Public hospitals in Lagos State are witnessing a massive surge in patient attendance, with outpatient patronage doubling in the last six months amid a worsening shortage of doctors and other health professionals.
Lagos State Commissioner for Health, Prof. Akin Abayomi, disclosed this while speaking in an interview with ARISE NEWS on Friday, saying the development was putting enormous pressure on healthcare workers already battling the effects of brain drain.
Abayomi said public hospitals, including Lagos State University Teaching Hospital, Ikorodu General Hospital and Lagos Island facilities, were now attending to thousands of patients daily.
“In the last six months, our outpatient patronage has doubled in our public health facilities, LASUTH, Ikorodu, Lagos Island.
“I’ve seen thousands of patients a day. Now, you can’t imagine that kind of patronage in a private hospital,” he said.
The commissioner attributed the development partly to the rising cost of healthcare, which he said was making it increasingly difficult for many residents to afford treatment in private hospitals.
He explained that while the cost of healthcare continued to rise, residents’ purchasing power had not increased at the same pace, forcing many to move from private facilities to public hospitals.
According to him, some residents were also abandoning formal healthcare altogether and turning to informal providers, including pharmacies and roadside drug sellers.
“So the public are shifting from the private sector to the public sector and from the public sector to the informal sector, where they can walk into a pharmacist or stop the hawker on the road and tell them, ‘I have a headache or I have a fever,’ and they get access to medication without going through the orthodox system,” he said.
Abayomi said the situation had become more challenging because of the migration of medical professionals from Nigeria.
“Our doctors and our healthcare professionals are under a lot of stress. You can imagine with the brain drain, with this influx of patients,” he said.
He stressed that the combination of increasing patient numbers and fewer healthcare workers could eventually affect the quality of care if urgent measures were not taken.
Against this backdrop, the commissioner said Lagos was moving towards enforcing compulsory health insurance for residents as part of efforts to improve healthcare financing and reduce pressure on government-owned hospitals.
He likened health insurance to other forms of compulsory cover required of vehicle owners.
“Now we’re moving into enforcement. So very soon, it’s just like if you have a car. You need three things. You need a licence, you need an MOT, and you need insurance. If you don’t have it, somewhere along the line, someone will enforce it,” he said.
Abayomi said Lagos domesticated the National Health Insurance Authority Act through an executive order in July 2024, making health insurance compulsory for people living and working in the state.
He said the government was currently restructuring the state’s health insurance system, while intensifying public awareness and education on the importance of health insurance.
The commissioner said the aim was to ensure that every resident had access to a basic social health insurance package, with private insurance schemes also incorporated into the wider system.
“So everybody should have at least a social health insurance basic minimum service package cover. And then in the private sector, we’re incorporating them into that narrative so that if you have private insurance, you at least have the basic minimum package,” he said.
Abayomi linked the persistent brain drain in the health sector to inadequate healthcare financing, arguing that increased demand-side financing would inject more funds into the sector and make it easier for healthcare providers to attract and retain professionals.
“It all boils down to healthcare financing. It boils down to demand financing, the ability to finance the purchase of your care,” he said.
He explained that insurance would spread healthcare costs among residents and reduce the financial burden on government.
“Health insurance does many things. It reduces the risk. It causes a cross-subsidy and social solidarity. It takes a lot of the burden away from government so that the private sector can flourish in a health system,” he added.
The commissioner expressed optimism that stronger healthcare financing could eventually help slow the migration of medical professionals.
“Brain drain is an economic narrative. If we fix the demand-side financing, then funds will flow. If the public, if the business people in Lagos suddenly see that Lagosians have purchasing power for healthcare, they will fix the supply-side,” he said.
Defending the state’s investment in public healthcare, Abayomi said government hospitals remained heavily subsidised.
According to him, the government builds and maintains hospitals, pays about 20,000 health workers, provides equipment, funds training and covers power and administrative costs.
He said the charges at public hospitals were generally less than half the cost of comparable services in private facilities.
On budget implementation, the commissioner said the health ministry had achieved more than 90 per cent implementation.
He also addressed complaints about payment systems and allegations that patients were sometimes asked to pay cash before receiving treatment.
Abayomi said the government had outsourced payment gateways to private operators to separate financial transactions from clinical activities.
“We’ve now outsourced the payment gateways to the private sector so that it doesn’t mess up with clinical activities,” he said.
He explained that payment collectors were available across the state’s health facilities to collect approved charges from patients.
