Patients in need of appointments with doctors to determine the next phase of their care or track their recovery progress are facing difficulty doing so.
Many patients are forced to wait several months to make appointments as understaffing, and constant loss of workforce in Nigerian hospitals continue to worsen an already disproportionate doctor-patient ratio.
But it is brisk business for some staff of some public healthcare centres who silently push the patients to offer under-the-table payments to move things quicker in their favour or be delayed.
BusinessDay’s findings from two tertiary hospitals in Lagos, Nigeria’s bustling commercial city with a population in excess of 20 million, found that securing appointments with doctors has been a hassle, particularly for patients who innocently believe providing a reference letter and digging up their file alone would suffice.
In what is increasingly becoming a trend, hospital attendants handling appointments don’t openly demand tips. Rather, they present it as help that can get the files of willing-to-pay patients quick enough to the table of the doctors, BusinessDay learnt from patients and sources within the hospitals. The files of patients who offer tips are shuffled among those of old patients queuing in the hope to eventually see the doctor.
For two consecutive Thursdays in November, Olayemi Okedele didn’t see the doctor despite being scheduled for a clinic appointment at the gastro clinic at the Lagos State University Teaching Hospital (LASUTH).
The young lady in her late 20s who was just recovering from chronic gastritis, an inflammation of the protective lining of the stomach, said she would get up very early in the morning and race to the hospital before 5am just to get a front-row seat. She always went with her mother because she needed to be assisted to get to the hospital.
Yet, on those two days, she and her mother left in disappointment around 5pm. Unknown to them, under-dealing was prolonging her appointments. The experience discouraged her from continuing the clinic appointments, even though they were very necessary.
But another lady, who gave her name as Maureen, the daughter of an elderly patient, learnt the ropes early from a co-patient who had offered money and recharge card to fast-track things.
During an undercover visit by this BusinessDay reporter to track the trend, Maureen was quick to point out her contact, a staff of LASUTH.
Maureen had been able to get her mother’s file atop others on December 2, after missing an appointment scheduled earlier last week.
Her aged mother has been billed for surgery but was advised to seek a doctor’s assessment of her blood pressure level before going ahead.
“I sorted her (the hospital staff) to fix my mum up for an appointment. If not, we will waste money transporting ourselves here back and forth without achieving anything,” Maureen told the BusinessDay reporter.
“When we came two weeks ago, I met people who have been coming since April and June and I decided that we can’t go through that stress because of my mum’s condition,” she said.
This reporter took a cue, and after setting the tone of the conversation with a promise of sending N1,000 to her Polaris account number, the recommended staff was easily convinced to fix an appointment for Thursday. It was not anywhere near what Okedele had been through. They quickly gave her number and asked this reporter to send her full name.
“Do you have connections here?” she asked at first. “Can you come here early tomorrow? Some patients get here around 4am. I’ll give you my number. Text your name and send it to me. I’ll forward it to someone to place your name on the list. By 8am, we will take them to the doctor. Be here before then.”
While some healthcare workers like Maureen’s contact are rigging the system to favour some, many other patients are left to their fate, bearing prolonged suffering until they learn the ropes. Some never learn, and only a few secure their appointments by chance.
Efforts to reach the management of LASUTH to react to the findings did not yield results. The hospital’s public relations officer said she was not authorised to speak, while the chief medical director did not take his calls and did not also respond to an SMS sent to his phone.
But despite relying on tipping, even some who are linked with well-placed hospital staff have had to wait several months before securing an appointment for major treatments like surgery as understaffing and constant loss of manpower bite deeper.
“It’s really sad to note how normal it is to bribe your way to survival in this country,” Jovita Uchenna lamented in a tweet.
“I was beyond disappointed at the Lagos General Hospital located at CMS. I had an ear infection which affected my blood these past weeks, hence I couldn’t work much,” Uchenna tweeted.
In a research piece on how to fix corruption in the Nigerian healthcare sector, Obinna Onwujekwe, a professor of Health Economics and Policy in the Departments of Health Administration, Management, Pharmacology and Therapeutics, College of Medicine, University of Nigeria, and some industry experts agreed that health systems essentially must block the incentives they unknowingly create for health workers to engage in corrupt practices.
“The proposed solutions could help address these practices. But they can’t be implemented through a top-down approach because health workers are likely to resist them. Instead, health workers, managers and the facilities needed to agree on what action needs to be taken that there’s buy-in,” they stated.
