NHIS crisis: Fed Govt, House to the rescue

• Council, students issue threats

The crisis rocking the National Health Insurance Scheme (NHIS) is far from being over. The governing council that suspended the schemes executive secretary has threatened to quit if its decision is reversed. Students’ unions are also plan to storm the NIHS office today. But the Presidency and the House of Representatives are intervening, report VINCENT IKUOMOLA, VICTOR OLUWASEGUN, ABDULGAFAR ALABELEWE and YINKA ADENIRAN.

For the Executive Secretary of the National Health Insurance Scheme (NHIS), Prof Usman Yusuf, this is not the best of times.

His suspension, the second in less than 18 months, has pitted workers’ unions within the scheme against one another.

The embattled NHIS boss had showed up at work a day after his ‘indefinite suspension’ last Thursday by the scheme’s Governing Council.

The unions staged protests and counter-protests on Monday.

Security agents had hectic time controlling the organised protests staged by three unions at the NIHS Abuja headquarters by pro and anti-Yusuf.

The unions are the Association of Senior Civil Servants of Nigeria (ASCSN), Medical and Health Workers Union of Nigeria (MHWUN) and Nigeria Civil Service Union (NCSU).

According to the Governing Council, Yusuf was suspended over alleged gross misconduct.

Other allegations against him include: fraud and severe infractions, public procurement infringement, unlawful staff posting, willful defiance of Council directives, violation of Federal Government’s Treasury Single Account (TSA) policy and superfluous arrogation of projects.

Health Minister Prof Isaac Adewole had on July 6, last year suspended Yusuf over similar allegations.

Students’ union bodies plan protest

The National Union of Nigerian Students (NUNS) said it has mobilised and concluded plans to storm the NHIS office with other students unions tomorrow.

The mission is to sack Yusuf from office.

The students’ union body said, aside the fraud and sundry allegations against Yusuf, “Tertiary Institution Students’ Health Insurance Program (TSHIP) under the NHIS supervision has become another fraud and scam”.

In a press statement by its spokesman Ibrahim Olawale Seriki, NUNS said: “While this is considered as bad precedence for our generation and those unborn, NUNS, National Association of University (NAUS), National Association of Polytechnic Students (NAPS) has jointly resolved to launch an action against this shameful act targeted at rubbishing the integrity of dear country and administration of President Muhammadu Buhari particularly as we approach electioneering year.

“The NHIS ES earlier suspension by Health minister in July 2017 was over N919 million fraud allegations which he refused to honor until his controversial reinstatement in February 2018 by the Presidency.

“The TSHIP under the supervision of NHIS has become another fraud and scam, it is best described as gambling on students’ lives, students are forced to pay the sum of N3, 500 each per session for TSHIP a charge increased recently from N2, 500 with approval of NHIS despite it woeful effectiveness and serial complains of poor and inconsistent fulfilment of statutory roles of HMOs by Students across the country.

“Students have not benefited from this programme as expected, students die on daily basis following poor implementation of TSHIP, it is assumed to be a conspiracy between NHIS management and HMOs to defraud the students as well endanger their lives as we bank on imaginary health insurance policy (policy which does not work in real sense).

“A student of the Emmanuel Alayande College of Education, Oyo State, is medically stranded with no aid from TSHIP; the Federal Polytechnic, Ado Ekiti, lost a student to reckless TSHIP; the Federal University of Technology Minna lost a student to the same failed insurance program; a 100 level student of the University of Abuja died recently over ineffective TSHIP, just as a student of same university (a victim/survival of an accident with permanent disability) is yet to get compensation and one is still financially stranded in National Hospital as we speak among many others too numerous to mention.

“The incessant refusal of executive secretary to suspension to pave the way for a thorough investigation is a pointer to guilt and culpability stand of the ES even before the investigation, hence, the students’ move to act in defence of the constituted authority and restoration of sanity in our system towards complimenting the effort of Federal Governments’ fight against corruption and most ultimately to end the failed TSHIP and continuous murder of students by HMOs under the NHIS supervision with ineffective and fraudulent TSHIP programme.

“Nigerian students, lovers of justice, admirer of rule of law, crusaders of due process and life savers are hereby invited to join us as we move to eject the adamant suspected Fraudulent ES who is refusing to stay aside from office for investigation on tomorrow (Thursday, October 25,)

“Our prayers are the immediate vacation of the ES from office until investigation is concluded and immediate probe of TSHIP Programme and discontinuation of the program by NHIS.”

But the Federal Government reinstated him on February 6, 2018, after an administrative panel found him not guilty of the allegations of abuse of office and maladministration.

Yusuf officially resumed work on February 8, 2018, after he was given the clean bill.

A protest staged by members of the NHIS chapter of ASCSN to prevent Yusuf from gaining access into the office, was countered by their NCSU colleagues.

The situation that almost degenerated into security breach was however contained with the intervention of a combined team of police, Nigerian Security and Civil Defence Corps (NSCDC) and Department of State Services (DSS) operatives.

But the Senior Special Assistant (SSA) to the President on Media and Publicity, Malam Garba Shehu yesterday said the Presidency has stepped into the NHIS crisis.

Shehu, who featured on Channels Television Sunrise Daily in Abuja, said the Secretary to the Government of the Federation (SGF) Boss Mustapha and Health Minister Prof Isaac Adewole, had intervened in the NHIS crisis with a view to finding lasting solutions.

The SSA noted with regret that the NHIS crisis had been ethnicised and politicised by some interest groups within and outside the agency.

Shehu said: “Did the board follow due process in suspending this gentleman? There are opinions that said ‘no they haven’t’.

“Again, we all have to do the right thing all of the times. I don’t deny the fact that there is a lot of work to do – (the crisis) is complicated by the fact that the whole thing about the NHIS has been ethnicised and politicised.

“Even a political party was issuing a statement on matters that are unknown to it. I’ll tell you one thing, as we speak now, you know that no matter whatever mistakes this gentleman may have made, and that is to be proven because I don’t have the records to say yes or no, he has launched a major reform in that institution, which had blocked access to public resources.

“Money from the NHIS is not money belonging to government, it is money taken from your salary, from my salary.

“If we have been enlisted, we are supposed to get treatments when we fall ill. Then, you should ask the question, in 13 years of the NHIS, how many Nigerians have received the treatments.

“Yet, you have HMOs, these vendors, taking N5 billion every month, money that is just being shared and somebody came and said, `look, this can’t go on’ and with strong support from this administration, the N5 billion has been reduced to N1.3 billion.

“And even at then, the administration is not satisfied. We want to see healthcare delivered to the citizens of this country. So, there is a lot of work to do.’’

The presidential aide, who stated that he was not in the position to challenge the allegations of wrong doings levelled against the executive secretary in some quarters, however, maintained that the two chambers of the National Assembly had previously cleared the executive secretary of the allegations against him.

He also dismissed the accusation of “double standard” by the Buhari administration while dealing with cases of corruption being levelled against public servants or political office holders in the country.

According to him, it was wrong to compare the case of former SGF Babachir Lawal to that of the NHIS scribe.

“Well, there is no double standard there either than to say that the pictures that the government is looking at, many Nigerians, perhaps, may not be seeing those pictures,’’ he added.

Fading faith in scheme

The Nigerian Medical Association (NMA) yesterday called on the government to strengthen Nigerians’ faith in the scheme.

The Association, which described the health insurance scheme as a vital tool in the attainment of the Universal Health Coverage, harped on the urgent need to improve enrolment to the scheme, which is currently put at less than five per cent coverage.

Oyo NMA Chairman, Dr. Akin Sodipo made the call yesterday at the NMA House at a press conference to kick-off the weeklong annual event to celebrate medical and dental practitioners in the country.

The event christened: “2018 Physicians Week” which is to run from October 21 to 27, is said to be “in recognition of the sacrifices and dedication to the wellness of their immediate communities and the Nation at large, and to also look at those factors that militate against the provision of effective healthcare by the Nigerian doctors.”

The celebration themed: “Universal Health Coverage- Leaving no one behind”, according to Sodipo is chosen after analysing key issues affecting “our health care delivery system vis-à-vis quality of lives of Nigerians and in line with the aims and objectives of the Sustainable Development Goals (SDGs) 2015.”

He said the UHC will enable everybody and all communities access the needed promotional, preventive, curative, rehabilitative and palliative health services.

Sodipo said: “The healthcare delivery in our country is still largely out of pocket which constitutes about 70 per cent of our health expenditure as opposed to the recommended 30-40, abysmal low coverage by NHIS which is still less than five percent, poor budgetary allocation to health (less than five per cent of the total budget), inequitable distribution of human resources for health with inverse distribution of health personnel compared with the population with over 70 per cent of health personnel serving 30 percent urban dwellers as against less than 20 per cent health personnel serving over 70 per cent population living in our rural areas, generally low doctor/health workers to patients ratio, low per capita income, poor access to healthcare facilities among others.

“In recognition of the importance of health financing in the achievement of UHC, a fundamental strategy to address our abysmal poor health indices, there is urgent need to improve enrolment in our National Health Insurance Scheme (NHIS) from the current less than five per cent coverage. Nigerians are increasingly losing hope in NHIS as a tool, which is vital to the attainment of UHC.

“To achieve UHC, it is, therefore, important to strengthen the NHIS and explore other health care financing system like community-based health insurance which some states have keyed into. This scheme will significantly cater for the informal sector especially the rural dwellers.

“There is also the need to ensure that our leaders muster enough political will for quality and effective healthcare services in Nigeria.”

The NMA also called on the Federal Government to immediately constitute the council of the MDCAN and its sister profession, the Pharmaceutical Council of Nigeria (PCN).

House investigate suspension of NHIS boss

The crisis rocking the National Health Insurance Scheme (NHIS) got the attention of the House of Representatives yesterday. The Green Chamber said it will investigate the suspension of the scheme’s Executive Secretary, Prof Usman Yusuf.

The House passed a resolution to raise an ad-hoc committee to investigate the issue.

The House resolution was sequel to the adoption of the prayers of a motion of urgent importance by a member, Diri Douye (PDP, Bayelsa) on the floor yesterday.

Moving the motion, the lawmaker said the latest NHIS crisis came barely five months after the executive secretary was ‘controversially’ reinstated by President Muhammadu Buhari from an indefinite suspension slammed on him by his supervising  Health ministry on July 2017 over similar alleged gross misconduct, corruption and nepotism.

Douye noted that the suspended executive secretary flouted the authority of the NHIS Council by violently breaking into the Abuja Head Office of the Scheme on Monday, “aided by almost 50 heavily armed policemen and overpowered the security men.

“The staff at the premises, including women were indiscriminately teargassed and manhandled.”

“This very critical sector, on which the hope of our universal health delivery is  hinged, far from being a theatre of health it has degenerated into a theatre of war, with so many scandals in recent times.”

Duoye’s colleagues condemned the scandals while contributing to the debate, with a member, Tobi Okechukwu (PDP, Enugu), lamenting: “this government claims to come and fight corruption but it is so sad that this impunity is happening”.

Edward Pwajok (APC, Plateau), however, cautioned his colleagues not to be judgmental since the motion is investigative.

According to him, “it does not need debating as it is investigative in nature.”

When Speaker Yakubu Dogara called for a vote on the motion, it was passed by the majority.

Council threatens to resign if suspension is reversed

•Leave us out of your problems, HMOs tells ES

The crisis took a fresh dimension yesterday as members of the Governing Council threatened to vacate office should the presidency reversed Yusuf’s suspension and investigation of infractions against him.

This is as the Health Maintenance Organisations (HMOs) urged the executive secretary to leave it out of its problems with the scheme governing council.

Announcing the suspension last Thursday, the council said the executive secretary would not be allowed into the office premises for the administrative panel investigating the allegations to do a thorough job.

But, the executive secretary insisted that the council lacked the power to suspend him, hence their directive to him to proceed on indefinite strike would not stand. Challenging the council, Yusuf argued that only the President who appointed him has the power to remove him from office.

Speaking to The Nation on the lingering issue, a source within the scheme doubted the possibility of council members working with the NHIS boss given their experience with him.

The source who pleaded for anonymity noted that Yusuf was in the habit of flouting the directives of the council.

Responding to the question on what would be the council’s next line of action should the Presidency quash the suspension and investigation instituted against the NHIS boss, the source said: “You see, one thing is clear, since this council was inaugurated till date, nothing has happened at the scheme. No instruction given to the ES was carried out. So, if he should be reinstated by the Federal Government, it is clear that the council and the ES can’t work together. So, we have to review that relationship.”

When pressed further to know if the council members would resign, the board member said: “We will walk away. We cannot work with him anymore. The council will work away. We can’t work together.

“The issue is this, in the course of this discussion; we need to clarify who has the superior power. The council formulates policies, serves as checks and balances to the management of all agencies.

“So, if there are infractions, it is the prerogative of the council to question those infractions and investigate those infractions and whoever is been investigated shouldn’t be seating on the council as at that time. So the law is very clear about that.”

Reacting to some of the allegations against the Council by Deji Adeyanju, a social crusader, Lekan Ewenla, representative of the HMOs on the Board of the NHIS governing council said there was no correlation between the HMOs and the infractions raised against the executive secretary.