Urgent Calls for Reform and Collaboration in Nigerian Healthcare
In a sombre and tragic turn of events, September 26, 2023, marked the untimely passing of Greatness Olorunfemi. Olorunfemi, a victim of a reported stabbing and assault by notorious ‘one-chance’ robbers on the Maitama-Kubwa highway in Abuja, tragically lost her life after being rejected for treatment at the Maitama General Hospital. A viral video circulating online suggests that the medical staff at the hospital had requested a police report before offering assistance, ultimately denying Olorunfemi the urgent care she needed. Heartbreakingly, the voice in the video mentioned her passing just 20 minutes later, shedding light on a distressing and concerning incident that raises questions about access to emergency medical care in such situations. This poignant event prompted the establishment of a nine-member investigative panel. The unfortunate demise of Greatness Olorunfemi, a young Nigerian citizen, has drawn attention to pressing issues within the Nigerian healthcare system.
The Patients’ Bill of Rights assumes paramount significance in this context as it serves as a cornerstone in the pursuit of justice and equity within the Nigerian healthcare landscape. This document encapsulates the fundamental principles that guide the relationship between patients and healthcare providers, emphasising the rights and responsibilities that underpin this essential bond.
Former Vice President Yemi Osinbajo took a pivotal step forward in 2018 when he officially unveiled the Patients’ Bill of Rights. This historic event signified a significant stride towards safeguarding the rights of patients and fostering a healthcare system that upholds the dignity and well-being of every individual.
A disquieting issue that has persisted within Nigeria’s healthcare landscape is the refusal of hospitals to provide treatment to injured patients in the absence of police reports. This alarming practice raises profound ethical and legal concerns and has sparked a nationwide debate on the balance between bureaucratic protocols and the imperative of saving lives.
This unsettling trend has been underscored by a series of incidents that have come to the forefront. These poignant examples shed light on the dire consequences of hospitals rejecting injured patients without the requisite police reports. These incidents serve as powerful reminders of the urgent need for reform within the Nigerian healthcare system.
Patients’ Bill of Rights and Its Significance
The Patients’ Bill of Rights stands as a cornerstone in the realm of healthcare, encapsulating a set of fundamental principles and entitlements that safeguard the interests and well-being of individuals seeking medical services. It serves as an indispensable document that outlines the rights, responsibilities, and expectations of patients in their healthcare journey.
One of the paramount roles of the Patients’ Bill of Rights lies in its capacity to combat and redress instances of consumer abuse within the healthcare domain. This vital document acts as a shield against potential maltreatment or exploitation, ensuring that patients are treated with the dignity, respect, and fairness they rightfully deserve. It places a critical emphasis on upholding ethical standards and transparency in healthcare practices.
The Patients’ Bill of Rights enshrines a spectrum of key rights and responsibilities that are indispensable in maintaining the integrity of the patient-provider relationship. Among these essential tenets are the right to receive high-quality care, the right to make informed decisions regarding one’s health, and the right to privacy and confidentiality. Concurrently, it outlines patients’ responsibilities, emphasising their active participation in their healthcare decisions, compliance with prescribed treatments, and respect for healthcare providers.
Investigative Panel and Mandate Secretary’s Directive
The investigative panel, led by Babatunde Irukera, and guided by Dr. Adedolapo Fasawe, the Mandate Secretary, plays a pivotal role in addressing the ongoing healthcare crisis. Their involvement signifies the seriousness and commitment with which the investigation is being conducted.
The panel places paramount importance on using the Patients’ Bill of Rights as a foundational framework for its inquiry. This document safeguards the rights and dignity of patients and serves as a benchmark against which healthcare providers’ actions are evaluated.
In addition to the investigation, there is a strong emphasis on strengthening the healthcare value chain. This involves a comprehensive assessment of all aspects of healthcare delivery to identify areas in need of improvement. Dr. Adedolapo Fasawe has set a stringent seven-day deadline for the submission of the investigative report, underscoring the urgency of the situation.
A crucial aspect of the inquiry led by Dr. Adedolapo Fasawe is the determination of the clinical status of affected patients and the establishment of clear roles and responsibilities for all parties involved. This meticulous approach ensures accountability and enables prompt corrective measures to prevent similar incidents in the future.
The Controversy Surrounding Police Reports for Medical Treatment
The ongoing predicament of hospitals mandating police reports prior to administering medical care has sparked significant debate and consternation within Nigeria. This enduring issue pertains to the insistence by healthcare facilities, both public and private, on the presentation of police reports as a prerequisite for patients seeking medical treatment, particularly in cases of accidents, assaults, and gunshot wounds.
To understand the gravity of this controversy, one must consider the alarming statistics surrounding road accidents and gunshot victims in Nigeria. The nation grapples with a distressingly high incidence of road accidents, leaving numerous individuals in dire need of immediate medical attention. Furthermore, the prevalence of gunshot-related injuries cannot be ignored, as these cases require urgent medical intervention to prevent complications and save lives.
In the midst of this contentious issue, medical practitioners confront a multitude of challenges when striving to fulfil their duty of providing essential care to accident and gunshot victims. Doctors and healthcare workers often find themselves caught in the crossfire of this dilemma. Their commitment to saving lives is frequently hindered by hospital policies or external pressures that insist on the submission of police reports before treatment can commence.
These challenges extend beyond mere bureaucratic obstacles. Doctors and healthcare professionals grapple with the moral and ethical burden of adhering to these policies, which may potentially lead to life-threatening delays in treatment. Moreover, the prevailing fear of harassment or intimidation, often at the hands of law enforcement agencies, further compounds the difficulties faced by medical practitioners in their noble quest to preserve human life.
Legal Framework Addressing the Issue
The legislative landscape pertinent to this matter is primarily shaped by the “Compulsory Treatment and Care of Victims of Gunshot Act, 2017.” This act serves as the cornerstone of the legal framework governing the treatment of gunshot victims in Nigeria. It embodies the mandate that hospitals, regardless of their public or private status, are obligated to provide immediate and adequate care to individuals suffering from gunshot wounds.
The act unequivocally underscores the duty of hospitals to initiate treatment without imposing the precondition of obtaining a police report. It demands swift action, stating that “every hospital in Nigeria shall accept or receive for immediate and adequate treatment…any person with gunshot wounds.” This clause emphasises the urgency of medical care for such victims and unequivocally establishes the duty of healthcare facilities to prioritise life-saving measures over bureaucratic procedures.
However, despite the clarity of the legal provisions, concerns regarding the practical implementation of the law have arisen. These concerns revolve around the two-hour window specified for reporting incidents to the police. Some stakeholders argue that this timeframe may not consistently align with the medical necessities of gunshot victims. The law, they contend, does not consider the complexity and time required for critical medical procedures, which could potentially result in undue delays in initiating treatment.
Moreover, a notable concern raised is related to the issue of healthcare financing. Nigeria lacks a comprehensive healthcare financing system, which can present a formidable challenge when patients are unable to cover the costs of their medical treatment. The law remains silent on the matter of financial responsibility, leaving open questions about who should bear the burden of payment, especially for patients without the means to do so.
These apprehensions, while valid, highlight the need for a nuanced approach in the implementation of the law. Striking a balance between the urgency of medical intervention, the practical constraints faced by healthcare professionals, and the financial considerations of both hospitals and patients is paramount. Collaborative efforts involving relevant authorities, law enforcement agencies, and the medical community are essential to address these concerns comprehensively and ensure the law’s effective application while prioritising the preservation of human life.
Editorial Opinion on the Issue
In an editorial from Punch newspaper dated June 25, 2021, it was stated, “The absurd insistence on police reports by hospitals before treating accident and gunshot victims has again sadly claimed the life of a promising youth.” In this case, it was the tragic, sad turn of Ebenezer Ayeni, a music producer who was shot by armed robbers and subsequently denied treatment by hospitals without a police report. The editorial emphasises the need to address this issue promptly to prevent further loss of life.
In another Punch editorial from June 26, 2016, it is pointed out that “The National Health Act 2014, in Section 20, states partly: ‘A health care provider, health worker or health establishment shall not refuse a person emergency medical treatment for any reason.'” This highlights the existence of legal provisions that should prevent hospitals from rejecting injured patients without a valid reason.
The same editorial continues to discuss the challenges associated with enforcing the National Health Act, stating, “The way out therefore is a holistic discourse involving the Nigerian Medical Association, the police, and the FMoH.” It also emphasises the need for a change in the mindset of the police and their approach to health workers who, due to fear, reject wounded individuals. It suggests that other countries prioritise immediate treatment and later reporting to law enforcement agencies.
Police and Medical Community Perspectives
The Nigeria Police Force maintains a strong stance on the requirement for police reports in cases involving gunshot victims. In particular, the Commissioner of Police in Lagos, Imohimi Edgal, has taken a firm stand on enforcing the “Compulsory Treatment and Care of Victims of Gunshot Act, 2017.” He has issued statements emphasising the legal obligation for hospitals to treat such victims without the need for a police report. Commissioner Edgal has even threatened to take decisive action against hospitals that fail to adhere to this law, characterising their actions as “cruel, unlawful, and inexcusable.”
From the perspective of medical professionals, there is an acknowledgement of their moral and legal duty to provide immediate medical treatment to gunshot victims. The 2017 Act clearly outlines that hospitals, whether public or private, are obligated to accept and administer timely and adequate care to individuals with gunshot wounds. This obligation extends to initiating treatment without requiring a prior police report. However, this commitment to patient care is sometimes met with practical challenges that require careful consideration.
Doctors have voiced concerns about the implementation of the 2017 Act. Some medical practitioners argue that the law has certain deficiencies, notably the stipulated two-hour window for reporting incidents to the police. They assert that this timeframe may not always align with the medical urgency and the need for comprehensive, sometimes lengthy, procedures to stabilise gunshot victims. Furthermore, the issue of financing healthcare arises as Nigeria lacks a comprehensive healthcare financing system. The question of who bears the cost of treatment, especially for patients unable to afford it, remains a matter of concern.
Within the medical community, doctors have exercised discretion in their approach to treating gunshot victims. This discretion often stems from fear of potential legal repercussions or police harassment, particularly when patients are suspected of criminal activities. In some cases, doctors may delay treatment due to these concerns, potentially impacting the patient’s chances of survival.
Recommendations and Calls for Action
Emphasising the importance of increased awareness and education is a crucial step in preserving the sanctity of life. By educating individuals about the inherent value of every human life, we can foster a culture that respects and prioritises the well-being of all citizens.
To truly uphold the sanctity of life, a comprehensive and inclusive approach is needed. This involves engaging in a holistic discourse that brings together key stakeholders, including the Nigerian Medical Association (NMA), law enforcement agencies like the police, and the Federal Ministry of Health (FMoH). Collaborative efforts can lead to effective policies and practices that prioritise saving lives above all else.
Ensuring that the police force reorients its mindset is vital. By aligning law enforcement practices with the principles of the National Health Act, which mandates the provision of emergency medical treatment without delay, we can prevent unnecessary loss of life due to bureaucratic barriers.
Establishing a network for hospitals to report instances of police harassment is essential for protecting the sanctity of life. Such a mechanism can help hold accountable those who obstruct or delay life-saving medical care.
Addressing the financial burden on hospitals that treat patients without police reports is a practical step in preserving life. When healthcare facilities are financially supported, they are more likely to provide immediate treatment to injured individuals, regardless of their ability to pay or produce documentation.
Encouraging collaboration between the police and the medical community is a significant measure to uphold the sanctity of life. When these two entities work together seamlessly, it ensures that injured individuals receive timely and efficient care, reducing the risk of unnecessary loss of life.
Prioritising Human Life: Urgent Calls for Reform and Collaboration
Addressing the pressing matter of demanding police reports for medical treatment is of paramount importance. This issue has lingered, jeopardising the lives of many in Nigeria. Rectifying this situation holds the potential to revolutionise healthcare delivery in Nigeria. It can pave the way for a system where every individual, regardless of their circumstances, receives timely and lifesaving medical care. The need for reforming the current system cannot be overstated. It is a matter of life and death. Timely access to medical treatment should not be contingent on bureaucratic procedures or financial considerations. It is crucial to underscore that human life must always take precedence. Bureaucracy and financial concerns should never stand in the way of a doctor’s ability to provide immediate medical attention to a patient in critical need. Ultimately, there is a resounding call for action from all stakeholders: the government, healthcare professionals, law enforcement agencies, and civil society. Together, we must work tirelessly to save lives and, in doing so, uphold the sanctity of every human life.
