There were strong indications on Sunday that the Federal Government had yet to start the implementation of the National Basic Health Care Provision Fund almost seven years after its bill was signed into law.
The Cross River State Commissioner for Health and Chairperson of the Health Commissioners’ Forum, Dr Betta Edu, in an interview with one of our correspondents in Calabar, called for the speedy implementation of the basic health care fund to solve the health sector’s funding crisis.
But the Minister of Labour and Employment, Dr Chris Ngige, blamed states for the delay in the implementation of the NBHCPF, saying many of them had yet to pay their counterpart funds.
Former President Goodluck Jonathan had in December 2014 signed the National Health Care Bill into law with a provision for the Basic Health Care Fund, but failed to make budgetary provisions for it.
In 2018, his successor, Major General Muhammadu Buhari (retd.), made budgetary provision for the fund.
One per cent of the Federal Government’s consolidated revenue goes into the BHCPF as well as contributions from donor agencies in form of grants and is set aside to fund basic health needs of Nigerians.
We need speedy implementation of health care fund – Chairperson, health commissioners’ forum
Edu, in an interview with The PUNCH on Sunday, said the health sector was in need of a revolution.
“The Basic Health Care Provision Fund, which, thanks to Mr President for approving it, is another means through which we can get funding to cover basic care at the primary level and also attend to the vulnerable. We want a full and speedy implementation of the Basic Health Care Provision Fund,” she stated.
The chairperson also said the forum was encouraging states to adopt health insurance as part of measures to improve the funding of the health sector.
Edu stated, “If everyone should make a mandatory payment of a little token into a central purse, it will help to decouple the health sector completely from the reliance on internally generated revenue or federal allocation.
“We had support from the Federal Government through the Presidential Task Force last year to be able to respond to COVID-19. States are soliciting support from the Federal Government in different ways to respond to COVID-19, to cholera and to be able to strengthen the health system at the state level.”
On funding assistance in the health sector by foreign donors, Edu said during its meeting in Abuja last week, the National Health Committee held discussions with all international donors and partners.
UNICEF sets up health sector award for states
She stated, “We agreed that they were going to support the states directly. They are going to work with states on their plans and to strengthen the system. The partners are willing. They were all present at the meeting. The Ambassador of the United States to Nigeria, heads of different global funds and UNICEF were all there at that meeting.
“We had a very robust discussion. In fact, UNICEF has organised a public health care challenge for states to compete and win money based on their performance.”
On plans by the states to combat cholera, she said, “First, we have resolved that we are going to need technical and financial support for states that are affected by cholera. But more importantly, states will set up multi-sector committees at the state level headed by the Ministry of Health that will look into the issue of cholera.
“Cholera is a multi-sector problem, not just about the health sector. We should start from prevention, information, health promotion and going out. We should engage with the Ministry of Water Resources, which has managed the WASH programme to ensure that water is available to everyone at the state level.”
Only two or three states accessing the fund, maybe they have no money – Ngige
Responding to the request for the speedy implementation of the fund, the Federal Government, on Sunday, laid the blame on the non-implementation of the National Basic Health Care Fund Act on the doorsteps of states, which it said had so far failed to provide counterpart funds that would make them access the fund.
It also said since health was on the concurrent list, states needed to domesticate the law to enable their Houses of Assembly to budget for it.
The Minister of Labour and Employment, Ngige, disclosed this in an interview with The PUNCH.
Ngige, a medical doctor, said he was a member of the Senate Committee on Health in the 7th National Assembly, which prepared the law that he described as a good one.
The minister said although he did not know why state governments were dragging their feet on the implementation of the law, he added that it could be that they did not have money to provide the counterpart funding.
He stated, “The National Basic Health Care Fund Act is part of the National Health Act. We prepared the bill when I was in the seventh Senate.
“It has been signed into law, but you know that health is on the concurrent list and tax is on the concurrent list. So, when you do a law on issues on concurrent list, states have to domesticate them to implement.
“It is not that they are not bound by it, but their state Houses of Assembly have to domesticate it so that they can start budgeting money for it.
“A section of that Act made it clear that they have to pay counterpart funds for any money that the Federal Government brings. They pay 25 per cent for it, while the Federal Government pays 75 per cent.
“Most of the states are not accessing it. Only one, two or three states are doing that.
“The law is an omnibus one, dealing with even health insurance as well as accident and emergency fund for people to get treatment free of charge first before you start asking for the patient’s details and who will pay the bill.
“It is an all-encompassing Act, which I believe is good. I was in the Health Committee of the Senate that produced it.
“The state governments are dragging their feet maybe because they don’t have money to do counterpart funding. I don’t know their reason, but the Act is a good one just like the UBE Act. That one also requires them to pay counterpart funds for primary education and a lot of state governments are not doing it even though the money will be used to build schools in their states.”
Non-implementation of Act shows lack of seriousness, says NMA
The General Secretary of the Nigerian Medical Association, Dr Philips Ekpe, in an interview with The PUNCH on Sunday, described the non-implementation of the Act as a sign of not being serious.
Ekpe said, “Implementation has always been a problem when it comes to policies. People are always looking out for their personal benefits.
“The National Healthcare Act has been passed since 2014 and that is like seven years ago, and now we are still on it. It shows the government is not serious.
“For us at the NMA, we believe that it is better late than never. We are hoping that the right things will be done.”
The spokesman for the Joint Health Sector Unions, Mr Olumide Akintayo, berated the federal and state governments for failing to implement the Basic Healthcare Provision Fund.
“The Basic Healthcare Provision Fund is a creation of the National Health Act. It is so structured in a way that it would have taken a lot of stress out of health care endeavours if it was adhered to,” he said in an interview with The PUNCH.
Copyright PUNCH.
