Reports from World Health Organisation (WHO) indicate that hospital detention is both a human right violation and inconsistent with efforts towards universal health coverage.
For the fact that it is a human right violation, it means that, for decades, hospitals have been violating the rights of patients who might not be able to pay their bills. This may not be in Nigeria alone; it could have been happening in other countries of the world.
It should not come to us as a surprise as sometimes the hospitals in question may not have a choice to detain their patients after rendering healthcare services.
Reports have it that often times, hospital workers volunteer to pay some patients medical bills just to save a life. That was a case where the parents of a child could not cope, but the workers put resources together and purchased drugs to take care of the patient.
I have also seen a situation where a woman spent about a week in a public hospital. The husband was expected to get some money for continuation of treatment. When money was not forthcoming, she was taken care of and even discharged without paying any more charges.
I think that decision was taken by the management of that hospital. The gesture is worthy of emulation and should be commended by all. The medical workers try their best but need money to get hospital consumables.
Another case in point was about a woman who, after delivery of a baby, had difficulty with her placenta. She spent about six months in a public hospital till she was okay. In fact, when she was finally discharged, her family could not pay part of the expenses.
The hospitals need money to render services. Management needs funds to run the hospital like any other institution. Sometimes, accumulated medical expenses become difficult for patients and families to offset, especially in life threatening ailments where hospital bills can run into thousands of naira.
Some persons have experienced that. A situation where a family was unaware of paying extra charges aside an initial deposit made in the hospital after spending extra days, they were mandated to settle the extra bills before they were allowed to leave.
The issue of how management of hospitals should handle cases like these calls for concern.
According to WHO, it is an infringement of patients’ human rights to withhold them from going to their destination after receiving medical treatment. The healthcare workers need to be paid, especially if it has to do with the private sector. Facilities and equipment need to be purchased and maintained for effective running of the hospitals.
There were times in the past when some persons ran away from the hospital when their wives had delivery of new borns for lack of funds to offset delivery fees.
In the public sector, I think consultancy is free and it is just for persons to purchase their drugs. In the kind of society we find ourselves, if medical services are available or some persons allowed to have their way, even those who are buoyant will pretend and refuse to pay their medical bills.
If you give such opportunity to every Nigerian, some will abuse it. They will expect government to do that. People should be able to pay their medical bills. Payment of medical bills in hospitals is very important because they must work.
Stakeholders in medicare should create a system that will ensure that the two sides of the matter are balanced. Government is not to blame but it can assist. The issue about hospital detention is not just making rules but it should be to create a balance.
Rightly, anybody that receives or accepts a service from another is expected to pay for such service rendered. It is not easy to run a hospital. The health workers need to be paid. If hospitals offer free services, let’s say private, they may not have funds to operate.
WHO should set up certain policies on ground, something in form of grant, free medicare, National Health Insurance Scheme, NHIS, so that it is said that detaining patients who could not afford their health bills should be set free, then such health policy will cover the bills.
Really, some health workers in public hospitals are so kind that they cater for a number of patients who have become old in the hospitals as well as the elderly. I think that at a public hospital level, there should be a declaration of free medical service. Otherwise patients should be made to pay.
In Nigeria, such rule may not be applicable considering a lot of factors. WHO should enact such rule. Some countries have health insurance for their citizens. In other countries according to reports, where there is free medicare, that it is not totally free.
While the patients need to live, hospital workers generally need to be taken care of, resources are needed to run and manage the health institutions, be it private or public. Even in the United Kingdom, where they operate NHIS, it is only to a certain amount and level.
Then if patients are detained, how do they look for the money. If there are really those who treat patients free, then they should be commended.
If you talk about the herbal traditional healers, he or she needs to go to the bushes to get some herbs for curative measures. This definitely costs time and money. If they render free care, their sustainability will be in doubt.
The truth is that there are persons in some health facilities who have run out of funds. They have probably done all they can to let their persons survive.
Emphasis should be on health insurance so that more people can have access to healthcare. If they cannot pay after hospitals have rendered services, the insurance can cover the bills.
Quite some time now, the issue of people registering in HMO has been going on, both for organisations and individuals. But I can’t tell how willing people have been about it. This is supposed to be for families as any member of the family enrolls the other for healthcare coverage.
It is high time families registered their households in health insurance scheme. This will go a long way in alleviating problems associated with detention and inability to offset health care bills.
Well-meaning citizens have been clamouring for good health care system in Nigeria. I think if it is available, they will surely pay.

By: Eunice Choko-Kayode