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That N51.22 billon for basic health and pensioners

It is heartwarming that N51.22 billion Fund has been proposed in the 2019 draft budget to take care of the basic health needs of the most vulnerable people in the country, especially children, women and older people or pensioners.

The President said at paragraphs 58 of his 2019 budget proposals that “one percent of the Consolidated Revenue Fund, amounting to N51.22 billion has been earmarked for the Basic Health Care Provision Fund and other related commitments.”

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In part of paragraph 78 the President amplified what he said at paragraph 58 thus: “we will be establishing a health system that prioritises primary health care so that millions of our people can be insured for a minimum package of services with the poorest exempt from co-payments.  In so doing, we will reduce the stress, strains and costs that the Nigerian people face in accessing decent health care.”

Part of the money would be spent through the NHIS, on which many pensioners were enrolled. They contributed to the National Health Insurance Scheme (NHIS) fund during their salaried life, but are excluded from its services on the day they retire from work.

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Readers of this column may recall that in the September 14, 2018 edition of the Daily Trust, the subject discussed in this column was “FMBN, NHIS, PENCOM AND PENSIONERS” in which it was pointed out that the action or inaction of any of these institutions could have serious negative effects on the lives of pensioners.

The following was specifically said of the National Health Insurance Scheme (NHIS): “the NHIS, in addition to severely limiting the type of health care accessible by workers, it totally denies retired contributors access to its services regardless of the extent of their need for such services.  They are denied, even at the point of death.”

Excluding the retired contributors, some of them  in severe sickness, from accessing even the most basic health care services  payable by the NHIS, clearly exposed the Act establishing it as a piece of legislation in need of urgent amendment.

But a separate legislation, the National Health System Act 2014, has given powers to the Minister of Health to exempt certain categories of Nigerians from paying for medical services in Government medical establishments. It says in a subsection that the exemption should have regards to the “needs of vulnerable groups such as women, children, older persons and persons with disabilities.”

The definition of “older persons” invariably includes pensioners, an overwhelming majority of whom are aged over 60 years. Many are in poor health and live on inadequate monthly pension.

The National Health System Act says that “50 per cent of the Fund shall be used for the provision of basic minimum package of health services to citizens, in eligible primary or secondary health care facilities through the National Health Insurance Scheme (NHIS).”

This means that more than N25 billion would be available to cater for the health needs of pensioners, among other groups of people, if the National Assembly approved the budget as proposed.

Beyond the budgetary provisions, all the laws relating to health care provision in the country should be reviewed by the National Assembly with the view to expunging sections that are inconsistent with the need to achieve Universal Health Coverage in the country.

This is because a provision of any Act of the National Assembly impeding the success of the Directives Principles of State Policy as prescribed in the 1990 constitution as amended is a nullity. Excluding pensioners who contributed to the NIHS fund on retirement from paid employment, is contrary to the intent of the Directives Principles of State Policy.

The Nigerian Union of Pensioners (NUP) should take up the inconsistency issue to the National Assembly for the necessary legislative action to correct the Acts by making their provisions consistent with the provisions of the constitution.

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