CYRIACUS IZUEKWE
The Association of Community Pharmacists of Nigeria (ACPN) has reacted strongly over recent press release by the Nigerian Association of Resident Doctors (NARD), challenging the long-standing dominance of physicians in healthcare administration and calling for holistic reforms to restore efficiency and fairness in Nigeria’s health sector.
P.M.EXPRESS reports that NARD had earlier stated that “leadership of hospitals by physicians produces better patient outcomes” and that “physicians do not interfere in the affairs of other health professions”.
However, the ACPN, in a statement by its National Chairman, Ambrose Ezeh, MAW DCPHARM, refuted the claims, calling it “misleading” and distortion of healthcare realities in Nigeria. “Hospital Leadership Not the Exclusive Preserve of Physicians”.
According to Ezeh, healthcare administration is an autonomous profession in itself and should not be the exclusive domain of physicians.
He traced the current situation to Decree 10 of 1985, enacted during the military regime of General Ibrahim Babangida and then Minister of Health, Prof. Olikoye Ransome-Kuti, which made the appointment of physicians as heads of Federal Health Institutions (FHIs) compulsory.
“This decree disrupted the ethical order,” said Ezeh, who argued that under trained professional administrators, Nigerian hospitals in the 1970s and early 1980s enjoyed efficiency, decorum, and respect from international patients. He cited the University College Hospital (UCH), Ibadan, once rated among the top five health facilities in the Commonwealth, as an example of what was lost with the physician-led administration model.
The ACPN accused physician leadership of fostering corruption, inefficiency, and mismanagement within FHIs. Ezeh pointed to reports by the ICPC, which labelled the health sector “the most corrupt realm in the national economy.”
He also highlighted specific examples, including:
The embezzlement of COVID-19 funds by the former MD of FMC Owo;
The collapse of Drug Revolving Fund (DRF) schemes in over 90% of FHIs under physician leadership;
Over ₦30 billion in debts owed to the pharmaceutical industry.
Ezeh argued that most physician-CEOs lack training in business management, strategic planning, and health economics, resulting in the underutilization of sophisticated medical equipment, erratic procurement systems, and the decline of preventive healthcare services.
He further pointed to the National Health Insurance Authority (NHIA) as an example, noting that insurance coverage sharply declined under physician leadership from over 10% to 1.72% since 2017, compared to its early years under professional administrators.
Responding to NARD’s claim of non-interference, the ACPN said evidence abounds of consistent attempts by physicians to undermine other health professions. This includes:
Resistance to the Consultant Pharmacist Cadre; Physician-dominated negotiation of salary structures, leaving CONHESS adjustments in limbo for over a decade;
Opposition to the appointment of non-physicians as Health Ministers or Commissioners.
“The NMA opposed the appointment of Pharm. Prince Julius Adelusi-Adeluyi as Minister of Health in 1993. That resistance continues till today,” the statement said.
Ezeh concluded by calling on the Federal Government to adopt global best practices and institute comprehensive reforms that promote professionalism, transparency, and equity in health leadership.
“For Nigeria to escape the wilderness of healthcare failure, we must return to a system that recognises the value of all health professionals and stops the monopolisation of leadership by one group,” he said.
The ACPN reiterated its readiness for continued intellectual engagement but insisted that leadership in the health sector must be based on competence and professional relevance, not medical hierarchy.