•Tinubu
Pharmacists under the auspices of the Pharmaceutical Society of Nigeria (PSN) have petitioned President Bola Ahmed Tinubu calling for a more equitable system for political appointments in the health sector, which is currently skewed to favour physicians.
The petition, signed by Pharm. Ayuba Ibrahim Tanko, PSN President, and Pharm. Gafar Madehin, PSN National Secretary, underscored the need for a more cautious strategy for appointments within the health sector’s Ministries, Departments, and Agencies (MDAs), reports Daily Independent.
Entitled, “An Appeal for More Circumspection in Appointments in the Health Sector,” the PSN petition cried the trend that it claimed had assumed worrisome proportions two years ago.
Since June 2023, PSN said that it has observed a troubling trend where nearly all key positions in the health sector have been filled by physicians, sidelining other essential healthcare professions. Lamenting, it alleged that the trend is particularly disturbing in light of Prof. Ali Mohammed Pate’s (Coordinating Minister of Health and Social Welfare) duty to create a sustainable and harmonious healthcare workforce.
A Worrying Trend Since June 2023
The PSN’s statement highlights a troubling trend observed since June 2023, where nearly all significant appointments in the health sector have been filled by physicians. The petition partly reads, “The PSN wishes to draw Your Excellency’s attention to the nature of political appointments in the Ministries, Departments, and Agencies (MDAs) within the Health Sector, particularly from June 2023 to the present.
“We observe with concern that nearly all appointments in this multidisciplinary sector have been awarded solely to one profession- Medicine-at the significant detriment of other healthcare professions.
“This observation is particularly relevant given the specific mandate assigned to the Honourable Coordinating Minister of Health and Social Welfare, Prof. Ali Mohammed Pate, upon his appointment, which focused on building and harmonizing a sustainable healthcare workforce.
“A random review of these appointments may reveal the challenges we face, as the full ramifications of these decisions begin to adversely impact non-physician health professionals in unprecedented ways.”
The association called for a multidisciplinary approach, saying that this is essential for effective healthcare in the country. Unfortunately, this one-sided approach, they argued, undermines the contributions of other healthcare professionals and jeopardises the multidisciplinary nature of healthcare delivery in Nigeria.
“The health sector is inherently multidisciplinary. It is crucial that all healthcare professions are represented in leadership roles to ensure a balanced and effective healthcare system,” Tanko emphasised.
Pate’s Mandate: A Call For Inclusivity
The petition stressed that PSN’s concerns are particularly poignant given the mandate of Prof. Pate. Elaborating that the Coordinating Minister of Health and Social Welfare role was expected to focus on building and harmonising a sustainable healthcare workforce.
However, a review of recent appointments reveals a troubling pattern of two Ministers in charge of the Federal Ministry of Health (FMoH) are physicians, as are four other ministers in different ministries who are members of the Federal Executive Council (FEC), PSN said.
The Society also pointed out that the National Coordinator of the Presidential Initiative for Unlocking the Healthcare Value Chain (PVAC) is yet another physician.
The implications of these appointments are beginning to manifest, with non-physician health professionals facing unprecedented challenges. The review further indicated that all Chief Executive Officers (CEOs) of the 73 Federal Health Institutions are physicians, as are the heads of key agencies such as the National Primary Healthcare Development Agency (NPHDA), the National Health Insurance Authority (NHIA), and the National Agency for the Control of AIDS (NACA).
“All CEOs of the 73 Federal Health Institutions are physicians, as are the heads of key agencies like the National Primary Healthcare Development Agency (NPHDA) and the National Health Insurance Authority (NHIA),” noted Madehin. “This overwhelming dominance of one profession in leadership roles is detrimental to the entire healthcare system,” Madehin stated. “It creates an environment where the voices and expertise of other healthcare professionals are marginalised.”
The Implications Of Unbalanced Appointments
The PSN argued that the current trend not only undermines the contributions of non-physician health professionals but also jeopardizes the overall effectiveness of Nigeria’s healthcare system. “How will Nigeria ever attain Universal Health Coverage (UHC) if Social Health Insurance is managed by individuals who have never appreciated consensus building in health management?” Tanko questioned.
A Call For Equitable Representation
The PSN acknowledged the constitutional prerogative of the president to make political appointments but insisted that a more balanced approach is necessary. “We urge the government to exercise greater circumspection in these appointments,” Tanko said. “It is concerning that even roles traditionally associated with other healthcare professions, such as the Chairmanship of NAFDAC, have been filled by physicians.”
PSN also expressed concern about the management of health initiatives, highlighting that efforts to unlock the healthcare value chain are also led by physicians. This trend raises questions about the inclusivity of health policies and programmes, the body bemoaned in the petition.
Controversial Appointments And Their Implications
The recent appointment of Dr. Ibrahim Oloriegbe, a former senator known for controversial legislative efforts, as Chairman of the NHIA has further fueled concerns among the body of pharmacists. PSN alleged, that his past attempts to legislate exclusive titles for Nigerian physicians within hospital walls through the failed Medical and Dental Council Amendment bill in the 2021/22 legislative year exemplify the challenges faced by non-physician health workers.
PSN argued that Nigeria cannot expect to achieve Universal Health Coverage (UHC) when the management of social health insurance is in the hands of individuals who do not value consensus-building in health management.
The NHFRA Bill: A Cause For Alarm
The PSN has also expressed alarm over a proposed National Health Facility Regulatory Agency (NHFRA) bill, which they claim was developed by a predominantly physician-led team. This bill, they argue, seeks to restore privileges that physicians could not secure through the National Health Act of 2014 and aims to repeal the enabling Acts of other professional regulatory councils.
“This bill represents a significant threat to the integrity of our healthcare system,” Tanko warned. “It is essential that all healthcare professionals have a voice in shaping policies that affect their practice.”
Multidisciplinary Approach As The Way Forward
Given these developments, PSN called for a more diligent and equitable approach to appointments in the health sector. “We envision a health system where all professionals—be they pharmacists, nurses, or allied health workers—are respected and included in decision-making processes,” Tanko stated.
The PSN draws parallels to the building and works sector, where architects, engineers, and surveyors coexist with mutual respect for their respective roles. “Healthcare should be no different,” the PSN President asserted. “A collaborative approach is essential for the stability and effectiveness of our health system.”
PSN’s Commitment To Resuscitate Nigeria’s Health System
As the PSN continues to advocate for equitable appointments, it remains committed to providing the necessary building blocks for a resuscitated health system. “We will not relent in our efforts to ensure that the voices of all healthcare professionals are heard and respected,” Tanko concluded.
In a time when Nigeria’s health system faces numerous challenges, the PSN’s call for balanced representation in health sector appointments serves as a crucial reminder of the importance of inclusivity in healthcare leadership. The future of Nigeria’s health system may very well depend on the government’s willingness to heed this call for change.
