Angela Onwuzoo
The Association of Nigerian Private Medical Practitioners has opposed the proposed emergency medical care bill, urging the National Assembly to create a conducive operating environment that enables private hospitals to save lives and discharge their professional responsibilities effectively.
The association argued that the government should provide financial and institutional support to private hospitals before imposing additional obligations on them, noting that provisions for emergency care were already contained in the National Health Act.
ANPMP warned that private hospitals were already grappling with unpaid emergency treatment bills, rising operational costs and shortages of medical personnel, cautioning that the proposed legislation could worsen the sector’s challenges and force more facilities to shut down.
The association’s position follows a proposed bill before the Senate seeking to impose a six-month jail term or a fine of up to N300,000 on hospitals and healthcare providers that violate its emergency treatment provisions.
PUNCH Healthwise reports that the bill also seeks to compel public and private hospitals to assess emergency patients within 15 minutes of arrival, commence initial stabilisation within 30 minutes and complete referrals to other facilities within three hours, where necessary.
In an exclusive interview with PUNCH Healthwise, the ANPMP National President, Dr Ernest Chukwuma, maintained that private medical practitioners were not opposed to treating emergency patients but rejected what he described as policies that imposed obligations on hospitals without providing the necessary support.
“We are not against regulation at all. We are asking for partnership. If we genuinely want to improve the health indices of our citizens and support the health sector, especially the private sector to grow, then we must start telling ourselves the truth in this country,” he said.
He said private hospitals were expected to treat emergency patients regardless of their ability to pay, but often received no reimbursement for such services, particularly when patients were brought in by ambulances not accredited by the government.
Chukwuma explained that government-funded coverage for the first 48 hours of emergency treatment applied to patients brought in by ambulances accredited by the National Emergency Medical Services and Ambulance System.
NEMSAS is a federal government initiative established under the National Health Act to coordinate, standardise, and provide pre-hospital emergency medical services.
The ANPMP president, however, noted that more than 90 per cent of emergency patients arrived at hospitals without ambulances, making it difficult for private facilities to recover treatment costs under the existing arrangement.
He said patients arriving in police vans, tricycles, cars or through other means were not covered by the reimbursement arrangement, leaving hospitals to bear the cost of their treatment.
“There is a law already in existence that only the emergency cases brought into the hospital in an ambulance, and those ambulances must be government-accredited ambulances. So even if a non-government accredited ambulance brings them, there is no one to reimburse you the money.
“You and I know how many emergencies are brought in by ambulance. Some, the transporters bring them. Even the police themselves bring in emergencies to us in their vans. So what our members have been receiving all this while is thank you, thank you, and no reimbursement except the ones brought in by ambulance,” Chukwuma noted.
The association president said the few eligible cases brought in through NEMSAS-accredited ambulances were paid for by the agency, but most private hospitals continued to absorb the cost of emergency care provided to patients who could not pay.
He said the situation had become a financial burden for private facilities, particularly as they were also expected to comply with regulatory requirements and could face imprisonment or fines if they failed to provide emergency care.
Chukwuma stated that doctors do not reject or delay treatment when a patient requires emergency attention, stressing that saving lives remains their professional and ethical responsibility.
“Our position is that no doctor should reject or delay treatment of a patient in an emergency because life comes first, that is the oath we swore to, and that is the ethics of our profession. In an emergency, we treat first,” he said.
However, he said the challenge often arose when emergency treatment progressed to investigations, medicines and other services provided by hospital departments that might require payment before proceeding.
The ANPMP president questioned how doctors could be held responsible when diagnostic or pharmacy units delayed services because patients had not paid.
“Medical doctors are always willing to attend to all emergency patients that require their attention. Consultation itself is often free if need be. The challenge arises when it comes to investigation and treatment, which involves other units like the diagnostics and pharmacy department.
“If those units refuse to cooperate or delay by requesting receipt of payment before giving drugs, who then must be jailed? The law must be clear on this,” the doctor said.
Chukwuma also said private hospitals sometimes referred emergency patients to better-equipped facilities when the cases were beyond their capacity, describing referral as part of appropriate care rather than refusal to treat.
He called on the government to establish a private hospital financing framework, provide structured loans and grants, and extend alternative power interventions, including solarisation, to private healthcare facilities.
He said private hospitals had previously been excluded from a government alternative power initiative that benefited public hospitals, despite the importance of reliable electricity to emergency services.
The association also urged the government to address the shortage of medical personnel and poor remuneration, which Chukwuma linked to the migration of healthcare workers abroad.
Chukwuma further called for an end to multiple taxation on private medical practitioners, arguing that they provided essential services and should receive support rather than additional financial burdens.
He said the government should create an enabling environment for private hospitals to operate sustainably, including access to affordable financing and support for the high cost of electricity, equipment and staffing.
“The sad reality is that the private health sector in this country is gradually shutting down. They do not want to think, hear or do anything to strengthen the growth of medical practice, especially the private health sector,” he said.
Chukwuma said the association was seeking partnership with the government rather than opposing regulation, insisting that private hospitals needed practical support to continue providing emergency services.
He urged lawmakers to reconsider the proposed legislation and address the funding and operational challenges confronting private healthcare providers before imposing further obligations on them.
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