Federal lawmakers have expressed their support for a private member bill for an Act to amend the University Teaching Hospitals (Reconstitution of Boards etc.) Act, 2004,’ sponsored by Hon. Bamidele Salam.

Tribune reports that members of the House of Representatives on Wednesday expressed overwhelming support for a bill that seeks to reconstitute the Governing Boards of Federal University Teaching Hospitals across the country.

Hon. Salam, a member representing Ede North/Ede South/Egbedore/Ejigbo Federal Constituency of Osun State who spearheaded the debate explained that the bill seeks to restructure the composition of the Governing Boards of tertiary health institutions with a view to making them more vibrant and efficient.

The Bill further aims to: “review the terminology of the heads of the hospitals, redefine the qualification of the Head of hospitals, provide a definite tenure of office of the heads of the hospitals, including students of Health Sciences in the training programmes of the hospitals and include hospitals established post-enactment of the extant legal framework in the schedule and for other related matters.”

Hon. Salam said “It could be recalled that, currently, the terminology used in referring to the Head of tertiary health institutions in Nigeria is called ‘Chief Medical Director’. He is accountable to the Board of the institution. The Chief Medical Director is responsible for the execution of policies and matters affecting the day to day management of the affairs of the Hospital.”

“Before one can be qualified to be appointed as CMD, the person must be Medical/Dental Practitioner registered with the Medical and Dental Council of Nigeria of not less than 10 years post qualification.“

“In addition, the person must be a fellow (s) of either the National Postgraduate Medical College of Nigeria or the West African Postgraduate Medical College or its equivalent registered by Nigeria’s Medical and Dental Council.

“Furthermore, the person must have been a consultant for a minimum of 5 years. Administrative qualification and experience is only an added advantage, amongst others. The Medical/Dental Practitioners who solely enjoy the privilege of being made the Chief Medical Director constitute not more than 5% of the total number of medical personnel in the Health Industry.

“The current legal regime excludes other health professionals – Pharmacists, Nurses, Social workers, Occupational therapists and physiotherapists, Psychologists, Bereavement Counsellors, Paramedics, Dieticians, Lab Scientists’ and Speech Pathologists, amongst others- from becoming a Chief Medical Director.

“Section 5 of the Principal Act, which provides for the appointment of the CMD, also provided the functions of the Office of the CMD, which includes: the execution of policies and matters affecting the day to day management of the affairs of the Hospital. A cursory study of these responsibilities reveals that the burden is purely administrative; it has nothing to do with a particular professional in the health profession.

“In the United Kingdom, to become a hospital administrator, one doesn’t have to be a medical practitioner. All you need is to be a Graduate from High School (4 years); Obtain a Bachelor’s degree in healthcare administration, business administration, or a clinical discipline (4 years); and a master’s degree in healthcare administration (MHA) or a related graduate degree (2 years).

“In the United States, there isn’t one specific path to follow to get a hospital administrator’s job. You may begin your career in some other role with that goal in mind (some start as Doctors or Nurses) and be promoted to the position. However, it’s common for hospital administrators to earn a relevant degree—and an increasing number of employers now require a master’s as well.

“Generally speaking, there are four basic steps to becoming a hospital administrator: Get a bachelor’s degree in health systems management and health services or related disciplines; Get a master’s degree in n hospital administration or healthcare administration; Gain experience and other certifications such as American College of Healthcare Executives (ACHE) Accreditation or Certified Medical Manager (CMM) Accreditation etc.

“It is clear from the above cross-country discussion that to be appointed as a Chief Executive Officer, one doesn’t have to be a medical doctor. Persons with Bachelor’s in Management or Administration with requisite experience can be appointed to head a hospital. Similarly, in the composition of the Board of the Hospitals, other critical stakeholders were not included. Greater attention was only paid to medical doctors.

“Against this background, this Bill is proposed to address all these challenges and include all other health professionals in the capacity building and administration of the Federal Hospitals in Nigeria and related issues,” he noted.

Hon. Salam who solicited the support of members explained that the objectives of the Bill seek to, “review the terminology of the heads of the hospitals; redefine the qualification of the Head of hospitals; provide a definite tenure of office of the heads of the hospitals; including students of Health Sciences in the training programmes of the hospitals; and have hospitals established post-enactment of the extant legal framework in the schedule.“

“Hospital administration is a speciality within healthcare administration; it is one of the most advanced leadership careers in healthcare. It focuses on the overall operation of hospitals and other significant health facilities and requires both healthcare experience and administrative/management acumen.

“The purpose of the bill, therefore, is to strengthen the administration mechanism of University Teaching Hospitals through the broadening of its administrative heads and entrench greater professionalism in the management of our medical tertiary institutions.

“The Bill will also considerably reduce inter-disciplinary rivalry within the teaching hospitals by ensuring that all critical stakeholders are involved in the composition of the Boards of the teaching hospitals.

“This Bill is in tandem with global best practices with special references to the United Kingdom, United States of America and other countries where medical training have been successfully implemented through collaborative efforts of all practitioners,” Hon. Salam explained.

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In a joint World Press conference held earlier today in Abuja by the World Health Organisation (WHO) and the National Primary Healthcare Development Agency (NPHCDA) the WHO Country Representative in Nigeria, Dr Walter Kazadi Mulombo has confirmed that WHO has secured 16 million doses of the AstraZeneca COVID-19 vaccines for Nigeria through the COVAX Facility. This is the amount alocated to Nigeria out of the 88 million allocated to Africa.

The Executive Director of National Primary Health Care Development Agency (NPHCDA) explained that the press conference became “necessary in order to ensure that just a few of us do not bring our country to ridicule.”

COVAX received requests from 72 countries around the world, of which 51 countries were considered by the review committee as “ready” (Nigeria was among these countries) and 18 countries in total were finally chosen to receive initial Pfizer Vaccine doses. Demand for the initial allocation of 1.2 million Pfizer vaccine doses was exceptionally high.

Unfortunately, Pfizer has a limited capacity to handle so much demand from so many countries at once so it was not feasible to provide each of these 51 countries with Pfizer doses, amongst several reasons.

As at the 18th of January deadline COVAX received 13 submissions from Africa alone and a multi-agency committee evaluated the proposals of which 9 were recommended as ready to deploy the Pfizer vaccine including Nigeria.

The WHO also emphasised that it had not disqualified any country in Africa from accessing COVID-19 vaccines through the COVAX facility and reiterated its aim to support all countries to access Covid-19 vaccines as quickly as possible.

Dr Mulombo was reacting to the rumours of disqualification of Nigeria from access to COVID 19 vaccines. He said “Currently, all countries on the continent are expected to start accessing the AstraZeneca/Oxford vaccines by the end of February.” adding that “WHO has not disqualified any country in Africa from accessing COVID-19 vaccines through the COVAX facility, but rather is supporting all countries to access vaccines as quickly as possible.”

Epidemiological data was taken into consideration, the decision was taken to proportionally balance the number of self-financing and AMC Participants, as well as Participants across all 6 WHO regions. Other factors taken into consideration were the mortality rates from COVID-19, the number of new cases, the trend in the number of cases, the population of countries and the availability of the appropriate Cold Chain equipment.

Countries like South Africa received more of the Pfizer allocation because they have the new strain of the COVID-19 virus, has the highest mortality rates and is struggling to contain transmission.

Nigeria has received over 18% of the total doses of the AstraZeneca Vaccine allocated to Africa making the country the largest recipient of the Vaccine.

The WHO representative states that the AstraZeneca Vaccine is under review by WHO for emergency use listing. In Addition there is also an inittial limited volume of Pfizer Vaccines available through the COVAX facility.

The NPHCDA has demonstrated capacity for storage and distrubution of the Covid-19 Vaccines on a National scale. This is as demonstrated in their new National Strategic Cold Store (NSCS) which has an Ultra Cold Chain Equipment (UCCE). These were comissioned under the oversight of the Presidential Task Force on COVID-19 (PTF) and Federal Ministry of Health (FMOH). The Ultra Cold Chain equipment can store over 400,000 doses of the Pfizer vaccine at recomended temperatures.

The NPHCDA has categoricaly stated that it has the capacity to store any type of vaccine that is allocated to Nigeria.

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