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HEFAMAA: Handling Public Hospitals With Kid Gloves

Allegations of bias and double standards trail the Health Facilities Monitoring and Accreditation Agency, even as it fights off the claim.

HEFAMAA: Handling Public Hospitals With Kid Gloves

Whenever the Lagos State Health Facilities Monitoring and Accreditation Agency sneezes, private hospitals and laboratories always catch cold.

Since its establishment in 2006, HEFAMAA has lived up to its name as the watchdog of quality and efficiency health care delivery in the state. In the last one year alone, it has axed over 100 private hospitals and shut 319 illegal pharmacies. But many people believe that while HEFAMAA has performed above average in its oversight functions over private hospitals, that has not been the case with public hospitals.

Statutorily, HEFAMAA’s mandate extends across public and health facilities. A key function of the agency is to “set required minimum standards for the establishment and operation of health facilities, both in public and private health sectors.”

Stakeholders say while the spotlight on private hospitals and other medical establishments will sanitise the system, it is also necessary to address many infractions prevalent in public hospitals.

That is the position of the Lagos State Chairman, Association of General and Private Medical Practitioners of Nigeria, Dr. Adeyeye Arigbabuwo. In a telephone interview with our correspondent, Arigbabuwo admits that though private hospitals, pharmacies and laboratories provide 80 per cent of health care delivery in the state, they are not being treated fairly by HEFAMAA.

“HEFAMAA is a baby of the health reform law in Lagos. The complaint has always been about the agency concentrating its energy on the private sector. The challenge is that it is rather difficult for the private sector to come up with a yardstick to measure the imbalance, though HEFAMAA has been saying that it has been monitoring and accrediting public health facilities as well.’’

A general practitioner, Dr. Olawumi Otusanya, holds the same view. Conceding that HEFAMAA has managed to put private hospitals in Lagos on their toes, he admits that public hospitals are often treated with kid gloves.

“HEFAMAA has done well in regulating private hospitals such that they meet up with basic standards in terms of infrastructure, personnel and service. But they do not have much effect on public hospitals. For instance, when patients go to general hospitals and they wait for hours, they just find a way of papering over it. They do not have power to close down government hospitals. But when the matter concerns a private hospital, they react.”

With an estimated population of 17 million people, there are 26 general hospitals, 256 public health care centres and 2,886 private hospitals, dental clinics, diagnostic centres and laboratories in Lagos. About 160 trado-medical centres are also functional.

And while the heat has been on private hospitals, no public health facility has been sanctioned by HEFAMAA since its establishment. The hospitals are often shut for reasons ranging from a dirty environment, non registration of facility, engagement of quacks and auxiliary nurses, among others.

In reaction, the Special Adviser to the Lagos State Governor on Public Health, Dr. Yewande Adeshina, insists that HEFAMAA does not engage in double standards and it is not out to witch-hunt any health facility, private or public.

“If the agency is being accused of witch-hunting, then that is far from what it should be. It should not be seen as any kind of punitive system; rather, it is a developmental system that is supposed to help our facility better positioned for service.”

Arigbabuwo says only HEFAMAA can address the allegations, urging it to publish its financial inflows from both the public and private health facilities.

“The public should be furnished with the money accruing to HEFAMAA through penal measures meted to both sectors. We have no such data yet,” he notes.

Efforts to speak with the Commissioner for Health, Jide Idris, were unsuccessful on Monday. One of the public relations officers, Bukola Bakare, told our correspondent that Idris was always very busy on a Mondays.

“Only the commissioner and the governor can give you information concerning anything and any agency here. When it comes to an interview, we can’t help you unless the commissioner is around,” she declared.

Meanwhile, for some of the affected private hospitals, it is different strokes for different folks: While some of them have been reopened, a few others, despite claims of restitutions, remain shut.

That is the lot of Chisom Hospital, a private facility at Orile-Iganmu, shut by HEFAMAA seven months ago. When our correspondent visited the hospital, HEFAMAA’s seal remained on the white storey building. Its proprietor, Dr. Okafor, who claimed to have met all the requirements necessary for the reopenening, decried the delay in action.

“I have borrowed money to pay the N850,000 penalty. I was sanctioned because I did not have an operating officer, a waste bucket and non registration with LAWMA for the evacuation of my medical waste. But I have since done all that.

“If what they are saying is true, then my letter is with Mrs. Adeshina who should sign it anytime from now,” he said.

Okafor however hailed HEFAMAA for ensuring that the standard of health care delivery does not fall. “In fairness to them, they are doing well. They ensure that private hospitals do not lag behind.”

That is also the position of Dr. Arinze Ezekweme, a medical doctor with Peculiar Hospital that was also shut down last year but which has since been reopened.

“I support what HEFAMAA is doing. If you are found wanting in any area, you should be sanctioned. Yes, I would love to see the agency do more with government hospitals, but at our own end here, we must ensure that we are not found wanting,” he asserted.

The state government has introduced certain reforms in the public health sector in recent times, obviously to strengthen the primary health care system and diffuse the burden on secondary and tertiary health facilities.

Last year, it embarked on the establishment of Maternal and Childcare Centres and flagship primary health care centres in each local government area of the state. They are mandated to provide a 24-hour service and tackle basic health challenges at the community level.

Source: Punch

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