Why private hospitals can’t pay N70,000 minimum wage – Practitioners
Private medical practitioners have stated that due to the current economic situation, many owners of private hospitals would be unable to pay the approved N70,000 minimum wage for their staff.
They noted that although some hospitals located in the highbrow areas of cities could afford to pay the new minimum wage, others, especially those in the rural areas would be unable to do so.
Their reactions come on the heels of a recent statement by a health practitioner that private hospitals could not afford to pay the approved N70,000 minimum wage approved by the Federal Government.
PUNCH Healthwise reports that President Bola Tinubu, in July, approved the N70,000 minimum wage and pledged to review the national minimum wage law every three years.
As of December, several states have agreed to pay the minimum wage.
Dr Kayode Adesola
In an exclusive interview with PUNCH Healthwise, the President of the Association of Nigerian Private Medical Practitioners, Dr Kayode Adesola, said although some private hospitals were paying the minimum wage, many hospitals would never be able to pay due to the existing local economy around every hospital.
He further explained that private hospitals had different levels, classes and standards, stating that this was responsible for pay disparity.
“When it comes to private hospitals, there are different levels, strata and differences in terms of economy. You can’t say because somebody in Abule-Egba cannot afford N1.2m that somebody in Lekki can afford and the person should not have doctors that will treat them. We don’t encourage everybody to move to one place. Yet, it is the same economy that everyone operates on,” Adesola said.
He further decried the insincerity of the government in its dealings with private practitioners.
The ANPMP president said, “We have all been saying we are supporting health insurance as the best way to reach out to the people, as the shortest route to universal health coverage. But what we are getting is not encouraging and enabling enough.
“The tariff decapitation has been left at N750 since 2012. Until recently, we started struggling and complaining. You can’t get any good anti-malaria drug for N750 and this is money you are supposed to use to treat a human being for 30 days. The person can come as many times as they are sick and even some basic tests are supposed to be covered.
“They say it is insurance, you cannot pay like when you pay out of pocket, then give us the numbers because insurance is a game of numbers. It’s not just giving me three patients and saying it is insurance, there’s nothing like insurance in that one. So these are some of those things that are not enabling the hospital to have, you know, a level playing ground.”
He emphasised that if all private hospitals, regardless of their location, were given good numbers of citizens on the health insurance scheme, the payment stratification would have been eliminated.
Adesola also faulted the government’s 50 per cent subsidy on electricity tariff to government hospitals, leaving out the private hospitals that have been advocating the electricity subsidy to reduce overhead costs.
“The minimum wage is supposed to be the least amount paid to anybody working in Nigeria but the government has not provided enough enabling environment for this to be practicable and it’s a big challenge.
“So if you look at all these things, you’ll find that there are reasons why some hospitals might never be able to pay that minimum wage. In Nigeria of today, what does N70,000 mean? How many things can it buy? So, apart from your locality, you are talking of other variables around you that might not make it easy for you to do that,” the doctor said.
The ANPMP president called on the leadership of the NHIA to uphold its promise to review the tariff to ensure Nigerians got better healthcare.
Speaking on the association’s demands, Adesola said, “What we are interested in is something that can work, that will make citizens have access to good health care, that’s what we are bothered about. They are not enabling us, they are rather frustrating us and it is as if the government is also competing with the private sector and the playing ground is not level.
“This is the same economy, and a N70,000 minimum wage, that would be paid in the government hospital. In private hospitals, you pay for repairs, water, electricity, generators, salaries and other things. In the practice, we pay a total of 100 per cent of these overheads and they still come around to harass us for tax and so many other things. They are not giving us a level ground, yet we have been surviving and struggling.”
Dr Austine Aipoh
On his part, the President of the Healthcare Providers Association of Nigeria, Dr Austine Aipoh, agreed that workers deserved a rise in salary due to the present economic situation but the current cost of services in the private hospitals was inadequate to do such.
He noted that for many private hospitals to pay the N70,000 minimum wage, there would be a commensurate increase in the cost of healthcare services provided.
“The challenge for employers of labour, especially in the health sector, is how do you raise this money? The first thing would be to increase the cost of services, which means that bills have to go up astronomically. When bills go up, the patients and Nigerians will suffer. If they cannot pay the fees in private hospitals, it means they will have to go to government facilities to seek medical help. But we also know we don’t have enough government facilities to take care of Nigerians,” Aipoh said.
The doctor further noted that the little amount paid by the National Health Insurance Scheme to private hospitals for patients using the scheme was inadequate.
The HCPAN explained, “The other source of income of private hospitals is health insurance. If this is a country where health insurance has taken its root and employers of labour get good tariffs and a high fee for service, then you know that you will have money to pay the minimum wage.
“For example, the NHIS has covered less than 10 per cent in the last 20 years of operation. So we don’t have enough releases. Until recently, just about two months ago, after several deliberations, we were given a minimal increase. Before now it was N750 to treat a patient for a month. So if you pay N750 to treat a patient for a month and the patient falls sick even once, the cost of buying anti-malaria is now about N2,000.
“Insurance is a game of numbers, yet you don’t even have the numbers to buffer the effect of that cost. Even the tariff that is just increased is still minimal.”
Aipoh decried the high electricity tariff and the cost of generating energy from alternative sources, stating that if such costs were added to the bills, it would be too high for the average patient to pay.
He emphasised that the many mitigating factors against the practice hindered the ability to pay the minimum wage.
The healthcare provider called on the government to increase the number of enrollees in the NHIS and the fee-for-service and tariff to ensure private hospitals got enough from the insurance and could pay the minimum wage.
The doctor reiterated the need for the set up of a health bank to ensure private hospitals could access single-digit loans.
