Guest Columnist By Jude Eze
Today, we’ll round off the last part of this topic. I am continuing it against popular demands and persuasion from numerous followers and readers, to discuss either Anambra election or the #EndSARS judicial panel report. Those were current affairs. But this space is not all about current affairs. It inclines more to discourses on topical issues across all sectors of national and international life. I resisted them for obvious reasons.
First, Anambra guber election was a shamble outing, not just because whenever INEC says they are ‘ready’, the exact opposite obtains in the field, but due to record-breaking voter apathy that markedly trailed it, yet many hail it as a success. How could a state with more than 2million voters sit back and allow a fraction of less than 5% of the registered voters determine the fate of the whole state?
A great Anambra son, former FRSC Boss, and former Aviation minister, Osita Chidoka’s reaction summed my opinion: “You sat at home screaming No Elections, 104,037 voters determined the Governor of Anambra State, less than 5 per cent of registered voters. The elected Governor will oversee state budget of at least 400 billion Naira over the next four years. If you add Local Government funds, it will be over 700 billion Naira.
You sat at home and said voting does not count, the election is already rigged. Two hundred nineteen thousand five hundred and eighteen persons (219,518) less than 10% of registered voters went out, and the parties bought votes from between 1000 and 5000 Naira per vote.
If voters don’t count, why did the Politicians buy votes? At an average of 3,000 per vote, a Governor can be elected with less than 350 million Naira by a hungry minority. If 1m voters had come out, it would have been difficult…”
Secondly, I avoided discussing the #EndSARS report because, I could not resist being emotional each time I reflect on that most patriotic civil match ever, in the anal of our history that exposed the despotism of our leaders. And as a writer, emotions should not mingle with your sentiments, otherwise your judgements would be fraut with logical errors and misconstrued by sane minds.
So, let’s continue with the epilogue of last week’s discourse on the obloquious opprobrium of quackery in our healthcare practice. We had implicated the dangers of amateurish infiltration of health care by jackleg practitioners previously. This piece will tone up as open letter to all regulatory agencies of the various professional medical/health workers. The Medical and Dental Council of Nigeria (MDCN), Radiographers Registration Board of Nigeria (RRBN), Nursing and Midwifery Council of Nigeria (NMCN), Medical Laboratory Council of Nigeria (MLSCN), Medical Rehabilitation and Physiotherapist Board of Nigeria (MRTBN), Pharmaceutical Council of Nigeria (PCN), Medical Records Registion Board of Nigeria (MRRBN) etc had in their respective complacency been accomplices to quackery of any sort in Nigeria. These sleeping giants need to wake up if we are to make any headway.
On the part of the patients (who can be me or you), there is need for them to know their rights. They should learn to demand their rights. Ask questions bordering on what, why and how their care is being or will be administered. There is a thing called Patients’ Bill of Rights (PBoR) launched by the federal government in July, 2018. It empowers the patients and tasks healthcare givers the rights and obligations of getting the best, and giving out correct information regarding treatments respectively.
That document has not been implemented since its launch. And some healthcare operators are taking undue advantage of the situation to take toll on the patients. Nigeria’s problem has always been implementation of laws. Recall the presidential executive order, eight months ago, which empowered law enforcement agencies to arrest and prosecute anyone not complying with Covid-19 prevention protocols. Till date, there is no implementation.
PBoR presents the needed checks on practitioners in diverse fields of medicine against abuse of rights/privileges. The era of physicians posing like unquestionable maximum arbiter of life and death should have gone, if this bill had taken full force. Patients will leverage on available medico-legal instruments to probe their loved one’s management by health workers. Questions like: “what was the provisional diagnosis? What is the Laboratory and radiodiagnostic test results? what is the relevance of drug prescriptions to clinical manifestations? Are referrals made in tandem with clinical diagnosis?” etc will arise
PBoR also checkmates the evil of kickbacks and rebaits in healthcare practice.
Physicians and other healthcare professionals are in position to refer business to a variety of individuals and entities: specialists, home health agencies, and others. But what criteria are used when deciding where patient referrals should go? Is it always what is in the best interest of the patient? Are there other unethical and pecuniary motivating factors?
Have you ever reported sick to a clinic and found yourself being refered to another clinic for a particular procedure, be it diagnostic or curative? Chances are high that someone has made thousands of naira off your coffers by that referral, as an inducement called ‘kickback’ which is the payment to a recipient as compensation or reward for providing ‘favorable’ treatment or services to another party. It can come in the form of money, gifts, credit or anything of value and may be viewed as a corrupt practice that interferes with professional’s ability to make unbiased decisions.
Paraphrased, it is the underhand reward by a healthcare provider for anyone (mostly his/her colleagues) that refers a patient/client to patronize his/her facility/services.
Some investigative studies released by Premium Times last year exposed the unsettling fact that most healthcare businesses in Nigeria are sullied by the evil of kickbacks.
There are threefold demerits of kickback.
First, it runs against the Hippocratic oath, by increasing the burden of the patient, akin to the adage of “curing someone with pills and killing him with bills.”
Second, it leads to compromise in the treatment the patient receives. The accuracy, precision and merits of the choice of referrals are questionable. For instance, patients will not be refered to the Laboratory facility that doesn’t give kickback even though it offers the best diagnostic service, but will be deceived (or prevailed upon) to patronize the one that may not meet the patient’s health demands, just because it played the underhand game of inducement.
Third, it is also a dehumanizing to use patients like commodities (slaves) to satisfy pecuniary interests.
It is the more reason why there is much clamour for ISO accreditation of all public and private healthcare facilities in the country, because kickback is outlawed by ISO codes.
In all, it is unethical to engage in kickbacks, whether as a receiver or giver.