Cross River budgetary allocation to health has risen from less than 5% to over 10% – Ayuk

The Commissioner for Health in Cross River State, Henry Egbe Ayuk, in this interview, reflects on his philosophy of leadership and governance, offering insights into the challenges and opportunities facing Cross River State and the Ministry. He discusses issues ranging from infrastructure, housing for healthcare workers and sustainability to politics, medical doctors, nursing students’ development and the future of the People’s Paradise City, while outlining his vision for building more resilient and medically-equipped healthcare institutions, inclusive and nationally competitive. BLESSING ADIMABUA brings the excerpts:

What can you say is the overall achievement of the Ministry of Health in Cross River State in the last three years?

Well, to have a better understanding of what the governor has done expressively is to have an idea of how the system works and how the health sector worked when he came and what it is now so that you will be able to have some understanding of what he has done. Let me start with the physical allocation for the health sector, because without funding you cannot do anything. We came in and met a grossly under-staffed Health sector. Then, the physical allocation, the financial performance even from public allocation for healthcare was far below five percent and less than five percent of the total budgetary allocation was allocated which was far below national target of 15 percent. Today, as I speak to you the allocation has risen to over 10 percent but we are not there yet at 15 percent which is the target nationally.

However, at least, we have moved for more than five decades and you can see it; we are operating at least, 10 percent. Then, the general budget performance of the health sector was less than one to two percent when we came in, but today, it has escalated to 38 percent. If we are able to meet 40 to 50 percent that is sufficient for a state that has nothing because we are still battling for our oil wells. You can see that the allocation suffers even from the Federal, so that is exactly what it is.

Secondly, in terms of human resources, we came in and met an embargo on employment because for over 10 years nobody was being employed into the health system, but His Excellency, the Executive Governor of Cross River State, Bassey Edet Otu has injected into the health system over 2000 different health professionals including Doctors, Nurses, Pharmacists and so on. It didn’t just end there because there is one thing to employ and one thing to retain them. As at the time we came in the disparity level compare it to their counterparts at the Federal level was too much but the governor has gone ahead to adopt the nationally-accepted consolidated salary structure for doctors and he is implementing it 100 percent.

Moreso, as I speak with you today, it is more profitable to stay in the state civil service than at the teaching hospital if we are comparing people at the state level, so that is exactly what he has done.

He didn’t do that for only doctors, he increased it by 15 percent, the allowances and basic salaries of all other Health workers in the state and that is the situation with healthcare workers.

Now, moving beyond that, we have been able to set up a framework, a legal framework for sustainable service delivery and we have started implementing it positively by passing it into law and by setting specific health programmes. The governor has passed it into law by setting specific health programmes so that by the time he leaves office nobody will come and say this is what was done in the previous regime. These are legal tools and policies that are backed up by law and not just statements. So, one of it was that when we came in, there was nothing like Health Management Board, but today we have it by law. We have almost implemented it because there is a law on Hospital Management Board which is currently in existence. We have a law on drug management called Drug Management Agency and that is the only agency that is in tandem with national objectives of healthcare policy. Our state is the only one with that policy and what does that policy do? It is telling you that drugs will be uniformly procured by a central body that regulates the source and use of drugs.

So, the agency will be dealing directly with the national manufacturers that are credited with that purpose. We use them for that purpose to ensure that drugs that are procured are regulated.

Furthermore, in line with that, we have the Anti Quackery Taskforce right now, so that the service delivery in terms of laboratory, in terms of drug usage and in terms of general healthcare services are defined, so that if you are running a clinic or private medical clinic, we are assured that you are licensed to do that job and doing things according to the service of national guideline and international standards and so a lot of people are today being dragged by the government to court for doing one thing or the other against quality healthcare services and so, that is exactly where we are.

We have on board the extension of retirement age of healthcare workers in the state so that instead of the mandatory 60 years or 35 years of service for retirement, it has been extended to 65 years and if you are still interested in working not on contract basis but full time though it is not mandatory because you must be examined and interviewed by the state Civil Service Commission to ensure that you are still strong and your health status is still okay and that is what is happening.

In fact, when we came on board, the health infrastructure of this state was in bad shape and a lot of healthcare centres and hospitals were vandalised by #ENDSARS protesters and apart from that they were decayed. There was nothing remaining, and again the Governor, His Excellency, Bassey Edet Otu has started a gradual process of rebuilding, reconstructing of healthcare system. First, with the primary healthcare because as of today, we have more than 100 Healthcare Centres across the state that has been revitalised and what I mean by that is that we have functional healthcare workers that are in those places.

We have existing infrastructure, we have increased the scope of healthcare service delivery and right now, we have miniature hospitals with full complement of facilities like theatres, labour wards, labour rooms and in addition to every ward in this state. We have 190 wards in the state and each has at least, one midwife, somebody who specialised, trained in skills in ensuring that women deliver safely by minimising mortality and mobility rate and that is what we have been doing.

In these facilities, there is a staff quarter to ensure 24-hour undiluted service delivery.

In each local government, the primary healthcare centres have ultra scan in the high-density primary healthcare centres so that pregnant women can be accessed and also ensured that necessary care is taken without any problem.

The governor has approved funding for few of the abandoned hospitals and we have started gradually and we call on social media activists to try and verify their information first before going public.

We have been voted by our people to address challenges and we are not running away from challenges neither are we afraid of challenges and we are aware that every implementation and every desire has a starting point and you don’t expect all things to be started the same time. But we have started deliberately, for instance, the General Hospital at Ikom. We are recovering some of our hospitals that were given out under some arrangements that were entered into public, private partnership but we are doing our best to discuss with those private investors and see how those services can be more affordable to our people. We have been reaching out to them and there were medical outreaches but they were not organised. Moreover, you know that medical outreach is a kind of financial innovation healthcare pharmacy where people can get free medical services. As of today, we are providing services medically to over 95,000 people who are the beneficiaries and these people you don’t only measure their temperatures and blood pressures but with services to people with swelling, appendix, hyena, etc and some that come in with special needs and become automatic beneficiary.

This is what we are doing in terms of training. We inherited one College of Nursing, but today, they are about four Colleges of Nursing and each of them has about 1000 students and this is to address the middle level shortages in terms of professionals in the system and that is deliberate to ensure that nurses are coming out and we can engage them.

Most of the healthcare workers we presently employed are graduates from those of our colleges and we are deliberate about that and even now, we are working on a document to the governor to employ 40 medical doctors, so that in every facility we have doctors because we have about 14 general hospitals and three cottage hospitals now. And we expect that each of them should have about three medical doctors working there on daily basis and these are the things we are deliberately doing in the state and we think sincerely that as much as possible we are reaching out to our people.

We have also free medical services and native care for pregnant women until delivery and few months after delivery.

We have free medical services in those locations and facilities for children less five years of age and elderly people above 70 years in each of the local governments of the state. So, we are encouraging all students in the critical area of medicine in medical healthcare in the state to study very hard because presently the governor has announced free grants to all medical students of Cross River State and the plan is being concluded. We have started paying even though it does not address totally their financial demands in the university. We are ensuring that it can address some of the barriers.

What will you say is the biggest achievement of the Governor in the Healthcare Services in the last three years and counting?

We have already mentioned that we have had 100 primary healthcare facilities that have been revitalised and have been providing services in their various locations. There is no local government in the state that do not have at least four of those health facilities, there was none before he came in and that was a classical achievement of the governor.

What has been the most challenging aspect of your office as the commissioner for Health in Cross River State?

You know, the governor’s work to me is a miracle because I don’t know how and where he gets the money to do all these things but we thank God that at least he has addressed substantially the issue of funding because funding is the major problem. I think if our wishes were the kind of things that we can get everything; we would have been in heaven but unfortunately, we can’t be there because of funding which is not something the governor or the state should be blamed for. We met a porous state financially and that is why we can’t compare ourselves with other South-South states for now in terms of what is happening there, and that is why we are insisting on our oil wells. We are not saying that they should give us Akwa Ibom oil wells but the ones in territorial water space of Cross River State because the governor is a God-fearing person.

We are trying our best within the limited resources and we never knew we will go to this extent because of the financial porosity of the state.

We don’t have that kind of space that states like Akwa Ibom, Delta and Rivers States have because they are receiving money in billions while we are receiving small millions. So, you can see the difference of what the challenges are. The challenge has been funding and that is the greatest challenge.

Was it a political sacrifice for you to accept the appointment considering your personal relationship with the governor to support the administration?

I don’t think so. It is a personal sacrifice because the governor is a longtime friend and I think he knows what I can do without disappointment. I have been trying my best to achieve the expectations and I don’t think it is a political sacrifice. I have worked all my life in the developmental world and I left them peacefully. My friend, the governor, my employer, my boss gave me this job and I am doing it with all my heart. I don’t think I am doing it as a sacrifice. This is greatest thing I can pay back to my community and my state judging from my background. I think it is the highest calling I have ever had so far. I am trying to make use of it and at the end of it glorify the name of God who made it possible.

Recently a call was made for the governor to sack you. Why?

Those who made that call were political jobbers and if you are from the village, you know what the pear tree is and if the pear tree is in your farm or by the road side with good fruits you should expect it to be bastardised because people will be throwing stones to pluck it. They will throw stones at it up and down because they want that fruit, but the one with no fruits will remain there untouched. Look at Jesus Christ. Was he not killed? So, I don’t allow those things to distract me and the government of His Excellency is not guided by the social media. I am not working to meet the expectations of the social media. Every day they will go to one facility or slum to take picture and they will not take the pictures of the good things the governor is doing. So, if you decide to go to slum and take pictures and forget the good things, that is their business. I serve under a man that has the fear of God because we are focused and all those things do not matter. Everybody knows that the health sector in the state is not a health sector that is dormant. We are doing greatly and also working very hard. Let me just tell you one thing if you want to silence a good man or a good government you go to very strong voices like Government House and start castigating them every day. Just watch any time the governor makes any pronouncement in the health sector or positive achievements you will see the kind of noise they will make and the next day you will hear them saying sack this person or that the governor is stealing money just to down play what he has done. Few days ago, the governor just approved some money to start a Dialysis Centre for management of chronic diseases like kidney failure at Ogoja and then suddenly, two days after somebody comes around and starts saying something differently. They want to steal the show and they don’t want the public to concentrate on what the governor wants to give to Ogoja people. So, we are aware of those their tactics because we know any time the governor is about to move another step forward, they will come up with one or two negative things. We are not disturbed by their tricks and let them continue to shout. All these things I have mentioned as the achievements of the governor, were they there when the governor came into office? There are things you can verify, even beyond the health sector, the roads are there for everybody to see. If they start, they will go and snap one pothole somewhere and the governor is quite conversant with those things. He is not a man that you give money to go and do job and he will do a shoddy job.

With political activities gradually building up ahead of 2027 general election. Do you think the All Progressives Congress still has a chance of retaining the governorship seat in Cross River State?

Who is there to fight the governor? There is nobody to fight the governor. I am a technocrat and I am also a politician. Where the presidential candidate of the People’s Democratic Party (PDP) comes from is also where I come from. 90 percent of the votes there will be delivered to President Bola Ahmed Tinubu and every other candidate of All Progressive Congress (APC).