OPINION: Reviewing the TETFUND Act to include Teaching Hospitals

By Clement James

(TETFUND) Act was established in 2011 to rehabilitate, restore and consolidate tertiary education in Nigeria. This Act replaced the Education Act, Cap. E4 laws of the federation of Nigeria, 2004 and the Education Tax Fund (Amendment) Act No. 17, 2003. The Act gave the Board of Trustees the power to monitor and ensure the collection of education tax and transfer same to the Fund as well as manage and disburse the tax imposed by the Act. Similarly, whatever money realized is expected to be disbursed to both the federal and state tertiary educational institutions specifically for the provision or maintenance of essential physical structures for teaching and learning, including instructional materials and equipment, research and publication, academic staff training and development, among others. So far, TETFUND has justified this mandate and its intervention effort has indeed given a boost to infrastructural development in tertiary institutions in the country, including those of polytechnics and colleges of Education. This intervention has also helped in moving tertiary education to a higher level and it is important to say that there has been relative improvement in the learning environment, including research work. However, adequate evaluation of the mandates of the Trust Fund also reveals a genuine relevance as it pertains to the development of teaching and research by teaching hospitals in Nigeria. This is because teaching or tertiary hospitals in the country can also be called the workshop of the universities. There is no doubt that about 80% of all students graduating through any medical school of a university would have undergone training in the tertiary hospital. For instance, medical students, dentistry students, medical laboratory students, nursing students, radiographers, physiotherapists and pharmacists, among others have their training in this apex hospital. When the University Teaching Hospitals (Reconstitution of Boards, etc.) Act, Cap 463, Laws of the Federation of Nigeria, 2004 which replaced the original Act, then Decree No. 10 of 1st January 1985 was established, the Board was given the task of equipping, maintaining and operating the hospitals so as to provide facilities for diagnosis, cure, promote and rehabilitate service in medical treatment across the country. Teaching hospitals also have the arduous task of facilitating and undertaking post graduate training, residency training as well as undergraduate programmes and research. Invariably, tertiary health institutions in the country have three core mandates, and these are health service delivery, training and research. Funding of tertiary health institutions has always come from yearly appropriations. Unfortunately, no budgetary allocation has always been made for training and research needs of tertiary hospitals. Thus, they are expected to always rely on epileptic overhead allocations and internally generated revenue. It has been discovered that overhead allocation so far ranges between N2million and N11million monthly. For internally generated revenue, hospitals are expected to charge clients for bed fee, consultation, card fee, operation, rent fee and from boarded items. In view of the current economic challenges, most tertiary health institutions’ overhead allocation cannot pay for monthly consumed power supply, not to talk of truck load of diesel. Investigation so far has shown that since 2011, capital releases to all tertiary institutions in the country has been between 38% and 52%. This has stalemated most capital projects which have remained uncompleted and in some cases, abandoned. Therefore, the need to look for a more effective and efficient way to fund infrastructure development, training and research becomes more imperative. Consequent upon this, there is the need to incorporate teaching hospitals as one of the beneficiaries of the TETFUND. This is given the realization that teaching hospitals are known as tertiary health institutions all over the world and they shoulder particularly peculiar challenges which touch on both the education and health needs of the larger public. In a country where poverty is prevalent and purchasing power low, government owes its citizens the responsibility of not only making health care services affordable, but also must develop health infrastructure to give confidence to the sector. Integrating teaching hospitals into TETFUND will not only relieve government of the burden of funding these critical institutions, but will also facilitate infrastructural improvement and create a nexus between effective health care delivery and the general well being of the public. Sadly, apart from the fact that many lives have been lost in our hospitals due to lack of adequate facilities and effective service delivery, there has been a huge capital flight from the country because many Nigerians seem to have more confidence in health institutions abroad. This, indeed, is a sad commentary on the health situation in the country. Clement James sent this piece to Strategic Media from Calabar, Nigeria.