Patients Bill of Rights; Shielding the HMOs… Pressuring Service Providers – Kayode Adeniji

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Nigerian citizens are excited about the launch of the Patients’ Bill of Rights, because it is a major breakthrough towards protecting the rights of Patients seeking medical intervention of Healthcare providers.

However, the role of one of the major stakeholders in the Healthcare value chain appears not to be fully incorporated in the Patients’ Bill of Rights. These stakeholders are the Health Management Organizations HMOs. The HMOs are the intermediary in the relationship between the healthcare providers and the patients. By this description, they are financial managers in the health sector value chain. It was reported that 23 out of the 57 HMOs were recently disaccredited, and only 1 out of this 57, has been fully accredited by the NHIS. The Chairperson of the NHIS board stated that the current value chain which puts the NHIS at the top, the HMOs, the healthcare providers at the centre and the enrollee (the patient) at the bottom is wrong. All of these maybe due to the fact that there has not been any form of probe in respect of the activities of HMOs since their inception in 2005.[1]

A review of the Patients’ Bill of Rights, gives an understanding that the instrument only seeks to regulate the relationship between the Patients and the Healthcare providers (hospitals). This development as earlier noted is praiseworthy. However, the exclusion of an important stakeholder like the Health Management Organizations (HMOs) should be immediately addressed. The HMOs are big players in the health sector, and cannot be left out as responsible parties in the healthcare value chain.

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The HMOs sit on the juicy side of the health sector, a market that is worth millions of naira. Therefore, it is our considered view that the ‘Provider Responsibilities’ under the Patients’ Bill of Rights be equitably shared between the Health Service Providers (Hospitals) and the Health Management Organizations.

A future amendment of the Patients’ Bill of Rights to expand the coverage of direct obligations of HMOs responsibilities to the citizens under the bill would ensure that all stakeholders in the healthcare value chain uphold the ideals encapsulated in this landmark document. As failure to do this, may put Health Service Providers (hospitals) under intense and needless pressure, even when it is obvious that the deliverables of the HSP could be hugely impacted by the input of the HMOs. This way, HMOs would be encouraged to contribute to the medical and healthcare sector beyond profit making.

Kayode Adeniji is Senior Partner Lawracle LP 


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