Shortly after President Muhammadu Buhari came into office just before the end of May in 2015, he dissolved the boards of federal parastatals.
The action was not unusual of a new administration. But close to two years after, the vacancies created by the dissolution of the boards are yet to be filled, showing a pattern of lethargy in decision making for which the president has received widespread criticism.
The delay by the federal government in appointing Chief Medical Directors, CMDs, to run some tertiary health institutions across the country is generating mixed reactions among health professionals and stakeholders in the sector.
Currently, out of the 52 tertiary health centres across the country, about 20 have no CMDs. These institutions have been run by interim heads for between six months to two years, against the provision of the Acts that established them.
The establishment Acts do not envisage that any of them would be run by interim head beyond six months at a time. Health centres caught in this breach of law include psychiatric hospitals, Federal Medical Centres and Teaching Hospitals across the country.
Some of the affected ones are Federal Medical Centres in Ido Ekiti, Abeokuta, Asaba, Lagos, Owerri, Owo; Federal Teaching Hospitals in Abuja, Kano and Maiduguri; and Pschychiatric hospitals in Sokoto, Maiduguri, Calabar, Lagos; Birni-kudu, Uselu, among others.
In a telephone interview with Premium Times, the spokesperson for Federal Medical Centre, Abeokuta, Segun Orisajo, confirmed that the head of the institution has been holding the office in acting capacity since June 20, 2016. But he said this has not in any noticeable way affected the activities and smooth running of the institution.
“The acting head has been part of the institution for 25 years and he is currently one of the chief consultants in Obstetrics and Gynaecology and knows the terrain of the institution. So there is no cause for alarm as the people in the institution are willing to work with him and the activities in the institution have been going on smoothly.
“The prerogative of appointing a Chief Medical Officer is that of the Federal Ministry of Health and I am sure they are already doing something about it because I know they have interviewed prospective candidates for the position and we are expecting a positive outcome very soon. As for the centre (FMC, Abeokuta), there is no loophole in the system based on administration”, he said.
Speaking in a similar vein, the Chairman of the Osun State chapter of the Nigerian Medical Association, NMA, Tokunbo Olajumoke, said although it is true that some health institutions in the country have had no substantive heads for a while now, the situation does not call for alarm as it does not have any effect on governance and decision making in such institutions, especially when such institutions have boards to regularize their activities.
“I know that the Federal Medical Centre in Ido Ekiti for example is being headed by the former Chairman Medical Advisory Committee (CMAC) and is the highest officer after the CMD. He has been an acting head for a while now and I don’t see how this should affect the smooth running of the affairs of the hospital.
“The hospital has a board which oversees its activities even with the presence of a CMD and the CMAC is usually part of the board. And this is not strange because even when the institution has a CMD, its activities are still governed by a board and the Federal Ministry of Health which still oversees the activities.
“To my best of knowledge, all federal health establishments should have such boards which mean there is likely to be continuity as the CMAC already knows what is happening within the system”, he said.
A medical consultant at FMC Ido –Ekiti, Sam Ukperi, however, disagrees with the position of the two earlier respondents.
He said there is a need for the establishment to have a substantive CMD as this will make the person accountable to the institution and staff as well.
“There are lots of decisions that need to be taken but because the person is in acting capacity, his authority to do so can be challenged”, he contended.
“I don’t know why the government is not following due process of appointing the CMD. After they have done a selection and conducted interviews for candidates, so why are they delaying the appointment?
“The person in Asaba has been acting for two years now. There are some actions that a substantive head should take that the acting cannot because they do not have the power and jurisdiction to do so.
“It is not that the delay in appointing a substantive head is affecting the health institution because the problem that he will face is what the acting head too will face; but the government’s inaction just seems that the government is not ready to invest in health institutions because they are not giving priority to health in this country.”
A petition received by Premium Times from some aggrieved medical professionals had stated that the Federal Ministry of Health, after stages of examinations and interview process, had made recommendations to the presidency for the positions to be filled in almost all the institutions that do not have substantive heads as far back as six months ago. The petitioners said it seems to them that the federal government is not ready to do anything about it.
The group urged the government to stop playing politics with the fragile healthcare delivery system in the country, saying this is predisposing professionals in the sector to unnecessary and undue politicking, as prior to this administration such appointments were treated with urgency.
Sources at the ministry told PREMIUM TIMES the ministry had sent its lists of successful candidates to the president for confirmation, but was yet to receive confirmation on such nominees and could not act without such.
The health ministry, however, says the procedure for the appointment is ongoing.
The Director of Media and Public Relations of the Federal Ministry of Health, Boade Akinola, said the ministry was aware that there are health institutions without substantive heads and that it was working towards filling the vacancies.
“There is a procedure for the appointment of heads of agencies in the government and the process is on-going and would be announced very soon,” she said.
The Osun State NMA Chairman, Mr. Olajumoke, however clarified that interim appointments can be renewed after six months.
“I see no reason why there should be issues unless the people doing so are doing it for political reasons. I have worked in an institution which had an acting head for a year and things went smoothly.
“Though I am not supporting the Federal Government for not appointing CMDs for the institutions, because it is not good for the system not to have an actual head so as to ensure efficiency and accountability. But every institution has its way of politicking and it is the political undertone in this institutions that is meant to be looked into and this could be one of such”.
Healthcare centres are not the only institutions in the health sector that are affected by the government’s inaction in filling leadership vacancies. The board of the Medical Dental Council of Nigeria, MDCN, which is meant to be the regulatory body of the professionals, has not been constituted since the president pronounced all boards of parastatals dissolved.
The non-appointment of the MDCN board has been blamed for the proliferation of fake doctors across Nigeria.