Between Kwara state government and lab scientists, who blinks first?

Laboratory scientists under the aegies of Association of Medical Laboratory Scientists of Nigeria (AMLSN) Kwara chapter and the state government are heading for a showdown. UMAR BAYO ABDULWAHAB reports.

Kwara state government had announced plans to manage state-owned laboraries through public private partnership arrangements.

It said the measures became necessary to chekmate unethical conducts among lab scientists which according to the government was largely responsible for a number of deaths recoded in the state.

Listing the sins of the lab scientists, the director general of the state hospital management board, Saad Oladimeji Aluko said, “It is pertinent at this juncture to let the people of Kwara know the antecedents of our laboratory services in the state and what led to the need for us to improve our services through a PPP arrangement.

“As we all know, the quality of results coming from our laboratory directly impacts the quality of care we offer to our patients. In recent times, public hospitals have recorded a number of casualties due largely to poor quality services and unethical practices by some officials in our laboratory.

“This ranges from extortion of patients in need of blood transfusions, overcharging of patients and opportunistic referral of patients to private labs, especially those owned by these officials. This is official sabotage perpetrated by persons paid from public purse.

“Three examples of near-misses arising from such inefficiency, conflict of interest and sharp practices may suffice.

“A retired nurse of Kwara State Civil Service brought his son for appendectomy (surgery) but was refused surgery because one of our labs tested him positive for Hepatitis B. He was later moved to another hospital (after a private lab confirmed him negative) where he was also confirmed negative. At the time, his appendix had ruptured and we nearly lost that young man due to negligence, lack of commitment and poor quality service.

“Another instance was the case of a very sick woman at the General Hospital Ilorin wheeled into a vehicle by her teenage son to run some tests at a private lab. Curious that such a sick woman could be discharged for lab test under such a risky condition, the hospital management quickly investigated what had gone wrong. It was discovered that this was a case of negligence and lack of empathy on the path of the lab workers. The claim that the test cannot be done at the GHI lab was found to be false as the same test was immediately run at the insistence of the office of the director general, Hospital Management. The treatment of the woman was diligently followed by the government to ensure all is well until she was discharged hale and hearty.

Government’s remedial actions

Explaining government’ s efforts to manage the situation before it gets out of hand, the DG said,
“Kwara State Hospitals Management Board has held several meetings with stakeholders within the state laboratory services to discuss these problems and generate solutions.


“Part of the problems was lack of automation and sabotage at our various laboratories. The government had procured 10 auto analysers and distributed same across the three senatorial districts. Today, less than four are working perfectly due to poor management and sabotage.


“Government had also engaged some companies to have equipment lease arrangement as is being suggested by some persons. Indeed, the UITH is having a similar arrangement, including PPP-driven services to run complete laboratory services. This is contrary to the claim that it is being sold to the populace.
“Government’s analysis of the proposition shows that patients wwould be paying significantly more than what is currently charged in those labs. So the government decided to abolish the mission in public interest. This is the experience with those who had implemented the arrangement. The government is not going that route in public interest.


“To tackle the issue of credibility on the results from our labs, the government had to introduce a quality control measure by bringing in laboratory consultants into the lab. The system was such that lab consultants must sign off the results from our lab before such results are released to the patients/customers, but this system was frustrated and those consultants had to leave to save their lives in the face of threats and intimidation.”

Justification

Justifying its planned strategic partnership with private sector, the DG said “The government is entering into a partnership with private bodies to ensure efficiency, credibility of test results and deepen public trust. Even so, in appreciation of the social nature of healthcare delivery, His Excellency, Governor Abdulrahman Abdulrazaq has given a strict instruction to see the MOU and the terms of contract before he can give a go-ahead.
“If there is any takeaway from the COVID-19 emergencies, it is that we need to build capacity and strengthen the efficiency of our local health services. This can only be achieved if we all put our feet down and not allow persons with vested interests to manipulate the system for their own selfish agenda. A situation whereby public facilities are destroyed and made inefficient for private businesses to thrive is definitely at the expense of the collective interest of the state and this should not be allowed to continue.”

Lab scientists’ counter claims

In a swift reaction, the lab scientists through their association debunked the allegations levelled against them, saying the government is misinforming the public in its bid to justify planned privatisation of government owned medical laboratories in the state.
Debunking the government cliam, AMLSN chairperson, Mrs Ogunwale K.A.T said the association said the excuse of the Kwara state government is customary to target the laboratory for personal gains in collaboration with their business friends.


Ogunwale said laboratory privatisation was first tried by Lagos state government at the advent of democracy in Nigeria and only resulted in immediate high increase in the cost of running laboratory tests with attendant profiteering which eventually led to the barrage of public complaints and collapse of the programme.
It argued that the privitisation in Lagos imposed hardship on the masses, increased their out- of- pocket spending and anti universal health coverage which is the current focus of healthcare strategy globally.
“This new attempt by the DG is in the least taking kwara state 20 years back.


“The Federal Ministry of Health experimented with this same strategy more than a decade ago at UCH and failed woefully. In fact, many private companies left unceremoniously after breaking terms of agreement.”
The association noted that the allegation of unethical practices by lab officials is akin to giving a dog a bad name in order to hang it.


She insisted that medical laboratory scientists are not among those exhibiting unethical conducts by the state government.
“The so called acquired equipments for the laboratories by the DG were done without carrying the end users along, only for them to purchase outdated equipment and dump them in the laboratories. What magic does the DG expect with wrong equipments it dumped in the laboratories?” she queried.

“It is trite to let the public know that referral for tests are never done by medical laboratory scientists as it is beyond the scope of our duties. The DG knows very well that this is the function of doctors who are compelled to refer tests to private laboratories knowing fully that there are no facilities to run the tests at the government owned labs. The General Hospital in Ilorin has been turned to a glorified Primary Health Centre where major tests cannot be done. This privatisation drive is to take away the little that is left for the public to enjoy in government hospitals. This is anti people and anti posterity.”


The association affirmed that the government’s statement is political. According to her, “Kwara state has just 14 medical laboratory scientists compared to more than 80 in neighbouring Niger state without mentioning hundreds in Kogi, Oyo, Ekiti, Osun and Benue states. Instead of addressing the manpower needs and poor welfare issues, the DG is using laboratory as cover up for crass inefficiency of government agencies who have been keeping facts from the government thus misleading it to enunciate anti people policies especially the one that affects the people’s health.”

The association said the state government must jettison the drive for PPP model it is currently promoting and consult with the association for better ideas on solving the current challenges instead of feeding the public with half truths and misinformation.


Blueprint recalls that doctors under the employment of the state government just called off thier warning strike which they embarked upon to press home their demands.
While the strike lasted, nurses under the employment of the state government also handed down 21-day ultimatum to the government to attend to their demands.


With the ultimatum still counting, the ongoing face off between the government and laboratory scientists is not a good signal. Unless there is an amicable resolution of the face-off, the sector may witness another round of industrial unrest.