The Interview Editors
In the first part of the interview, the NHIS Executive Secretary, Professor Usman Yusuf, said he was on a divine mission to rescue the agency. In this second part, he claims that his suspension of October 18 was a preemptive strike by HMOs to stop him from publishing the names of organisations that have been ripping of the NHIS. It’s another must read:
You are not disagreeing with anybody on policy issues? We have to ask the question why there is a problem
The last time I was suspended was due to petitions. Unsubstantiated petitions by a union. And I was suspended to allow for unfettered investigation of these petitions. And I ask, if unsubstantiated petitions are reasons for suspending public officers in Nigeria, there will not be any public officer today sitting on this desk.
There are so many petitions all over. Where I came from, the burden of proof is on the accuser rather than the accused. If you tell me I stole N10. Show me the N10 that I stole. But in Nigeria, anybody can just go and write or say anything about you and in public service, it is you who should go and say I didn’t steal this.
I went through all of that for the last two years. Let me tell Nigerians, if I am here to steal money or make money, you won’t hear all this noise in the NHIS. NHIS has been quiet for the last 12 or 13 years.
If you want to steal money, just keep quiet and enjoy the loot. It is not why I am here. That is not why I am here. I am here to make a difference and I will shake the tree. And I am shaking the tree. Personal issues, just get them out of the way.
There are larger issues than all of us. This is our people. I am here to work. I find myself here and I will do my best. Any petition, any accusation against me, there are agencies that are supposed to investigate all of this against any public officer.
The EFCC, ICPC, police, Code of Conduct, everybody should run and tell them. It is on record, I am the first chief executive of NHIS on resumption, I reached out to all of these agencies. I went to them, EFCC, ICPC, police, army, Air Force and told them, this is the new NHIS. I need your help to rid and flush this place of corruption.
If there is anything, because of the criminal nature of any allegation, a small committee is not the place to do that. You should go to EFCC or ICPC and say this is new. Investigate this guy. But writing petitions, I speak and write better English than these petitioners.
There are professional petitioners that are paid by mischief makers. I have been to EFCC and ICPC. During the last time, the charge was, you got money to travel to this place, you didn’t go. I brought my passport.
Oh yes, you are supposed to be in Geneva at this time, you didn’t go. See the stamp. You are supposed to be in D.C, see the stamp. What are we wasting their time for? And I understand, these young men and women in EFCC and ICPC, I have a lot of respect for them.
They are young, professional, not intimidated by position. They are doing their job. At the end of the day, you are wasting their time. And at the end of the day, the person walks away after accusing you of nonsense.
But this is Nigeria. Tomorrow there will be something else. But all I say is do not distract me. If the aim is to distract me, you have the wrong person. Take all your allegations to people that will investigate them and let me work for our people.
The Secretary to the Government of the Federation has pronounced publicly that the governing board cannot suspend you but has the powers to investigate and make recommendations. Would be willing to submit yourself to an investigation by the governing board?
I have been investigated by EFCC, ICPC. People should remember, I am a member and secretary of the governing board. I am the chief executive of NHIS. If anybody has anything, investigate me. But be careful.
Why you should be careful is anything bordering on criminal issues, there are agencies that should be the ones to do that. And I have warned everybody, the last time people said this and that about me, I tell people now, I swear to God, if you say a thing about me, be ready to defend that in the court of law.
It is not just saying, it is impugning my honor and integrity. This job, I was given by the President of the Federal Republic of Nigeria. Nobody gave me my honor and integrity. I earned it over my lifetime.
And I will fight fiercely and vigorously, anybody that tries to impugn that. This is all it is about. So, what I tell people, he who has no sin, let him cast the first stone. And if anybody has a case against me, don’t waste your time, run to EFCC and ICPC.
That is why they are there. Governing council and I are not separate. I am a member and I am the secretary of the board. I am the chief executive, so it is not me against them. It is us, simple.
“Our patients would go to hospitals and they were not treated with the respect and dignity they deserve. Why? Because HMOs have not paid. So, in the process of my research, I found that they (the HMOs) were heavily indebted to hospitals. I addressed a committee of CMDs in Calabar when I first came, it was in November 2016. Why are you not treating our patients well? What I heard consistently was that HMOs were not paying.”
In the allegations made against you, questions have been raised about a number of items like the cost of training and running the IT department. Do you have an explanation for the discrepancies?
Do I prepare the budget? We are a Council. Listen, the Council is indicting itself. And it is not the Council to be honest. It is the chairman of the Council.
How?
When the Council came, there were 11 of us. I am part of the Council, men and women if integrity, all of them without exception. Men and women of integrity, when they came, I was very pleased they came to help me make this agency achieve its mandate.
That is their mandate. They are responsible for policy guidelines, appointments, promotion and discipline. They are part time, supposed to meet four times a year.
They have their job, the chief executive has his job. Day to day running of the scheme or any agency is the chief executive. And the Council is supposed to give policy guidelines, appointments, promotions and discipline.
What about deployments, who is responsible for that?
It is the prerogative of the chief executive anywhere in this country, anywhere. Posting and deployment is the prerogative of the chief executive, period. And I asked these questions at the SGF’s office.
As far back as June, in writing. And I am not the only person. There were many agencies that were having problems with their councils. And you understand that we were all getting to know each other. So, the SGF’s office is like the place where all the children go and ask for things to be sorted out. In June of this year.
I wrote a formal letter to the SGF’s office asking questions, specific questions, eight of them to help me and help the Council. One of the questions is how many times are we supposed to sit? Our act says at least four.
But the Federal Government came out with a circular in April 2016 and restricted sitting of the board to four to cut cost. I showed it to Council and Council said no, no our Act says this. And we were doing Council meeting weekly, spending so much money, distracting me from doing my job.
This was one of the questions I asked. Each time I asked a question, how many times are we supposed to sit, please SGF’s office advise me. Does the chairman or the Council have the power to usurp the responsibilities of the chief executive when it comes to postings and redeployment?
The answer is clear. It is the prerogative of the chief executive to do postings because this is part of day to day running. One of the other questions is if I am traveling, who do I ask permission from? Is it the chairman of the board or the minister? Answers are clear.
This is all informed by issues that arose in the NHIS. Does the chairman of the board have the power or the board have to query the chief executive because she was querying me every week about day to day running of the scheme.
So, because of that, because they sow problems and every agency has its problems unique to it. The SGF’s office sees all of these problems. Letters were written back to me and the responses were very clear.
When they saw this, NHIS was put into one of the first agencies for a retreat between the chief executives and their boards which we had in July. This is the second set of retreat. The SGF, just like he did the other day at the retreat came and clearly stated functions of the council, functions of chief executives.
The DG BPP was there. EFCC was there. Everybody was there to guide us all. Everybody has his duty and responsibilities, period. After this retreat, it’s like a fire brigade putting out a fire. Things settled down. But then it continued again.
“I went to them, EFCC, ICPC, police, army, Air Force and told them, this is the new NHIS. I need your help to rid and flush this place of corruption. If there is anything, because of the criminal nature of any allegation, a small committee is not the place to do that. You should go to EFCC or ICPC and say this is new. Investigate this guy.”
You didn’t answer the question on the budget; did you fiddle with it?
Good, I will answer your question about the budget. What is the responsibility of Council and Board? Council has no hand in money. Council has no hand in procurement. The NHIS is unique in the sense that we get X percent of our contribution.
And it is that X percent that we use for our day to day running. If I get N10, I have to budget how to use that N10. If we didn’t have a council, the minister would and over the years has been signing and approved our budget.
Now that we have a board, it is the Council. Remember, not the chairman, council. It is the Council that will approve the budget. This is my second budget in the NHIS. There has never been a more thorough budget than this year’s.
The honorable chairman of the Council has herself recommended a firm that will help us with the budget. And they came in very helpful. We had several days with management. This is what we do in the NHIS, every department, if it is procurement, finance, office of ES, everybody, go and come up with your budget.
We collated and would be at the conference room. Each department would defend its budget. ICT would come and defend its budget. We would say no, we don’t need this. This was not in my office as it used to be done before. Everybody is there.
You brought in consultants?
To help us with the formulation, but not to be a part of our discussion or final decision. Suddenly, I saw on the pages of newspapers, that I was padding budget. What budget will I pad? I cannot spend a penny that is not in the budget.
So, it is just mischief. And is doing this? We are in Council, collectively taking decisions, no budget has been approved. I am presenting power point to Council and then the next day I will see my presentation verbatim on the pages of newspapers. Who does that? It’s the chairman.
Are you accusing the chairman of leaking classified documents?
Absolutely. I have said it in Council.
What proof do you have?
I have said it openly and directly to her and in Council. Let her deny it.
You were accused of inflating the cost of the data capturing machine in the budget
People do not know how budgeting works. Remember nothing has been approved. All these things come from various departments. You are from department for media. You want to buy camera for N10. That camera is N1.
If you present it to Council. Whose responsibility is it to approve or not approve? You tell me. Padding for what, talking to contractors? I am the first chief executive that doesn’t talk to any contractor.
I have no hand in procurement. Council wanted to see contractors, I said no, it is not your job. You should not get involved. I don’t get involved in all this nonsense. If I want to make money, I won’t be making noise. So, all this is mischief.
“I tell people now, I swear to God, if you say a thing about me, be ready to defend that in the court of law. It is not just saying, it is impugning my honor and integrity. This job, I was given by the President of the Federal Republic of Nigeria. Nobody gave me my honor and integrity.”
How come the 2018 budget has still not been approved?
Good, thank you very much. That is a very good question. What is the purpose? The Chairman has arrogated herself the sole power and responsibility to sign the budget. If the purpose is to sabotage this agency, it is not working because we continue to pay for the healthcare of our people. Our NHIS has abdicated its responsibility to the Chairman.
The only thing you’ve separated is capital projects from the running cost. How can you be running without a budget?
We are within what we need to spend. NHIS has its money and we are mindful of what we spend. We are not going outside the limit. The less you spend, the better. And this is informative.
You have described yourself as a whistleblower. What exactly have you exposed?I never described myself as a whistleblower. Whistleblowers in Nigeria, they get a percentage of the whistle they blow. Nobody has paid me anything. The whistle I blew, I didn’t know it was too loud in some people’s ears. I am not a whistleblower. I am here to do the right thing.
“One of the questions is how many times are we supposed to sit? Our act says at least four. But the Federal Government came out with a circular in April 2016 and restricted sitting of the board to four to cut cost. I showed it to Council and Council said no, no our Act says this. And we were doing Council meeting weekly, spending so much money, distracting me from doing my job.”
What have you exposed?
I have exposed the ills of HMOs in Nigeria. What I have noticed, the 13 years of NHIS has been nothing but subsidies to HMOs over this period. They are the greatest beneficiaries of this. And I asked why, what they used to do before.
And this is what Nigerians need to know. This is what they used to do. They were paid three months ahead to pay for patients when they go to the hospital, yet they were not paying the hospitals. Our patients would go to hospitals and they were not treated with the respect and dignity they deserve.
Why? Because HMOs have not paid. So, in the process of my research, I found that they (the HMOs) were heavily indebted to hospitals. I addressed a committee of CMDs in Calabar when I first came, it was in November 2016.
Why are you not treating our patients well? What I heard consistently was that HMOs were not paying. Who are these HMOs? Are they from heaven or what? They say, if you want to be in peace, if you want to be on this chair, let sleeping dogs lie. Don’t rock the boat. HMOs can do and undo.
They are owned by big and powerful people, highly connected. Essentially, what they were advising me to do was not to rock the boat. After I studied everything I said I am not here to rock any boat. I am here to sink this boat of corruption.
I see the effects of this corruption on the lives of our people. I am a pediatrician, I go to every hospital in this country from the edges of the Sahara to the creeks of the Niger, I go to all federal tertiary hospitals.
My first default is to go to children’s ward, because I am a pediatrician and I see. I see a mother holding her child, a sick child, not a place to lean her back. Or a delivery room with roofs leaking when the mother is delivering, or women dying.
Millions of women dying across the country from childbirth. Yet, HMOs are dripping with money. So, I asked, what do they do with the money? They do one of three things. The fix this money in banks to accrue interest, they buy foreign exchange or they use this money as collateral for loan from banks.
All their licenses have expired since 2016. Many as far back as 2013. And I asked, will NNPC give fuel to any petrol station that doesn’t have a license? Will the Central Bank deal with any bank that is not licensed? I am a physician.
Will I be able to go and practice without a license? I asked, tell me why you are giving billions of people’s money to unlicensed entities? It is not new, it has been around in Nigeria. You are a journalist. Why didn’t you pick this up?
There are journalists, there are members of the House of Representatives, there are Senators, everybody; yet, this great injustice has been allowed to fester in this country to the detriment of our people.
They are strong and powerful they say, untouchables. We started touching them. How? I said they must be licensed. The first condition for licensing is that every HMO (there are 57 HMOs) is that they must get me a letter signed by the Chief Medical Director that you don’t have any debt.
So, a letter of non-indebtedness from all hospitals you serve signed by the CMD. Guess what? Now hospitals are calling me and thanking me for empowering them. Whereas previously, hospitals will call HMOs and HMOs will not pick the phone, now HMOs are coming to them, begging them to give them this and that.
And they are paying. They are paying billions and they are paying NHIS billions. We are collecting the money back. It is not their money, it is people’s money. But they realized they are not going to pass this exam.
That was one of the reasons I was suspended the last time. They will pay, and they must pay. It is not their money. They don’t pay, they can’t pay, we will take them to EFCC to get people’s money back and I will delist them. So, Nigerians need to know.
The problem with healthcare financing in Nigeria is HMOs. Their actions are a threat to our national security. But all this is the fault of the NHIS as a regulator. Because we’ve not been the regulator we needed to be.
We have been entrusted with people’s money. Over the years, we’ve been complacent, sleeping on duty, allowing HMOs to dictate to us.
“in Nigeria, anybody can just go and write or say anything about you and in public service, it is you who should go and say I didn’t steal this. I went through all of that for the last two years. Let me tell Nigerians, if I am here to steal money or make money, you won’t hear all this noise in the NHIS.”
So, why were you suspended about two weeks ago, if you’re doing your work as you claim?
The reason I was suspended on October 18th on a Thursday? I was supposed to present to Council, the results of NHIS licensing; those who have passed, those who haven’t passed. And the big ones haven’t passed.
It was a preemptive strike, a preemptive coup. So, don’t be bamboozled, don’t be deceived. This is the reason, the one and only reason. It was a preemptive strike, preemptive coup against my announcing to Council, those who have won to be licensed as HMOs, those who have not been.
And I am not going to be deterred. Those who won will be announced, those who have not will be delisted and they will pay back people’s money.
