THE COST OF GETTING SICK (2)
The Referral Racket: Sending You to Their Own Clinics
One of the most disturbing forms of corruption in Nigeria's teaching hospitals involves consultants employed by government hospitals. These consultants, using government equipment and training funded by taxpayers, direct suffering patients to their private clinics just down the road.
Both the Medical and Dental Council of Nigeria (MDCN) and the Nigerian Medical Association have stated that the practice of diverting patients to private clinics by doctors who are government employees is unethical. Despite this, it is widespread and largely goes unpunished.
In May 2024, the Anambra State Ministry of Health suspended the salaries of a medical doctor and two nurses who were caught directing patients from General Hospital, Ekwulobia, to private hospitals. This case received media attention, but thousands of similar incidents occur each week without notice.
Medical personnel often abandon their official duties to treat patients at their private hospitals or at other institutions where they have contracted work, neglecting their primary responsibilities. Some act as consultants at multiple hospitals, spending minimal time at each, which compromises the quality of care. They justify this behavior by citing low government salaries. The true victim in this situation is the patient, who arrives at a public institution only to be redirected to a for-profit business they cannot afford.
The law is explicit. The MDCN's Deputy Registrar has clarified that the Code of Medical Ethics allows qualified consultants with ten or more years of experience to operate a private clinic for consultations only, any procedures or treatments must not take place there. However, this boundary is routinely violated across the country.
The referral racket is not a problem unique to Nigeria. It reflects the consequences of underfunded public institutions and the desperation of those who work within them to survive. Tragically, the very people who are most affected by this informal economy are the ones these institutions were created to help. Unless the structural violence caused by underfunding is acknowledged alongside the interpersonal violence of extortion, the racket will persist. Consequently, families will continue to arrive at teaching hospitals with hope, only to leave with nothing but a longer list of receipts they should never have had to pay.

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