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The Pharmaceutical Society of Nigeria (PSN) heartily appreciates the dynamic gover
nor of Lagos state, HE Akinwunmi Ambode for the creation of pharmacists’ consultancy cadre in the Scheme of Service of Lagos state, Nigeria. This is a milestone in the history of health care system in Nigeria in general and Lagos state in particular. The governor is surely in a march to advance mankind.
This circular was, however, visited with an uncivilized growing dictatorship and cruel tyranny from the NMA where they threatened and requested for the withdrawal of the circular, with even a deadline. PSN ordinarily never wanted to join issues with NMA, considering the fact that NMA is in crisis with itself in an ego cocoon, complicated by gross ignorance, incompetence and clear display of deficiency of wisdom that lengthened the strike action with JOHESU. This has turned the health sector into ridicule, a situation any serious minded body will avoid as enshrined in the Hippocratic Oath. At times like this, when inter-professional collaboration is the way forward in International best practices, NMA has chosen the path of desperate destruction.
For the sake of clarity, let me educate NMA on global best practices.
The World Health Organization (WHO), is the highest body in the world which set or make a standard for international best practice on all issues of health. Just as other systems of the world are so dynamic, so is the healthcare delivery system-dynamic in all ramifications. And any government that proclaimed good governance should always refer to WHO standard on regular bases to meet the health needs of its nation. To buttress our precarious situation, let’s look at current International best practices according to WHO ranking (April 2018) under the following headings:
The first 5 best hospital systems in the worldThe worst 5 hospital systems in the worldConsultancy/specialists status in the two systemsHealth administration in the two systems (best and worst)
The first 5 best hospital systems in the world
According to WHO ranking of 191 member countries April 2018, the following are the best 5 with effective healthcare delivery system
FranceItalySan MarinoAndorraMalta
The worst 5 hospital systems in the world
The bottoms up ward, which are considered the worst 5 among 191 member countries are:
Sierra LeoneMyanmarCentral African RepublicDemocratic Republic of the CongoNigeria
Among the 191 WHO member countries, Nigeria is sadly ranked 189 in healthcare service provision. It’s is very obvious that in Nigeria, healthcare service delivery is averse to change. We are where we are today because of the cataclysmic barrier NMA catalysed by their poor choices in the health sector. These barriers prevent the policy makers from seeing reality from the international point of view. Lagos State Government is absolutely in line with harmony and inter-professional needs to attain International best practices in the healthcare delivery system.
To understand global best practices, according to a 2017 report of the Economists Intelligence Unit, on the global access to healthcare index: UK, Canada, Australia and USA make the top 10. While Nigeria ranks among the bottom 6 overall of the 60 countries listed on the same global index. Let me take a drive with you to the practices in these countries
Health administration in the two systems
Health administration entails administrative structure in the health sector, the incumbent ministers and other heads down the structure and the bases or criteria of selection will be x-rayed to justify current positions in WHO ranking.
CountryMinister of HealthSpecialtyFranceMorisol TouraineEconomicsItalyBeatrice LorenzinJournalism and politicsSan MarinoDidier GamerdingerLawAndorraCristina Rodriguez GalanMolecular BiologyMaltaChristopher FearneMedicineUSAAlex AzarLawGermanyJens SpahnLawSaudi ArabiaTawfiq Al RavishMathematicsIsrealYaakov LitzmanTorahSpainDolors MontserratLawIndiaJagat Prakash NaddaLawCanadaGenette Petitpas TaylorSocial works
A look at the above appointments is a testimony that performance index is dependent on neutrality and administrative prowess and not on ‘medical qualification’ as commonly claimed by Nigerian medical doctors. Incidentally the Director General of World Health Organisation (WHO), Tedros Adhamon, an Ethiopian, studied Biology. If he, and all those above, were in Nigeria, NMA would have protested. This is the situation the NMA of Lagos is attempting, and writing to a Governor as knowledgeable as HE Ambode Akinwunmi- a distinguished administrator who knows his onions and is committed to advance mankind.
The criterion for selection in these great and successful countries is based on professional and administrative experience and this is the same down the administrative structure. In Nigeria (‘International best practices’ epitome!!), the criteria for selection are solely based on MBBS qualification and it is also the same down the administrative structure. Does that tell you the reason(s) for failure? Yes indeed. What a shame!!
Consultancy/Specialist status
Specialists and consultants in various fields in healthcare are a common trend. They are mandated to train and award fellowships based on their skills and competences. These healthcare team members earn specialist allowances as they render services to the patients. In this current loggerhead, NMA said the consultancy cadre is sacred to only doctors (yet, citing certain international best practices). We run Fellowship in the West African Postgraduate College of Pharmacists to improve our knowledge, attitudes, skills and competences to promote and maintain a high standard of professional pharmacy practice. We have Primary level (1 year), Part One (Two years) and Part two (Two years). Pharmacists undergo a minimum of 12 months Residency training and present dissertation that are assessed by erudite academics (Professors and all PhD holders), before the award of Fellowship in various specialties. In fact, in the USA, a Nigerian (Dr Teresa Pounds- a consultant pharmacist) heads the Residency training and runs the consultancy program in one of the biggest Universities.
I read with utmost dismay, as NMA has turned both Judge and jury in its case. Representing all parties in the health sector. Deciding the fate of everybody and declaring others as they will. This has messed up the sensibilities and sensitivities of the health sector by incessant and unrelenting relegation of others. What we have is a contradistinction to the labour law. NMA determining what others should get when NMA is not an employer of labour. This negates labour engagement and a breach of human rights. I all along thought the NMA was a serious union, until recently when the deficiency of purpose and leadership was obviously testified especially in this pharmacy consultancy cadre as embraced by a leading state in Nigeria.
A profession regulating another? This is strange. Only in an indecent and decaying system can this happen. Can a Building engineer regulate the training of a civil engineer? Can an Architect tell government not to recognize the M.Sc of a Building engineer? Nigeria is not and should not sink so abysmally. Other health professional have the right to develop themselves in line with best international practices-sincere practices please; NOT the one only NMA has access to. The interference with growth and development of healthcare in this country is becoming an embarrassment to civility.
The pharmacy consultancy cadre, as approved by Lagos State Government in the service of scheme is the best thing the health sector can achieve. PSN shall not relent in promoting the health sector in Nigeria. We commend the Lagos state Government for this bold action of International best practice.
Pharm.Ahmed I Yakasai, FPSN, FNIM, FNAPharm, FCPharm
President, Pharmaceutical Society of Nigeria (PSN)
Pharm. Emeka C. Duru
National Secretary
Pharmaceutical Society of Nigeria (PSN)