After THISDAY Healthcare Summits, N’Assembly Earmarks N57.15bn for BHCPF


• Passes 2018 budget, pegs oil benchmark at $51/bl

• Silent on Tucano aircraft, demands inclusion of fuel subsidy in Supplementary Bill

Damilola Oyedele, James Emejo in Abuja and Martins Ifijeh in Lagos

After the two policy dialogues held by THISDAY on Healthcare Financing and Universal Health Coverage, the National Assembly has for the first time earmarked N57.15 billion for the Basic Health Care Provision Fund (BHCPF) in the 2018 budget passed Wednesday by the legislature.

Aggregate expenditure in the budget was also hiked by about N500 billion from N8.61 trillion to N9.12 trillion, as the lawmakers increased the oil benchmark from $45 to $51 per barrel, but maintained oil production at 2.3 million barrels per day and the exchange rate at N305 to the US dollar.

With the passage of the 2018 budget, the N57.15 billion set aside for the BHCPF, amounting to one per cent of the Consolidated Revenue Fund, is meant to cater for the basic healthcare needs of all Nigerians.

This is the first time since the passage of the National Health Act in 2014, that the federal government has earmarked the funds for the BHCPF.

THISDAY on March 6, held a high powered policy dialogue on healthcare financing where it brought together policymakers, healthcare stakeholders, development partners and the business community to discuss a working model for increasing healthcare funding.

As part of efforts to progress the conversation around healthcare financing for the provision of improved primary healthcare services for Nigerians, THISDAY, in partnership with the Federal Ministry of Health and the World Bank, held another high powered summit on April 12 where the Minister of Health, Prof. Isaac Adewole, launched the logo of the BHCPF.

At both summits, the Chairman, Senate Committee on Health, Dr. Lanre Tejuoso, had pledged that the 8th National Assembly would push for the inclusion of the funds for the implementation of the BHCPF.

This and other efforts by the Senate health committee and the federal government resulted in the allocation of the N57.15 billion to the BHCPF.

Speaking on the development Wednesday, Tejuoso told THISDAY that the inclusion of the funds for the BHCPF means primary healthcare will be better funded and functional, basic drugs, equipment and infrastructure, including water and electricity, will be present at primary healthcare centres (PHCs), among others, nationwide.

“By this fund, PHCs in each ward in the country will be operational and functional. At least 2,000 vulnerable Nigerians in each of the 774 local governments will receive basic healthcare paid for by this fund,” he said.

Tejuoso, who had been very pivotal to the inclusion of the funds in the budget, said: “The one per cent contribution has occupied half of my advocacy as chairman of the Senate health committee. This advocacy included maximum pressure. It will be a legacy for this 8th Assembly.

“Now that we have passed this hurdle, it is expected that the BHCPF will be a statutory transfer that will certainly enjoy release. This fund will be set aside perpetually. It will not be returned to the Treasury Single Account at the end of the budget year.”

Going down memory lane on how the journey started, Tejuoso said it took three years to arrive at this point. “When I was appointed chairman of the committee, I looked at all we inherited, and we identified the National Health Act as the game changer for the health sector.

“I then decided to focus on this. I began a series of consultations with the executive arm – the vice-president, Ministers of Health, Budget and National Planning and Finance, among others. And we came to the conclusion that the proposal could not come from them due to various similar requests from other sectors.

“So the next phase was for me to convince my colleagues in the National Assembly to get it included in the budget. The Senate President, being a medical doctor himself, was a major advocate that did not need convincing. He was very passionate about this,” he explained.

Senator Tejuoso and Senate President Bukola Saraki are the only medical doctors in the 8th National Assembly.

Tejuoso said one of his strategies in getting the inclusion of the funds in the budget was to tell Bill Gates, Co-Founder of the Bill & Melinda Gates Foundation, during a private meeting with leaders of the National Assembly, to always harp on the importance of implementing the NHA.

“I led some of our development partners, United Nations Children’s Fund (UNICEF), the World Bank, Bill Clinton Foundation, among others, on a road show round the National Assembly to convince our chairman, appropriation committee, the finance counterpart, and the entire leadership of the Senate on the need for the inclusion of the one per cent for the BHCPF from the Consolidated Revenue Fund into our budget. I made efforts in 2016 and 2017, which failed, so I told myself we would be aggressive this time. I am very happy this is now a reality,” he added.

On his part, the Lead Health Specialist, World Bank, Benjamin Loevinsohn, described the development as a game changer for Nigeria’s healthcare system.

He said this would go a long way in transforming the health of poor Nigerians who ordinarily are unable to pay for health services in the country.

“Now that this has been captured in the 2018 budget, government should ensure its release. It is one thing to budget for something, it is another thing to release those funds.

“We all know that before now public sector spending on health in Nigeria has been very poor, so this development is a big deal for the country,” he said.

Meanwhile, the 2018 budget passed by the National Assembly Wednesday was increased to N9.12 trillion, from the N8.61 trillion proposal presented by President Muhammadu Buhari to a joint session of the National Assembly last December.

Like the 2017 budget, however, the 2018 Appropriation Bill was passed without any request by the executive for the payment of fuel subsidies to oil marketers, despite the glaring difference between the landing cost of petrol and its official pump price.

The budget was also silent on the recent anticipatory approval sought by the president for the inclusion of the $496 million in the 2018 Appropriation Bill, having withdrawn the amount from the Excess Crude Account (ECA) for the procurement of 12 Super Tucano aircraft from the United States government without the consent of the National Assembly.

Speaking on the omission, the Chairman of the Senate Committee on Appropriation, Senator Danjuma Goje, said the request was not entertained due to the amount of money involved.

He said: “Don’t forget that the president wrote to this chamber requesting that it should be included in the budget. But we did not, because of the quantum of the amount. It should come as a supplementary budget.”

Presiding in the Senate, Saraki explained that the increment in the 2018 budget was done with due consultations with the executive.

“Let me comment on some of the wrong impressions regarding the issue of the increase in the aggregate expenditure. As highlighted by the chairman on appropriation, this has brought about a good working relationship between the Executive and the National Assembly. Both the executive and the legislature had seen areas where there was need for intervention.

“We’ve heard the chairman of works telling us there was need for equitable distribution of road projects which account for a significant amount. Power project intervention is also needed.

“We have seen a significant increase in the percentage of capital expenditure in 2017 and I hope that this will lay a good foundation in 2018,” he said.

Saraki also called for a more harmonious relationship between the executive and legislature to ensure speedy passage of subsequent budgets.

“A lot has been said on areas of how we have passed the budget, on areas of how we could have passed the budget earlier. I think there’s definitely room for improvement in the area of cooperation and collaboration between the executive and the legislative arms of government.

“At least 50 per cent of the capital expenditure of ministries, some of them, up till the end of February had not done their budget defence. I think this is the area that we must wake up as the two arms of government,” he said.

The Senate President also asked the executive to provide for fuel subsidy payments in the supplementary 2018 budget, noting that the inclusion of subsidy in the supplementary bill would result in savings in the Excess Crude Account (ECA).

“In the area that we could not address, which is the issue of fuel subsidy, I appeal to the executive to look into this for the interest of transparency. Expenditure close to over one trillion must be captured in the budget and when the supplementary budget comes, the hope is that the executive does something about it. It is an important issue and must be addressed.

“Now that crude oil price is close to $80 per barrel, a lot of Nigerians are expecting to see the savings in our excess crude reserve account rise, but if money is being used for subsidy, it will be difficult to explain.

“That is why it is important that we capture the subsidy element in the budget,” he said.

Saraki urged his colleagues to undertake proper oversight of the ministries, departments and agencies of the federal government to ensure the budget is well implemented.

In the House of Representatives, the lower legislative chamber, however, suggested measures to make it difficult for the federal government to spend appropriated monies on items not captured in the budget, particularly on fuel subsidies, which the administration has consistently denied it has bankrolled.

In this regard, House Leader, Hon. Femi Gbajabiamila, called for an amendment to the relevant clauses in the Appropriation Act and sought the Senate’s concurrence.

Agreeing, House Speaker, Hon. Yakubu Dogara, said the legislature was not “Father Christmas” that just provides for subsidy when no request has been made by the executive.

According to him, “The executive must come for subsidy if they need it, having told us that subsidy has ended. We can’t just allocate an amount for subsidy because no request has been made for it.”

Of the N9.12 trillion budget, the sum of N530.42 billion was earmarked for statutory transfers, while N2.20 trillion was for debt service, of which N190 billion is for the sinking fund for maturing loans.

Recurrent (non-debt) expenditure got N3.51 trillion while the sum of N2.87 trillion was set aside as contribution to the development fund for capital expenditure (exclusive of capital expenditure in statutory transfers).

The sum of N1.95 trillion was earmarked for the fiscal deficit while the deficit as a percentage of Gross Domestic Product (GDP) was put at 1.73 per cent.

The Chairman, House Committee on Appropriations, Hon. Mustapha Bala Dawaki, said the increase in the budget was due to the hike in the oil price benchmark from $45 per barrel to $51 per barrel, which was applied to critical sectors of the economy including the reduction of the budget deficit by N50.88 billion.

Other sectors that got increments included security, N46.72 billion; health, N57.15 billion; and power, works and housing, which had N106.50 billion added to its budget estimates.

According to him, other sectors that benefited from the increase in the budget were education, which got N15.70 billion for infrastructure for the 12 newly established federal universities and meal subsidies for Unity Schools.

Also, the judiciary got a N10 billion top up while the Niger Delta Development Commission (NDDC) got N44.20 billion added to its budget.

Under statutory transfers, the National Assembly budget was put at N139.50 billion, Universal Basic Education got N109.06 billion, the Independent National Electoral Commission (INEC) got N45.50 billion while the judiciary got N110 billion.

Also, the sum of N33.98 billion was set aside for part payment of NDDC’s outstanding liabilities.

Other highlights of the budget included the provision of N350 billion for Special Intervention Programmes of the federal government.

The sum of N45 billion was set aside for the North-east Intervention Fund to help address the problems created by the Boko Haram insurgency, while N78 billion was earmarked for military operations across the country including Operation Lafiya Dole in the North-east and other operations of the Nigeria Army.

The sum of N100 billion was earmarked for Zonal Intervention Projects as well as N15 billion for the payment of local contractors’ debts.

The 2018 budget further set aside N193.33 billion for the Power Sector Reform Programme of the federal government, including N10 billion for the settlement of electricity bills of ministries, departments and agencies of government.