Published On: Tue, Nov 7th, 2017

Challenges in State House Clinic and ways out

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By Lawrence Olaoye

The State House Clinic has been in the news for negative reasons in recent past. There have been reports that patients at the Clinic are complaining for lack of drugs and equipments at the facility and this has generated a lot of negative comments from the citizenry.
The Clinic primarily established to cater for the President, the Vice President and other top notch in government is meant to provide top-rated medical services for the people and at least reduce incidences of medical tourism. It is by design meant to provide free consultation and drugs to the patients who patronize it.
Like everything free in our society, the facility has attracted a lot of patients owning not only to the high quality of services provided but also to the fact that complex medical issues are treated with no hassles. The State House Clinic is populated with medical experts who can hold their own anywhere in the world.
With the recent economic reality, many more patients with weakened financial status, who hitherto patronize private and public hospitals charging fees for consultation and drugs, have devised means of getting enrolled in the State House Clinic.
These perhaps explain why everyone gravitated towards the State House for treatment of any ailment from headache and flu to the most complex of medical predicaments. As at the last count, the facility caters for over 10,000 patients and all these for free!
Until recently, the facility has been able to at least carry out its functions with commendations coming from the people. But with shortfall in allocations and releases to the management of the facility experienced in the 2017 appropriation, notwithstanding the high cost of maintenance of its equipments, there is obviously bound to be some hiccups in its operation.
According to the Permanent Secretary of the State House, Jalal Arabi, it costs the Clinic a whopping sum of N2 million monthly for the maintenance of its Magnetic Resonance Imaging (MRI) and other scan machines amongst others. This high cost of maintenance can only be sustained with adequate budgetary allocations and timely releases. These high-tech machineries do not understand dearth of funds or downturn in economy, they must be constantly overhauled for them to function optimally.

Budgetary allocations
Being a wholly government owned and run facility, the State House Clinics depends solely on budgetary allocations from the federal government. But with the advent of economic recession in the country, the facility, like most others, suffered its dire consequences.
The Permanent Secretary, while defending the proposed N3.219 proposal for 2015 budget at the National Assembly, told the lawmakers that the government intended to upgrade the facility to a state of excellence. This, according to him, would reduce the incidence of medical tourism and save the much needed foreign exchange for the country.
But between 2015 and 2017, the State House Clinic received only 32.97 percent of its total capital budget, while 48.41 percent was released for its recurrent appropriation. This was a reaction from the Presidency to a misleading report that the facility got N11.01 billion released to it within the same period.
According to the Permanent Secretary, “out of the total Capital Appropriation of N2,941,062,044.00 and Recurrent Appropriation of N465,935,358.00 for the period under reference, only the sum of N969,681,821.53 (representing 32.97%) for Capital and N225,575,200.60 (representing 48.41%) for Recurrent was actually released.
Arabi also said there was zero capital allocation for the Medical Centre in 2017, while out of the N331,730,211.00 being recurrent appropriation for 2017, the actual amount released up to September was N91,370,053.60 (representing only 27.54%).”
Arabi emphasised that the figures were verifiable from the Ministry of Finance, Budget and National Planning.
He observed that during the three-year period under review (indeed two years since no capital allocation for 2017), and despite the shortfalls between budgetary provisions and actual releases, the Medical Centre continued to provide free services to the over 10,000 registered patients annually. In addition, the Centre has continued to execute on-going projects.
Giving further insight into the scope of the Medical Centre’s clientele, Arabi stressed that apart from the Presidency, other beneficiaries of the free services include political appointees, the military, para-military, other security agencies, members of the National Assembly, and the general public.
In the words of the Permanent Secretary, “Considering the unrestricted patronage base and free services of the State House Medical Centre, coupled with the funding hiccups and periodic receipts, it may not be far-fetched to notice gaps between demand and supply of medical equipment and consumables at certain stages of the budget circle.”
The foregoing however suggested that with adequate funding, the Centre can return to its path of excellence; stocked with drugs and brimming with state of the art facilities to take care of the people and thereby reduce the incidences of medical tourism.

Way Forward
It has become obvious that the major constraints of the Clinic now is insufficient funds. In a situation where its budget could not be increased with assurances of releases to match, chances are that the facility may not be able to continue to deliver on its mandate. The litany of complaints will therefore continue unrestrained.
This calls for the management to think out-of-box in order to prevent further rots in the facility. The Permanent Secretary, having studied the situation, has suggested that the facility be commercialized to ensure greater efficiency.
This suggestion means that those patronizing the Clinic would be charged some fees for the services rendered. Others have added that such charges should be subsidized as the current freebies in form of consultation and supply of drugs to patients are obviously unsustainable.
Considering the class of people patronizing this facility, charging them tokens should not be a burden. This is against the backdrop of the fact that most of them can afford to pay for the best of treatments both at home and abroad. Such funds should be used to upgrade the Clinic and elevate its status to one of the best in the world.
When the facilities are upgraded and its members of staff are world class, its patronage is likely to increase and the goal of discouraging medical tourism would be realized.
Again, since majority of those patronizing the Clinic comprised of government officials and civil servants, they should be made to domicile their National Health Insurance Scheme (NHIS) in the facility. Substantial percentage of their medical bills could be settled through the insurance scheme while the patients offset the meager remainder.
With these, coupled with a well focused and disciplined management, the dust raised by non availability of drugsand inability to maintain the Aso Clinic’s equipments would become a tale told in the moonlight meant only to entertain toddlers.

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