…As high electricity tariff poses huge challenge
The University College Hospital (UCH, strategically located in Ibadan, founded almost 67 years ago, has remained an important health superstructure.
The flagship tertiary health care institution in Nigeria and the West African region which opened its doors on 27th November, 1957 has been fulfilling its mandate of clinical services, research and training.
The first health care institution, offering world class services, has remained relevant as the tertiary healthcare needs of the country.
The University College Hospital, Ibadan, which was initially commissioned with 500-bed spaces, presently has 1445-bed spaces and ranked the best even on the African continent.
Having come a long way especially at this crucial period when primary healthcare in some states and local governments are near comatose, this put more pressure on the hospital, especially for indigent Nigerians who cannot afford travelling abroad for medical treatment.
Jesse Abiodun Otegbayo, the new Chief Medical Director of UCH, said: “In a year from our records, we received about 250,000 out patients; it keeps increasing because these days, we now have health management organisations using UCH for health insurance purposes. Then we have patients in the wards, we admit over 150,000 including accident victims every year.”
Otegbayo, a professor who resumed as CMD early last year, also said: “We are number one teaching hospital, want to remain so, although it’s easy to get to the top but to remain the head is tough because people will compete with you; so, we want to remain the flagship that we call ourselves.”
While saying that the hospital wants to step up training and research, he stated that “some of the services we are not yet providing regularly like the cardiac services and kidney transplantation, we want it to be something like a routine.”
The CMD, who said he came with a mantra of shared vision for excellence, added: “I also say shared vision, shared responsibilities and our catch phrase is staff welfare and patient comfort.”
According to him, “At the forefront of our administration is the issue of staff welfare and patient satisfaction.
“One of the things I noticed is that when you are going to our wards on the staircases, you’ll see people sitting on the floor, some using mat and all that, they use to bring dogs to chase them away; so, the first thing we did was to get some chairs like the type they use at the airport, with the provision of the chairs, people are so happy and the feedback was very good.
“Then I also felt there are three critical areas in our services- theatre, wards and clinics- I set up three committees, one of them is theatre management committee headed by a general surgeon. Then the ward management committee headed by a nurse, then the clinic management committee so that all the problems or complaints or challenges they have will be forwarded to the office of the Chief Medical Director; they work directly with me and I always address all the challenges.”
The CMD also said: “The other thing I noticed was that prescriptions are given and people were always going outside to pharmacies and those pharmacies making millions or billions out of us. Then, I felt if we can make the issue of our pharmacies more convenient it will go a long way to helping us. We first started with what we called ‘cash and carry pharmacy’ that will look like pharmacy outside the hospital because the bureaucracy of accessing pharmacy things here is really long; people having to queue for long, go this way, go that way, go and pay in that place, go and collect receipt here and all that. With the ‘cash and carry pharmacy’, it’s like a kind of fast care and people love it and because of the way it affected the quality of our services, we established the second one.
“Also, it is true, we have departments, and units to handle certain things, but you know sometimes they may not be up to date in doing it. I had to set up a special duties unit and they’re responsible directly to me with a mandate to always go around to see areas of deficiencies for the management to intervene. So, they have subcommittee to look into aesthetics of the hospital, patient concerns and other things even staff welfare.
“Then, disease outbreak usually comes in a subtle way. If you’re not careful in monitoring, it may become epidemic or pandemic. I established a disease surveillance unit headed by a Professor of Public Health (Prof. Osunpade).
“I also noticed that health insurance department is a sub-population of our patient because they have health insurance they don’t need to pay out of pockets because the HMO (Health Management Organisation) will take care of it. So, we need to take care of them specially; with that I created a Health Insurance department headed by a family physician with support staff, to take care of all challenges that may come; so, usually resolve it and if there’s any challenge or issue it will be referred to the CIMA or myself to iron out.”
He also disclosed that the biggest challenge facing the hospital is that of electricity.
According to him, “Sometime in April this year the hospital was disconnected and the story was all over the place. Electricity has been a challenge and for a hospital we’re not like the University that you can switch off the lights in your laboratory, your offices and go away, weekend there may be no activity and socials. But here, the day you open the hospitals you throw away the keys, the doors must be opened to patients except during Ebola and pandemic we reduced the number of intakes, you can’t stop people because people will always be sick.
“Then many of the cables that conducts electricity for us, some of them have been there since 1957 and have not been changed, the panels also called the change-over units we have problems with them because some of them are older than me you know; I was not born in 1957. So, they are currently developing issues and of course, coupled with the high cost of IBEDC charges. IBEDC wants to put us on Band A when we are still struggling to pay on B, we’re still on that we’ve contacted the Minister of Power but it still remains a challenge.
“The other thing is that the cost of electricity they pass to UCH and College of Medicine of University of Ibadan. You know the College of Medicine like in LUTH, is also situated within the hospital but they are different administrations. They are Ministry of Education, we are Ministry of Health but the way UCH is wired in those days, everything was put together; so they pass the bill to us and all efforts to say they should separate us like they’ve done in LUTH has not really been successful,” the CMD added.
“The other is the issue of manpower. The ‘JAPA’ syndrome has really affected us. We have approval of the head of service for manpower of 7,200. Not just doctors alone but the entire workforce. What we have now is less than 600 and we’re creating more departments, units, some people are subspecialising.
When this hospital started in 1957, there were only 150 staff. Now, we still have the same structure but expansion of departments.”
He also said that funding has become a serious issue as government alone cannot handle it.
“We are looking at possibility of doing
Public Private Partnership (PPP) with some private companies in funding this place and when you talk of funding, you talk of equipping laboratories, radiology departments, theatre, accident and emergency for better and quality services to the clientele.
“As for that of water, it also revolves around electricity and other things because if there’s no electricity, you can’t pump water, then we generate our water by ourselves because there’s no municipal supply, we get our water sources from Dandaru, around Mokola in Ibadan.
“We have a reservoir, pass it from there, it comes to our water treatment centre and every week, we buy chemicals to sterilise the water and filter to the standard that can be used within the hospital. Then we need the electricity to pump it to our overhead tanks, from there we then pump into UCH. Many of these pumps are old, they need replacement, even the tanks itself, it’s getting rusty at some point and even the water we treat is leaking.
“On our own too, we are working on an independent power project but later we discovered that renewable energy is even cheaper and because the sun is free, it’s just to get the panels and the batteries. So, we have set up an energy committee headed by one of us that is interfacing with many companies, so, we are looking for companies or individuals that will do it for us at 0% equity contributions at least at the initial face, only for us to commit ourselves that we would be buying energy from them.
“He further said the hospital hope to improve on what it is doing now and one of the major future plans is to ensure that we have our own source of electricity because we cannot continue to wait for government because if we can get the electricity right our productivity will increase remarkably.
Then the digitalisation of the hospital which we have started with a company called Health Station for about 5 years, through this, we do away with major paper things.
“So, we can remotely do a lot of things even as the CMD, I may be in America and be working, work from home. I don’t have to sit on so many files and all that, we have done the software, we only need the hardware which we have put in our 2024 budget.”
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