Medical Laboratory Department in all Ministries, Departments & Agencies in Nigeria, to date, Medical Doctors, who are not trained, Registered and certified Medical Laboratory Professional, are still struggling headship of Medical Laboratory Services with the Medical Laboratory Scientists who have the statutory trainings,registration and certifications to head the Medical Laboratory Services Department. There are several other court judgements for Pharmacists, Radiographers, Physiotherapist, Nurses, etc which these Greedy Medical Doctors heading health facilities in Nigeria refused to implement out of Greed and archaism. FELLOWS NIGERIANS, MUST WE CONTINUE LIKE THIS? NO!!!

viii. These greedy analogue Nigeria Medical Doctors have refused to grow with the trend of best practices obtainable globally as enshrined in the principles and practices of the World Health Organisation. This is another big problem eating the Nigeria Health System like gangrene. For example, their zeal in heading ALL the other health professional bodies, is a move against the principles of system specialization, growth and development is the health system. This again, amounts to a “jack of all trade master of none”. This if untamed, shall continue to hunt and hurt them (the Medical Doctors), the patients-centered-services and the entire health system in general. #ENOUGHISENOUGH! !!

7. WAY FORWARD: “A stitch in time, saves nine” they say. Therefore, all stakeholders,NGOs, FBOs, CSOs, INTERNATIONAL ORGANISATIONS and Nigeria government at ALL levels shall going forward, immediately call for:

i. Deployment of ONLY seasoned and experienced Health Administrators to head and control all the health facilities in Nigeria.

ii. Let each care team/health professional group in Nigeria health system head and control its members as eshrined in their enabling statutory instruments in line with World Health Organisation, African Union and ECOWAS principles of health best practice.

iii. The Honourable Nigeria Senate and House of Representatives MUST DELETE ALL CONTROVERCIAL CLAUSE OR CLAUSES TRESPASSING IN OTHER HEALTH PROFESSIONAL GROUPS STATUTORY REGULATIONS ON GROUNDS OF SOCIAL JUSTICE.

iv. The Medical Doctors in whatever form or association, should be made to understand that the era of archaic/analogue medicine is far gone. We are in the 21st century where principles of division of labour (specialization) through historic dynamism of existentialism is the order of the day. Without health system specialization and team work, Nigeria will remain even lower than 187/195 World Health Organisation ranking in health matters to the detriment of Nigerian citizen/population..

v. Nigeria Health System should strive to be like 1-10/195 in WHO health ranking. This can be achieved if these Greedy Medical Doctors can stay on their own lane and allow other individual health professionals to exhibit their leadership qualities in their chosen field of medicine.

vi. All health stakeholders and the government of Nigeria at ALL levels MUST ensure that pool of egalitarianism not elitism prevail mostly, in Nigeria Health System for the benefit of all her citizenry/population.

#ENOUGHISENOUGH!!!

Mls Humphrey ELENDU, is a Development Mentor and Quality Improvement Experts based in Sokoto.

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