The Chief Medical Director, Lagos University Teaching Hospital, Prof. Chris Bode recently got the nod of President Muhammadu Buhari for a second term as chief executive of Nigeria’s busiest tertiary health facility. He spoke with journalists including Martins Ifijeh on his experience in the past four years and his determination to improve the lot of the 57-year old institution
Challenges of the Past
When I came on board four years ago, the system was suffering. The greatest challenge was lack of confidence in the system, both among the workers and the people who come here. Our various clients stopped believing in us. Now, with the co-operation and collaboration of others, that narrative has changed. It is humbling to know that the same environment that was so hostile has gradually embraced change. We had stormy relationships, stormy reception from the trainees, workers group, but I guess through appealing to their good side and showing by example from the leadership of the institution in the past four years, the situation has improved appreciably.
We have been able to change the mindset so that all workers at LUTH now appreciate what we were established to do – render services to people. That is what matters; any other thing will be an excuse. People are not interested in that, no matter what you do, if you do it very well, people will come to you and if you don’t, they would go elsewhere. So we don’t want them to go elsewhere for many reasons because even our own livelihood depends on it and the mandate given to us would be a failed mandate if we don’t fulfil it.
On Re-positioning the Hospital
There has been enormous support in the last four years from top management team, the nurses, the head of nurses and all heads of department; they have been marvellous as they embraced the experiment. The change we tried to implement has yielded very good results, with all modesty. We must give thanks to the Federal Ministry of Health, the minister and his team. They have really risen to the challenge, done very well for us and also the workers in LUTH have been marvellous. I must say that our people know good things when they see it. I think that is what has been driving us, when you do something good and people see it, they comment. But we know that we need to do more.
The entire workforce, all are eager to reflect the new order. The changes are manifest. For instance, our dental school that was discredited last year because we didn’t have dented chairs has now been re-certified. Through joint effort between the university, alumni and management, we have been able to put LUTH back on the path to its former glory. Good things are happening, that’s my message and we must do more. The greatest enemy of progress is to be complacent, there is no resting here. We must commend the management board led by Alhaji Isa Sali Bello and his team for astutely leading the hospital at this time; we have been able to accomplish a lot.
Of great importance has been that there is calm in the system now. I recall there was a year we didn’t work for eight months; our salaries were paid by government. At another time, we went on strike for five months. All that had to stop. The healthcare sector cannot afford such disruption. So we had to start whittling that down with support from members of the public, our staff and even government. With time, government started listening to what the agitations were and government was fulfilling them, promising and fulfilling; coupled with delivering on low hanging, deliverables, intermediate term and long term plans. All these have now started bearing fruitful results and I like to add that it has really brought LUTH to the fore again.
A lot has been done during the past four years. We now have reliable power supply through our gas fired electricity, we now have a very good blood bank, water supply; our wards are beginning to be rehabilitated and other facilities as well including the acute stroke care centre. We are repositioning our radiology department. We are putting up a new structure for the care of over 8,000 HIV patients and our advanced facility centre has been up and running and is doing very well. Workers are going through further training and we have crowned it with the $ 11 million NSIA-LUTH cancer centre which President Muhammadu Buhari commissioned in February.
A lot more needs to be done, looking ahead. The reward for hard work is more work. Because our facilities are aged, they have been there for 57 years now, we need to rehabilitate, complete rehabilitation of our wards, our out-patients department and many other structures. The out-patients facility is inadequate; we want to build an extension so that patients can be seen more promptly rather than being given long appointments. We are going to do the same thing for our operation theatre facilities and other facilities that need to be upgraded and expanded.
Recently, we had the Lions Club International come for laying of the blocks for the establishment of dialysis centre. We are appealing to all like-minded bodies to assist LUTH. Late Chief Isaac Olusola Dada, who was the district governor of the club, promised to build a renal dialysis centre for us before he passed away suddenly. It is going to cost more than N200 million. It will have 36 dialysis machines and will be one of the largest in the country for modern renal dialysis. The Lions Club and the family of Chief Dada will build and furnish it on a Public Private Partnership (PPP) basis, experts in dialysis, institutions that supply equipment and consumables can just come and use it, we will make the services affordable to ensure that Nigerians come here rather than go abroad.
We are still going cap in hand. Already, we have immense support from the Sovereign Wealth Fund; they have promised to sustain the cancer centre so it will be a modern cancer centre that would render services and give meaningful returns to investors. It will serve as a beacon for public-private collaboration in healthcare delivery. If they don’t see us as valuable, they won’t bring their money to tie down.
We are planning a hospital wide information management system to reduce the paper work, improve efficiency and reduce the stress faced by patients. Another plan is to expand operation theatres, intensive care unit and eye treatment unit. The ultimate goal is to make LUTH a comprehensive and reliable hospital in one structure so that we don’t refer any patient. We want to achieve 100 per cent proficiency. If LUTH refers somebody to any other place, it’s like telling them to go and die because we ought to have everything. Even if our accident and emergency ward is full, I would rather you move patients straight to the ward and begin emergency care at the ward rather than tell them there’s no bed. We would do all what we can to increase bed space. Even while doing this we must appeal to all Nigerians, services in LUTH are highly subsidised between 30 and 80 per cent. Depending on the services, for an average operation you may pay a million naira outside, here you might pay just N200,000.
Appeal for More Support
We are a government institution, but we must agree that services are not free. We need to review the concept of healthcare financing so that there will be universal coverage. There should be a safety net provided by the national institutional scheme for those who may easily fall through the cracks. The elderly, children, pregnant women and accident victims should be taken care of under a solid health insurance scheme.
Public health institutions must continue to treat patients whether they are able to pay or not, and we cannot reject anybody brought as an emergency. We found out that such obligations are a big drain on the finance of tertiary institutions, not only at LUTH, it happens everywhere. Maybe because this is a large hospital, we feel it a lot.