Association of Community Pharmacists of Nigeria Challenges Physician Monopoly in Healthcare Leadership

Strategic Insights -

The Association of Community Pharmacists of Nigeria (ACPN) has refuted claims by the Nigerian Association of Resident Doctors (NARD) that physician-led hospitals yield better patient outcomes and that doctors do not interfere in other health professions. The ACPN argues that physician dominance in hospital leadership has led to a systemic collapse of efficiency, transparency, and innovation in Nigeria's healthcare delivery. According to the ACPN, the dominance of physicians in healthcare leadership has been damaging, leading to corruption, inefficiency, and a lack of innovation in the healthcare sector.

Key Takeaways:

  • The ACPN argues that physician-led hospital management has been overwhelmingly negative, accusing doctors in administrative positions of dismantling civil service norms and entrenching corruption.
  • The association notes that physicians control procurement processes, including pharmaceuticals and hospital equipment, leading to massive inefficiencies and corruption.
  • The ACPN cites cases of former physician-ministers and hospital CEOs dismissed or prosecuted for corruption, including the alleged embezzlement of COVID-19 funds by the CEO of Federal Medical Centre (FMC) Owo.
  • The association argues that physicians often lack the business, management, and communication skills needed to run hospitals effectively, resulting in abandoned modern equipment, poor health insurance coverage under the National Health Insurance Authority (NHIA), and deteriorating health indicators.
  • The ACPN criticises the physician-led model for prioritising curative treatments over preventive healthcare, noting that malaria treatment remains largely curative while preventive strategies like environmental management are neglected.
  • The ACPN points to disputes over the Consultant Pharmacist Cadre, accusing physician-led bodies of resisting policy advancements for non-physicians, including adjustments to the Consolidated Health Salary Structure (CONHESS) and appointments of non-physicians as health ministers or commissioners.

Statistics:

  • Until 1985, Nigerian hospitals were led by professional administrators, contributing to efficiency and professionalism, but this changed with Decree 10 of 1985, which enabled physicians to dominate hospital leadership roles.
  • The Independent Corrupt Practices and Other Related Offences Commission (ICPC) has described Nigeria's health sector as the most corrupt segment of the national economy.
  • NHIA coverage increased significantly under professional administrators but declined under physician-CEOs.
  • The ACPN notes that 31% of Nigeria's health budget is allocated for facility management, procurement, and maintenance of PHCs, but these funds are often poorly utilized.

Sources:

  • Association of Community Pharmacists of Nigeria (2023)
  • Nigerian Association of Resident Doctors (NARD)
  • Independent Corrupt Practices and Other Related Offences Commission (ICPC)
  • National Health Insurance Authority (NHIA)
  • Consolidated Health Salary Structure (CONHESS)
  • Nigerian Medical Association (NMA)
  • Federal Medical Centre (FMC) Owo