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Ahmed Lawan and Femi Gbajabiamila

Reps move to include nurses, pharmacists, others in headship of teaching hospitals

Members of the House of Representatives on Wednesday 2 March 2022 expressed overwhelming support for a bill that sought to reconstitute the governing boards of federal university teaching hospitals across the country. The lawmakers expressed their support after debate on a private-member bill to amend the University Teaching Hospitals Board Reconstitution. The bill was sponsored by Hon. Bamidele Salam.

In his lead debate, Hon. Salam, representing Ede North/Ede South/Egbedore/Ejigbo Federal Constituency of Osun State explained that the bill sought to restructure the composition of the governing boards of tertiary health institutions with a view to making them more vibrant and efficient.

The bill further aimed to review the terminology of the heads of the hospitals, redefine the qualification of the head of hospitals, provide a definite tenure for office of the head of the hospitals, include students of Health Science in the training programmes of the hospitals and include hospitals established post-enactment of the extant legal framework in the schedule and for other related matters. It would be recalled that the current terminology used to refer to the head of a tertiary health institution in Nigeria is ‘Chief Medical Director’. He is accountable to the board of the institution. The Chief Medical Director is responsible for the execution of policies and matters affecting the day to day management of the affairs of the hospital.

The bill recommended that before one can qualify to be appointed CMD of a health institution, the one must be a medical or dental practitioner registered with the Medical and Dental Council of Nigeria of not less than 10 years post qualification. In addition, he or she must be a fellow of either the National Postgraduate Medical College of Nigeria or the West African Postgraduate Medical College or its equivalent registered by Nigeria’s Medical and Dental Council. He or she must have been a consultant for a minimum of 5 years. Administrative qualification and experience are only added advantage, amongst others. The medical or dental practitioners who solely enjoy the privilege of being made the Chief Medical Director constitute not more than 5% of the total number of medical personnel in the health industry.

The current legal regime excludes other health professionals like pharmacists, nurses, social workers, occupational therapists and physiotherapists, psychologists, bereavement counsellors, paramedics, dieticians, laboratory scientists and speech pathologists, amongst others from becoming Chief Medical Directors.

Section 5 of the Principal Act, which provides for the appointment of the CMD, also provided the functions of the office of the CMD, which include: the execution of policies and matters affecting the day to day management of the affairs of the hospital. 

A cursory study of these responsibilities reveals that the burden is purely administrative and has nothing to do with a particular department in the health profession.

In the United Kingdom, for example, one doesn’t have to be a medical practitioner to become a hospital administrator. All you need is to be a graduate of a high school (4 years); obtain a Bachelor’s degree in healthcare administration, business administration, or a clinical discipline (4 years); and a Master’s degree in healthcare administration (MHA) or a related graduate degree (2 years).

In the United States, there isn’t one specific path to follow to get a hospital administrator’s job. You may begin your career in some other role with that goal in mind (some start as doctors or nurses) and be promoted to the position. However, it is common for hospital administrators to earn a relevant degree—and an increasing number of employers now require a Masters degree as well.

Generally speaking, there are basic steps to becoming a hospital administrator. The first is to get a bachelor’s degree in health systems management and health services or related disciplines. The second is to get a Master’s degree in n hospital administration or healthcare administration. The third is to gain experience and other certifications such as American College of Healthcare Executives (ACHE) Accreditation or Certified Medical Manager (CMM) Accreditation etc.

It is clear from the above cross-country discussion that to be appointed as a Chief Executive Officer, one doesn’t have to be a medical doctor. Persons with Bachelor’s in Management or Administration with requisite experience can be appointed to head a hospital. Similarly, in the composition of the board of the hospitals, other critical stakeholders were not included. Greater attention was only paid to medical doctors. Against this background, the bill was proposed to address all these challenges and include all other health professionals in the capacity building and administration of the federal hospitals in Nigeria and related issues. 

Hon. Salam who solicited for the support of members explained that hospital administration is a specialty within the healthcare administration and one of the most advanced leadership careers in healthcare. It focuses on the overall operation of hospitals and other significant health facilities and requires both healthcare experience and administrative or management acumen.

 

“The purpose of the bill, therefore Hon. was to strengthen the administration mechanism of University Teaching Hospitals through the broadening of its administrative heads and entrench greater professionalism in the management of our medical tertiary institutions. The bill will also considerably reduce inter-disciplinary rivalry within the teaching hospitals by ensuring that all critical stakeholders are involved in the composition of the boards of the teaching hospitals. This bill is in tandem with global best practices with special references to the United Kingdom, United States of America and other countries where medical training have been successfully implemented through collaborative efforts of all practitioners,” Hon. Salam explained. 

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