Headship Of Hospitals
A committee on hospital reform set up by the Minister of Health, Professor Eyitayo Lambo, has just submitted its report. The major thrust of its recommendations is that hospitals should be managed by persons with competences in administration. With regard to the time-honoured situation where medical doctors were often placed at the headship of hospitals and other tertiary medical facilities, the committee was of the view that the search for competent persons to manage a hospital should be extended to other professionals who may not be in possession of medical degrees. The committee also unanimously agreed that government should sponsor a bill to be known as National Tertiary Commission to give effect to the reform. It was only in the matter of the proposal for the headship of hospitals that differences along professional lines emerged among the committee members.
Whereas the medical doctors have risen in disagreement, other professionals like pharmacists, nurses, and medical laboratory scientists have welcomed the move.
As part of the reform package, the federal government may soon establish a special commission to oversee the activities of hospitals. The body when established would be responsible for monitoring, supervision, and establishment of guidelines, including minimum standards, to be adhered to by teaching hospitals and other designated hospitals. Among its functions will be the determination of the headship of hospitals that will henceforth be semi-autonomous.
Traditionalists would argue that Decree No 10 of 1985 as amended vested the headship of hospitals on medical doctors with considerable administrative experience, although it must be remembered that prior to the decree this was not always the position as there were hospital governors later renamed Directors of Administration. However, modern thinking on management will indicate that running a hospital is like running any other business. The rules of core competences, service delivery, customer care and innovation, systems thinking and budgetary projections, etc equally apply. No one can claim to be in possession of these competences merely by being a medical doctor. Indeed experience has shown that aside from the ability to diagnose and treat, some medical doctors could benefit from a moderate exposure in human relations skills and human resource management.
We believe that the time has come for this country not to get hung up on paper qualifications and not to reserve any high level positions exclusively for any group of persons. For instance, there is no reason why a competent administrator cannot run a university. As far as the headship of hospitals is concerned, persons who have distinguished themselves in the art and science of management can be called upon to head these institutions.
In today's world, it is possible to obtain degrees in hospital management. Medical doctors and pharmacists who wish to stand themselves in good stead for the top job may well be advised to broaden their scope with additional courses in hospital management or arm themselves with good training in reputable business schools. At the end of the day, regardless of qualification the individual at the head of a hospital must demonstrate the ability to manage resources and lead a team.
By making this recommendation we are not suggesting that a hospital administrator must necessarily do the duties of a doctor. The doctor is there to manage the health of his patients and no one can deny him this role. But there is more to hospital management than the treatment of patients. It may well be that new appellations will be found that more accurately reflect the roles of the headship of a hospital who may or may not be a medical doctor vis-�-vis that of the most senior medical officer in the hospital.
The private sector has already gone beyond these arguments in the placement of doctors. They do not immediately assume that a medical officer must be the head of their clinics. They appear to have successfully drawn the distinction between 'line' and 'function'. If our teaching hospitals or indeed universities are to be run on modern lines, the government must wean itself of old thinking.
The issue must be proper training in management, competence, performance and experience. Medical people who have availed themselves of opportunities by attending courses in management are positioning themselves for the headship of a hospital to which they can be considered. In this day and age, it just is not a sufficient argument to quote how many years one had been a doctor or what paper qualifications sometimes in irrelevant discipline which one possesses. The issue is what has been the quality of that experience or training.
We hope that all would find the recommendations of the committee worthy of consideration. Perhaps under new heads well tutored in modern management and administrative techniques, our deteriorating teaching hospitals might just be revived.
