The Chief Medical Director, University College Hospital (UCH), Ibadan, Professor Temitope Alonge, in a chat with Tribune newspapers Ibadan spoke on some of the challenges of running the health institution.
When asked this question: Can you speak on poor patients access to care? Do you delay patients who cannot pay?
He replied:
If we confirm that a patient cannot pay, we usually exempt them. We only insist that people pay once the debt recovery officials are able to confirm that such patients can pay. Some are allowed to pay later while by virtue of the hospital’s benevolence, some medical bills are waived off.
The debt recovery office will find out if they can pay before we insist on payment. At UCH, Ibadan, two kinds of forms are designed; the payment deferment form and a waiver exemption form.
Payment deferment forms are for those that have ability to pay but do not have the money immediately and the waiver exemption form is meant for those that really do not have the money or the prospect of even paying in the future.
We would want you to be specific on waivers granted by the hospital.
In September, two patients from North-West 3 were discharged after they had a waiver amounting to about N700,000. One was post-abortion sepsis. She was a prostitute without any job, who got pregnant and ran into trouble trying to abort. The other was a post-delivery case, a prostitute too. When we called her people in Imo State, they said they didn’t have any money to come and pick her. She is the most educated in their family. Of course, she couldn’t speak one complete sentence in English. I think she was a secondary school drop-out. So, they said that we should bring her. Anyway, I said since you know some people in town, we are not going to take you to Imo State, and so I discharged her.
There were two patients during the industrial strike that, aside waiving their bills, we had to give rice and money before we could tell them to go home. These were elderly men, who could not pay for treatment. Afterwards, arrangements were even made to transport them home because they were not even willing to leave.
Has there been any abuse of these gestures?
Some patients have insiders who will tell them, just say that you don’t have money or start crying when they come, but actually they can afford it. Such people, when we see them, we don’t want to exempt them.
Again, we are owed hundreds of thousands of naira because people refuse to come and claim their corpses. And for everyday they stay in the mortuary, they are further accumulating money.
What other services do you have for comfort of patients?
Provision of patient lifts as well as a concrete ramp was aimed at ensuring patients, goods and material are conveyed in the 880-bed-hospital with little or no stress.
The hospital has acquired two new pateint lifts and one luggage lift to convey goods and materials from the ground floor to the third floor. One of my prime priorities was to have a concrete ramp.
Again the Medical and Dental Council of Nigeria has increased the quota of doctors that we can employ through housemanship and therefore, there is the need to provide accommodation for them. So, the second priority is that we have a new set of accommodation for house officers. The first phase of that house officer residency is now completed.
Apart from indigent patients, what about the aged?
The number of elderly patients attending our clinic has increased and therefore, a propostion for the construction of a geriatric centre was made.
The geriatric centre in UCH is the first purpose-built geriatric centre. It has two operating suites that will allow them to have surgeries done exclusively for them. They have consultation for various clinic cases, a multipurpose block that contains things such as gynasium and dining room as well as in-patient geriatric centre where you can bring your aged parents to live in.
The hospital has a toll-free helpline. Nigerians can put a call through to the hospital to ask what can be done in emergency situations.
If you put a call to 070UCHhelp, there would be somebody at the other end of the telephone to answer your questions. They will offer what can be done. However, they are not supposed to prescribe on the phone, neither will they tell you how to operate.
The second phase of the helpline is to be able to deploy ambulance to pick victims if anything happens. We have a central information office where we have staff working 24 hours of the day.
What challenge does the hospital face in carrying out its duties?
We are the oldest and some of the ageing problem includes our sewage pipes which we have to visit. We have a new set of pipes that were imported from England to care for our major sewage problem. Currently, we have converted our sewage system in the hospital from mechanical to biological. It has been team work, not an individual effort.
Like with other sectors of the economy, there are key performance indicators set by the Federal Government for all players in the health sector, inclusive of health institutions like UCH, Ibadan. Despite the initial challenge of overcoming the high debt burden of the hospital, the restructuring of the hospital’s sharing formula of its internally generated funds had led to the revitalisation of the hospital’s many sectors.
The hospital’s procurement department is ensuring that procurement is airtight and so no room for laxity. This has helped to rule out the accumulation of any non-capital debt and to ensure that the hospital pays more attention to the major goals and objectives of the hospital which centres on research, service and training.
Can you speak on the hospital’s rating and research activities?
Currently, three per cent of the amount generated from the hospital’s revolving funds, which amounted as at August to about N35 million, has been deployed to encourage research activities in the hospital to ensure that the hospital ranking would surpass its 2011 Scimago world ranking as the third best in all hospitals in Africa and the seventh among all higher educational institutions in Nigeria.
Only nine institutions in Nigeria were eligible to be ranked based on academic publication citations of work that are published. Only UCH, Ibadan, was ranked in the entire West Africa in this world ranking.
Eligibility for the research grant is being determined by an independent committee had been saddled with the role of selecting proposals that are well worth it.
What about staff training?
Over N78 million was paid for sponsorship of training of its staff as at 31st of August, exclusive of the payment of the training of the hospital’s resident doctors.
With the increase in ability to operate as well as the introduction of disposable diapers, the waiting list of people to have surgical operation has declined at the hospital.
The disposable drape system, in fact, had helped to cut down on the risk of infection which is evident from reports from our infection control unit. Also, the number of cases that are being operated upon is increasing by the day.