FCTA Backs Garki Hospital PPP as Blueprint for Sectoral Growth

Tajudeen Kareem

To engender good governance, Nigerians are desirous of continuity in programmes and policies. Indeed, annual budgets are becoming meaningless where successive administrations prefer new schemes rather than combining inherited programmes.

But the Federal Capital Territory Administration, FCTA, under Barrister Nyesom Wike is showing a good example in the management of its hospitals.

To address the shortcomings of the traditional ‘general hospital’ system, the FCTA in 2007 handed over the management of Garki Hospital to Nisa Medical Group as a model to evaluate the efficacy of its Public-Private-Partnership policy. Eighteen years down the line, the managers of Garki Hospital have made an enormous difference in making the facility one of the most sought-after in Abuja.

Available information shows that the population in the Federal Capital Territory has grown from 1.5 million in 2007 to 3.4 million, being an annual increase of 5.67 percent. Estimated increase in 2020 stood at two million. The number of people living in the FCT has doubled in about 20 years, tasking the government’s response in the provision of infrastructure and services.

For a sizable percentage of this population, government hospitals stay the choice when considering accessibility, affordability, and quality service. They are, however, often mindful of the costs, waiting for time to see a doctor or having their laboratory tests conducted.

The concession agreement that led to the takeover of Garki Hospital by Nisa Medical Group has gone a long way to providing succor to this substantial number of Nigerians.

It is on record that since its handover to private operators in 2007, Garki hospital has not shut its doors for a single day and not a single employee has been laid off. Not even during the peak of the coronavirus pandemic. The PPP model of which Garki Hospital, Abuja is exemplary also provides a clear pathway to upgrading the healthcare sector to world best standards, especially at this time when government finances are severely constrained. Indeed, resources available to the government are limited while many sectors need intervention; roads, water, and sanitation require much more government attention.

Data from Healthy Partnerships in 2010, relying on a World Bank report, declared the Garki Hospital as a model PPP hospital. Here a private provider manages a government structure, where patients get higher-quality services than at public hospitals at cheaper rates than other private centres.

The PPP initiative involving Nisa Premier and the FCT in managing a once moribund Garki Hospital has proven to be amazing as a creative solution for policy makers.

Patients who have attended the hospital bore witness that the hospital is fully digitalized. The in-patient, the out-patient, the labs, the pharmacy, and every other department is fully computerized.

Outside the issue of waiting time, the hospital has also stepped up its services to include advanced diagnostic aid, CT scan, advanced MRI with state-of-the-art tools for monitoring, such as fibroid scan, among others. For about 10 years, the hospital has safely delivered premature babies weighing less than one kilogram; and from simply basic fertility management to providing low–cost in vitro fertilization since 2014 with high success rates.

In October 2019, the Garki Hospital became the first in sub-Saharan Africa to conduct Sleeve Gastrectomy, a surgical weight-loss procedure performed by inserting small instruments through multiple small incisions in the upper abdomen. By implication, Nigerians need no longer seek medical tourism in view of the feat at Garki Hospital.

A model worthy of celebration

The immediate-past medical director of Garki Hospital, Dr. Adamu Onu noted that the PPP between Nisa Medical Group and Garki Hospital, being the first of its kind in Nigerian health sector, has successfully passed the litmus test.

“Nigeria’s healthcare sector is not as strong as it should be and the Covid-19 crises that came about is basically what I will call a stress test for the Nigerian health sector and in that regard, we have not done as well as we ought to have done. But based on my experience at Garki Hospital, I can confidently say that the PPP model is a very good way to improve the healthcare sector so that when pandemics like this arrive, the capacity is there to be able to curb or handle such and take care of it.

“It is clearly evident that the public-private partnership model of which Nisa Garki Hospital Abuja is the exemplar provides a clear pathway to upgrading and extending the Nigeria healthcare sector to world best standards, especially at this time when government finances are severely constrained,” said Adamu.

Recently, Barrister Wike approved a renewal of the concession to popular acclaim. The Chairman, Nisa Medical Group Board of Directors, Dr Shamsudeen Usman said Wike’s action in ensuring the renewal of the concession of Garki Hospital, despite all odds and challenges met earlier, serves as an endorsement for the Nisa Group to do more.

“The renewal of this concession, despite the challenges met during the first term is indeed a positive development for the public. I believe the caliber of individuals being inaugurated today will provide a strong and capable foundation for the hospital’s governance moving forward,” said Shamsudeen.

He noted that the second phase of the Public-Private Partnership between Nisa Medical Group and the FCTA was successfully completed, with the support and cooperation of the two ministers in the FCT and the permanent secretary.

The former minister of budget and economic planning expressed confidence that the new board will effectively manage the hospital and serve Abuja residents well.

“One of the major challenges during the earlier era was the lack of effective communication among stakeholders. I urge this new Board to address that by ensuring seamless communication at the highest levels, fostering mutual respect, cordiality, and a clear, unified direction for the progress of the hospital.

“Transparency, patient safety and excellence in clinical practice must remain top priorities. I am confident that with proper communication and cooperation, this Board will function efficiently and harmoniously,” Usman said.

He described the new Chairman of the Garki Hospital Board, Dr. Peter Nmadu as a seasoned medical professional with a solid record in managing healthcare services across the country.

“His experience across both the public and private sectors positions him as a balanced and competent leader,” having had a meritorious career in NNPCL rising to the rank of Group Executive Director, Corporate Services before his statutory retirement.

The Permanent Secretary, Health Service and Environment, FCTA, Dr. Baba-Gana Adam reaffirmed the passion of his team for effective and efficient service delivery that will serve the community.

“Particularly, I can say that I am on this board not for any personal reason. I am on this board to ensure the government does its part,” he said. “We thank the Mandate Secretary, Dr. Adedolapo Fasawe for working through and having an understanding for us to sign the dotted lines. We thank Minister Nyesom Wike for speeding up this process and ensuring its delivery.”

Adam noted that the Nisa-FCTA partnership has proven that the PPP is working for Nigerians to see and promised that the FCTA is open to similar agreements to improve service delivery.

Medical Director of Garki Hospital, Dr Kenneth Ityo praised the team which steered the hospital through the first 15 years of concession and promised to leave an indelible mark during his tenure.

“It is our sincere hope that after 15 years of concession, we will leave a legacy that will stand the test of time, deepen the system and the success of PPP in Nigeria”, said Ityo.

Early and sustained successes

One of the early successes of the PPP arrangement was recorded during Covid-19 in 2020 when Garki hospital became a major centre for treatment of infected Nigerians.

The hospital has also deliberately pursued workforce development, even as it gains recognition for advanced medical training.

For instance, all its medical officers and doctors in 2022 receive Advanced Cardiac Life Support Training, being an accredited centre for training house officers. Newly graduated doctors are taken through post registration training before they become fully registered doctors.

The hospital was the first to gain accreditation in the whole of West Africa for Post Fellowship Diploma Training in Assisted Reproductive Technology, creating opportunities for consultants from other hospitals to train and obtain their diploma from the West African College of Surgeons.

Little wonder that with the success posted by the Nisa-Garki Hospital partnership, the Infrastructure Concession Regulatory Commission has raised the possibility of replicating the initiative to revive more fledgling healthcare centres in Abuja. The plan entailed a world class case study of the hospital to find the factors responsible for its success and deploying and replicating the same arrangement across the country.

The Garki Hospital model, without a doubt, underscores the need for government to speedily expand the PPP model to other hospitals. This would help to revitalize the insufficient and badly equipped health facilities, due to limited resources at their disposal and realities of the populace in need of quality and affordable health services.

*Kareem wrote in from Abuja.