We are not perfect yet, says LUTH CMD
The Chief Medical Director (CMD), Prof. Chris Bode, spoke with The Guardian on challenges
We gathered that the equipment was not working and the treatment and test were so costly? There was also complaint about the attitude of the doctors and health workers that left him there to die?
Let me give you an example, he could have said that because when he got to UCH he paid N70, 000 before he had his operation, he paid another N22, 000 for consumables before he could go to the ward. He was made to donate four pints of blood; he donated four pints of blood before he had surgery. Here we did not ask him to donate blood before we transfused him the two units that he took. We did not ask him to say go and donate blood. We took him in and treated him. The machine that is not working that day, the machine that you use everyday of the year sometimes breaks down. If it broke down is it LUTH’s fault? The man who placed it knows that he is making money from it and hurries to repair it.
The MRI is working now but it wasn’t working that day. But to save his life, all we had to do is put him in an ambulance let him go and do it outside. I am not going to pay for that. Let him go and do it outside. There are other places you can go and do it outside and come back and continue his treatment. His complaint must be his mindset and he feels he has somebody in power that can harass us. Because if I didn’t say go and donate blood before I gave him two units of blood he needed that day, if LUTH didn’t say go and pay money before they treated him in Accident and Emergency (A&E) and stabilized him and got him better for him to go to Ibadan where he paid almost N100, 000 before he was treated.
How about the issues of delay, attitude of health workers and cost?
There is a timeline here on how we carry out treated. Within minutes when decision was taken, he was activated. He was seen immediately at A&E and we got bed for him. In Washington DC General you can get to the A&E and still wait three hours to see a doctor. He was not delayed. Depending on what is on ground that day. There are days when patients are seen even in their cars when there are not beds because those on the beds are not going into admission to the wards because the relatives are not forthcoming with money. The doctors have asked them to go to the ward but they are still on the bed at the A&E. What do I do? So what we would want is that we want the press to continue to be partners in making things better. Inform our people that because of the day when we may need emergency care, every Nigerian should carry NHIS card. You don’t need to even talk about money. I was not carrying NHIS, he lost one and didn’t replace it and when we told him ‘let your brothers go and help you do it he said he was not interested for now.’
Secondly we will want you to help us. We are not perfect yet in LUTH but we are working towards it. As of last week we had 498 patients on admission and we cannot be wrong. If they are being badly treated they wont come here. We have seen over 600 out patients in a day in our out patient clinic. If LUTH was as bad as it is being brandied around, it won’t happen. If anybody has specific issues there is SERVICOM in place with their notices everywhere, there is the CMAC on ground, there is two deputies CMAC. They would have sought audience with somebody and asked questions. But to now generalized that he is being delayed, at what point? The man came in at 4.13pm and he was seen immediately, doctors reviewed him within 15 minutes, he needed blood, IV, antibiotics and x ray and it was given him. So where did the delay come?
Another issue that came up is the issue of cost. Some patients’ relatives say the drugs and treatments are cheaper outside. Why?
It is left for you to investigate. The biggest surgery in LUTH is N135, 000 even if it is neurosurgery. Outside you cannot get those surgeries done for N400, 000. So it will be mischievous for anybody to say our services are costlier. It costs N65, 000 to deliver a baby in LUTH but in private hospitals you pay well over N100, 000.
Then on cost of drugs you have to be very careful. As a reference we can only give drugs that we can certify as genuine drugs only. If we give you an amount of insulin now, we are sure that what we prescribed is what is being given to you not drugs that have been adulterated or substandard or brought from some third world country that is only interested in Nigerian way of doing things. But we have seen before where people performed life-threatening surgeries and in just using drug to reverse a condition they have caused death of the patient. I wont name where or what drug.
So when LUTH says this is the drug that is genuine. We cannot compare costs. Go and investigate, buy paracetamol from LUTH pharmacy and buy it outside and you will be able to compare. Our drugs are subsidised. For the quality we give it is below market standard and consistently of good quality.
Another issue is that of the toilet, the toilets are very bad based on our findings.
Because you were told to besiege LUTH and find out what can be really wrong.
Now let me go on that too. LUTH is a 52-year-old hospital and they open everyday except few times when there were strike action. It is a public hospital. A public hospital that is used everyday, what happens to the facilities? We, as we come in as a management, part of what we are doing is the restoration off the hospital empowered by the government, building by building and that is. You need to get to the neonatal unit; you need to go round our premises. Part of what we have been battling was to reposition the image of LUTH. A theatre that was built over forty years ago were just rehabilitated we had to gut it up, take out everything and start putting it back in a way that we can use it for the next twenty to thirty years and all done with Internally Generated Revenue (IGR).
So it is our dream now to take each of the five ward blocks in the hospital and ask companies or socially minded corporate and private companies adopt one and rehabilitate for us. It is a big project. We started doing some. While going round, you must have noticed that in the last two months, we have replaced over one hundred and twenty of our seven hundred beds in the hospital. If we have fund, we will replace more.
We want to redo each building to modern standard whereby each person will feel this is a hospital; this is the way a hospital should be. If we do that, it will form part of the reasons, the ways of reversing the trends of what we call ‘medical tourism’. It is not by tearing down the name of the hospital in the public.
On the issue of surgical theatres, we gathered there is high demand and there are so many people on the waiting list. We learnt that some patients have been on the waiting list for more than eight months. Why is this so?
It is true. Let me tell you why: a lot of the cases we are handling now refer to the seventy percent that I told you could be done effectively in primary and secondary tier hospitals. We are supposed to be doing only big and difficult and complicated cases but we are not supposed to be doing hernia in LUTH but in paediatric surgery it happens. Over fifty percent of my cases are either hernias or hydroceles. They are supposed to be done outside but this is the only place that they come. So I do hernias from morning till evening on Wednesdays, I do two or three hernias on Thursdays. A population of twenty million in Lagos has only two teaching hospitals, Abidjan with the population of eight millions has three teaching hospitals, does that give you the idea of the case load that we have? So we can only do as many as the system allows.
There is a lot of confidence in the system that people want to come here for treatment. We are innovating with various ideas that will shortly be deployed in terms of improving, increasing our daycare surgery, so we will do the operation today and leave same day. We are also going to introduce fast track surgeries so that when you are ready for us to do it, we can use after-hours to do it for you, in fact, that is part of why we are renovating the theatre so that our modular theatre, which was only functional for three operation will now be fashioned for six, take care of them till when they finish and that modular theatre should start working the next one week or thereabout. Once our power generating plant comes up, it is only the gas we need now.
So it is true. It is not that we are not doing many operations but the caseload is much. This happens not only here, but also everywhere in the world. Go to NHS in UK and see the operation list. So it is not a strange situation. There is a lot to be done in the healthcare sector. One, if it is run as a business, the business efficiency must be put into it; more private investments must be put into it and more facilities will be brought in through that kind of approach. What we want for you in the press to mention things to us like this but to be constructive in the way you criticize such facilities, otherwise it saps and removes from the confidence of the people in the system on group and the people now go to lesser endowed places for things they should not. How many people go to India and come back alive? How many go and come back better?