ABUAD 20th Oct 2024.
EKITI HEALTH SYSTEM NEEDS A NEW HOSPITAL, “LIKE A HOLE IN THE HEAD.
“I first came across the phrase “Like A Hole In The Head” in James Hadley Chase novels many decades ago. My friend and I read his several novels with unusual rapacity. In almost all these novels, we came about this phrase: Like A Hole In The Head.
80-BED HOSPITAL IS A HOLE IN THE HEAD OF EKITI HEALTH.
Ekiti Health System needs this new 80-bed hospital like a hole in the head.
The most appropriate scenario that I have ever come across to use the phrase “like a hole in the head” is the new 80-bed hospital commissioned by the Governor of Ekiti State. I know I will be crucified by the tortoises and sycophants surrounding the governor, but I make bold to say that Ekiti Health System needs this new hospital like a hole in the head. Ekiti Health System will be worse off. Come with me.
PRIMARY HEALTH CARE CENTRES ARE BETTER.
This new 80-bed hospital will not significantly advance the PUBLIC HEALTH in Ekiti. This policy betrays the government’s lack of understanding of the trend in healthcare delivery all over the world and the essence of Sustainable Development Goals. For a start, 70% of health conditions attended to in our hospitals can be treated in Primary Health Care. They could be diverted to Primary Health Care. Yet secondary and tertiary health care institutions gulp up 60% of the health care budget in Ekiti. I sat in a conference where JKF lamented this imbalance but did nothing about it. Unfortunately, BAO has decided to make things even worse!
THE TREND IN HEALTH DELIVERY.
The trend all over the world is for ambulatory care to be delivered closer to the people rather than in hospitals. It is cheaper to construct and to manage, and it is more affordable and more accessible to the people. I am not sure anybody has told BAO about Health For All and Universal Health coverage. Secondly, there are 17 Sustainable Development Goals. Attaining health related SDG 3 does not necessarily entail building new hospitals. The federal government has been preaching Universal Health Coverage, which is the vehicle for SDG 3, but the State government is ploughing the opposite path. On this occasion, the state government is wrong. Very wrong.
THE AIMS OF SDG 3.
These include reducing maternal and child mortality, end epidemics, achieving universal health coverage, and protecting the environment by 2030. Of course, hospital treatment will be important to reducing maternal and child mortality, but many women and children die before reaching the hospital. Therefore, out of hospital services in our primary health care centres are better placed to reduce maternal and child mortality.
Only severe life-threatening cases should be brought to the hospital. Everybody else should be diverted to the Primary Health Centres. Simplicita. In medicine, the cliche is truer now than ever that PREVENTION IS BETTER THAN CURE. Reducing epidemics should be the principal priority of Primary Health Care Centres.
Public Health Practitioners will argue that the resources to achieve universal health coverage, to make health care accessible, accessible and affordable, to the population, lie predominantly outside hospital premises, but lay within the remit of Primary Health Care centres all over the State.
Without attempting to argue about it, all of us will agree that protecting the environment is not what hospitals are built to achieve and can be better implemented by Primary Health Care service policies.
SPEND THE MONEY IN PRIMARY HEALTH CARE.
If you are not following my train of thought thus far, what I am accusing this government of doing is neglecting Primary Health Care institutions and universal health coverage, described by Margaret Chan as the greatest idea that public health offers, because it offers the greatest health gains. A new 80-bed hospital is like a hole in the head for Ekiti Health System. Functional Primary Health Care Centres where everybody receives evidence based health care and which acts as the gateway to the hospital achieves better health and well-being for the population.
A LEGACY PROPERLY SO CALLED.
I wish to congratulate the doctors who will work in the new 80-bed hospital. They have got something out of this government that ordinary people will never get. But I remind them that the new hospital will increase competition for private secondary health care services without advancing universal health coverage in Ekiti. We are celebrating a PYRRHIC victory.
Congratulations, too, to Governor BAO for an inconsequential legacy for which the health of the people was brutally sacrificed for political capital. Accessible, affordable health care has been sacrificed by BAO to leave a legacy of an eighty bed new hospital. Nothing is transformative nor disruptive about this. In Ekiti, “health is wealth” will remain a mirage. The economic productivity of Ekitikete will continue to falter.
Professor Olikoye Ransome Kuti will be reeling in agony in his grave. The policy he fought for has been turned upside down in quest for a cheap legacy rather than genuine interest in people’s health and well-being that provides a better legacy. A legacy properly, so-called, is one that delivers primary health care based universal health coverage for all Ekitikete.
