There was a predictable response to the news of the approval-in-principle the Infrastructure Concession Regulatory Commission (ICRC) granted the Federal Ministry of Health, to work out public-private sector (PPP) schemes for further rehabilitation and management of 22 teaching hospitals across the country.
Nigerian Labour Congress (NLC) kicked against the move. It is time for the NLC to review its predictable routinised response for a more robust engagement aimed at achieving better outcomes for the citizenry.
ICRC at a ceremony on August 20, 2019, presented a certificate to the health ministry for the rehabilitation and concession of federal teaching hospitals. Chidi Izuwah, ICRC Director General, said the ministry could now pursue other steps in the process. These include picking partners, obtaining financial closure and signing relevant concession agreements.
However, the NLC would have none of it. Supported by the Medical and Health Workers Union of Nigeria, the sectoral association, the umbrella labour body has stated its objection against any efforts to carry out what it called the privatisation of the hospitals. Labour’s primary opposition is the fear of an increase in rates and charges and concomitant unaffordability to the poor. NLC says rather than a concession; private sector investors should build new facilities. What happens to the existing ones though?
Labour has consistently opposed efforts to inject private sector approaches to the management of state-owned enterprises in the country. They similarly kicked against upward review of the electricity tariffs. The evidence is that citizens continue to pay more for the inefficient services of the power firms attributed to poor returns on investment and their inability to generate enough profits to make needed investments. The citizen pays for the cost of using generators and sundry power sources.
We invite NLC and persons so inclined to take a second look at the matter. In the first place, state-owned enterprises such as the teaching hospitals are in the half-way house of free enterprise. They are legal entities that governments create to partake in commercial activities on its behalf.
A significant challenge is the weak pricing of services because of a poor reading of their overall purpose. Government management of business in Nigeria has increasingly revolved around fixed and unsustainable pricing supposedly to protect the poor but which ends up punishing them with inefficiency and lack of service. Earning inadequate returns leads to a panoply of other problems. The consequence is the poor returns to all stakeholders, but even more so the citizen who does not get proper services from outfits supposedly priced to assist him.
Nigerian history with state-owned enterprises thus far points to the desirability and near imperative of adopting a model that would ensure the enterprises survive. Sustainability is the first rule of businesses, institutions or enterprises. Only those who remain can debate policy options.
All stakeholders, including labour, must pay attention more to the baking of sustainable wealth rather than sharing and allocation of what is now an illusion. As presently run, those 22 teaching hospitals cannot sustain their operations; they would, therefore, fail to serve even the poor.
Rather than quibbling, the unions should work with the federal ministry of health and ICRC to agree on appropriate technical and financial criteria for the selection and emergence of the partner firms. Similar consideration should feature in the choice of management, protecting the interest of workers as well as patrons of the hospitals.
We urge full speed ahead with the planned concessions, working with all stakeholders to achieve a win-win.
