Professor Christopher Bode is the Chief Medical Director, Lagos University Teaching Hospital. In this interview with Martins Ifijeh, he emphasised the need for hospital staff to work as a team, as everyone is important in their field. He also talked on the importance of public private partnership in growing the health sector
You have witnessed many strikes as Chief Medical Director of LUTH. What is the solution to health workersâ€™ incessant strike?
It is a phase that will pass. I think we were used as political folders by various political interests in the past. We pitched against one another because of this. There was a time in this country that doctors, nurses, laboratory workers and the rest worked as one team. But when people want to achieve various political short time gains, they start fights. I am not talking about the general politicians but the medical politicians who see this division as a means of accruing power.
These things only happen because they are public institutions. You canâ€™t see all that happen in the private sector where you are paid depending on hours you clock in for work and leave. As we speak now, up to 50 per cent of hospital consultations in the country take place in the private sector and it is growing. It may not be efficient yet but it will be. What we will advise medical health workers activists and politicians is to take heed and to know that the private healthcare will one day come to stay. And we should stop the battle of superiority. The patients does not care who is superior, once they come, they want treatment and care. Everybody is important in their field.
It is a team work. I am a good surgeon and will be a hopeless nurse. The way I was trained is that when you get to the ward, greet and appreciate the nurses because they have been with the patients all day. Everybody is important and it is a team work. We can’t play each otherâ€™s roles. Let’s all remove our ego. We don’t need to fight. I don’t care how much you pay a pharmacist or a lab man, as long as you pay and appreciate me. The government can say they need more radiographers and we will be paying them one million naira, that’s not enough to start discriminating.Â TomorrowÂ they may be paying the radiographer ten naira.
There is a general belief that government workers are lazy and do not work optimally. How do you cope with such workers in LUTH?Â
Here, attitudinal problem is very insignificant compared to productivity due to availability or non availability of facilities. Our workers are very willing to work when they have the right tool and technology to work with. It’s important to empower people with what they will work with, but doing that takes a lot on its own.
The luck I have is that I have a dedicated team. What I do is the least. There are leaders on their own who can initiate dreams. If you demonstrate a good leadership, people will follow you, and you will discover you will be winning over half of the crowd. The thrust is that I am very lucky to have a dedicated team. I trained here in LUTH, I owe my success story to LUTH and it is expected of me to make it better than how I met it. If I don’t do that I will be mocked.
I realised early that LUTH staff want to work if given what to work with, so I try everyday to empower them in this regard. We have realised whenever we upgrade our technology, our staff do better productively. So I try to make sure every tool that needs to be available for work is available. Someone like Obama at his young age led a free world, so we can do it too. I was at an exhibition today and I was shown a hospital cloth made in Turkey and my question was, why not make-in-Nigeria and see if I wonâ€™t patronise you. Even if these products are not 100 per cent okay for now, one day they will be. I don’t use imported chairs in my house, most of the things I use are made-in-Nigeria. I believe in Nigeria.
The Minister of Health has once advocated for Public Private Partnership to grow the health sector. How has LUTH benefitted from such partnerships?Â
LUTH has benefitted in many ways from Public Private Partnership (PPP). The fact that the hospitalâ€™s treated water supply is running is a result of PPP. That was part of the projects that were abandoned for over 12 years before we came on board. Today, it is producing 20,000 gallons of water per hour to serve the whole of LUTH.
We realised that if we do a good business by inviting investor to invest their money, they will make more money and LUTH will make theirs too. Our blood bank for example was abandoned for years, and we were using small rooms. But some people came with their proposals, and today, a private body has renovated the blood bank with their money and equipped it fully. This has given us the privilege to deliver advance services. And that has saved us from spending over N10 million monthly.
After when the private investor has invested, we split the profit as agreed in a way that it will favour them and favour us. A company spent over 240 million naira to renovate the blood bank and equip it fully. It is fully running now. That’s PPP at work.
Another example is that when we realised we get over 100 patients daily needing eye care, we felt there is need for PPP in this area where these eye glasses will be produced here and then given to patients with ease. A company built the eye centre with millions of naira, and equipped it with eye lenses. Today, you can come to LUTH and get eye glassesÂ within one hour. That’s PPP working. We discovered that most diabetic patients have problems with their eyes. Our diabetes clinic has collaborated with the eye clinic. So we have made it more comprehensive that they are being attended to in a building. Rather than seeing a doctor today and coming another day to see another doctor.
We have also been able to drive PPP in so many other ways. For instance, a company from Dubai told us about the need for us to get machines from them. I told them we wonâ€™t be able to afford the $40,000 machine. We told them if they can bring in the machine to train our people we will appreciate it. When they saw our commitment and enthusiasm, they not only gave us the machine, they gave us the one that costs $140,000. Now we have given them a room here which is fully equipped, and that will be the first Endo-Lacer Surgery Team not only in Nigeria but in sub-Saharan region.
The administrative building, the Biomedical Engineering building, and a host of others have all been fully completed because of our commitment. In our time we donâ€™t want any abandoned project.
How are you able to bring private investors into partnering with you, considering a lot of health institutions are complaining of inability to drive PPP?
It is very simple. When the private investors see that where they want to put their money is safe and will yield desired result, they will want to invest. Recently, I presented a slide somewhere, where I emphasised that the problem the public sector is having is that it lacks business direction bottled with bureaucracy. But the private sector has a business focus expertise. They are profit-oriented. Most of what we have here are being funded by PPP and it is because we have been working. The secret of development is by asking a simple question that if I own this place what will be my strength and weakness? What are the opportunities I have? Those are what we considered before going into PPP and it has been stationed in a way that it doesn’t create a burden on our bureaucracy. PPP is very possible if the environment is conducive for private investors.
What are those areas you still need PPP in the hospital?
We will be looking towards implementing a hospital information management system. I can’t mention any companyâ€™s name because we will be throwing it out and letting competitors bid in.
We need quarters for our trainees, we need houses for our workers, we need new wards and expansion of existing wards, and so on. With the way we are driving PPP and putting new technologies in place, if you add N1,000 to cost of treatment, patients will be willing to pay because they are now seeing quality of treatment.
LUTH looked as though there are no spaces for more buildings? So what kind of expansion are you still talking about?
Who says old rehabilitated buildings cannot be pulled down and rebuilt now that we will be having 24 hours uninterrupted power! Building vertically is the next thing. Who says we can’t have stories of 15 floors where we will have wards, theatres and all. We just have to be innovative. Some international hospitals do not have half of what we are using here but they just stack it up. Their security is in order and other things. Height is no more a problem because there will be lifts to carry patients and equipments. If the money is there, we can stack up many of our buildings. Some buildings here were built in 1962. Who says we can’t stack it up more efficiently.