Wednesday, May 13, 2015

Our hospital is now better equipped –LASUTH CMD

Chief Medical Director, Lagos State University Teaching Hospital, Ikeja, Prof. David Oke
The Chief Medical Director, Lagos State University Teaching Hospital, Ikeja, Prof. David Oke, in this interview with BUKOLA ADEBAYO relates new development in the hospital

The Ayinke House – a maternity cllinic – has been shut down for renovation that has taken many years now. Why is that?

Ayinke House served pregnant women within and outside Lagos; but structural evaluation of the building some years ago showed that it was about to collapse. We closed it down and provided alternative maternal centres because the state government wanted to do a complete overhaul, which has taken a lot of investment and time.

Patients complain that ultra modern health facilities often come with high cost. Would the masses bear the cost of this renovation?

Health Insurance is the way to go. The Lagos State Government will soon start an insurance scheme that will help patients, no matter their socio-economic status. This will enable them to access health care services. If many women and their children patronise Ayinke House, it will beat down cost because medical care is a game of numbers. If more patients use the equipment and facilities, much more revenue will be generated internally. That, itself, is an insurance against high cost.
Then, realise that the state government has a policy that ensures that Lagosians that are less than 15 and those above 60 years of age are looked after. Ayinke House is not meant to serve the elitist only, but to continue to provide services for people at the grass roots.

The general perception is that teaching hospitals are full of cases that should be treated at the primary health care centres. How can we correct this anomaly?

To some extent, you may be right. Prior to this time, most of the PHCs did not have doctors, they just had experienced nurses who could take care of many things. But now, we have doctors in PHCs, and a lot more care is delivered better than what it was eight years ago.
That is why we have cases where patients are given three-month appointment for surgery. It is simply because there are too many patients and surgeons are human. If it is safe for a surgeon to do four surgeries in a day, he should not do six because of the fatigue which could lead to irreversible error.
What the Lagos state government has recently done is to empower the primary health care centres and further empower the secondary health facilities so that a lot of the patients that come to LASUTH with minor cases will be reduced.

So if the appropriate care is given by doctors at the grassroots in PHCs, a lot less will be referred to the general hospitals and a lot less will come to the teaching hospitals and we would be able to solve a lot of the problems. In the next two or three years, we should be over that.

What is LASUTH doing to discourage Nigerians from seeking treatment overseas?

We have a cardiac centre that has now evolved into a Critical Care Centre. It is now equipped to take care of anybody that is critically ill. It can be medical or surgical. We have beefed up manpower such that all consultants in LASUTH will see the patients.

More than 20 per cent of Nigerians who travel overseas for treatment go for cardiac surgery; 75 per cent go to treat kidney challenges, while the rest may be cancers and other conditions. The Lagos State Government wants to change that. Right now, the cardiac and renal centres have been inaugurated and operative; so that more Nigerians can be treated in the country.
Most modern health facilities in our hospitals have no manpower to drive them. How do we rate these centres in this regard?

We run cardiac training in LASUTH. We have specialists training residents. We have two cardiac surgeons, four physicians in cardiology, three renal surgeons and four renal physicians. We also collaborate with physicians in the Diaspora to develop our human capacity. We have also sent many of our doctors and nurses to India for further training on this specialty.

But the challenge is that cardiac surgery is not cheap and getting paid for these high-end surgeries is difficult. For instance, we had a patient with chronic heart disease. We did an open-heart surgery for him, for which we had to get experts from India to collaborate with our surgeons. For three years now, he has not paid a kobo!

But we had to do it because we wanted Nigerians to know that we could have these surgeries done in LASUTH. We have done five cochlea transplants for hearing-impaired individuals. We have been awarded the Best Managed Health Care Facility by the Nigerian chapter of the International Facility Management, in addition to other international awards.

Incessant strikes by doctors, nurses and other health workers almost crippled health care delivery in Lagos. What is being done to curb such?

I can tell you that strike is going to be a thing of the past. After the last strike, the Nigerian Medical Association tried to see how disputes and other matters could be resolved without an industrial action or total strike in which case the emergencies will be shut down. The council of elders, with the executive, have agreed that things should now be done differently.

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