HEALTH SECTOR REFORM LAW OF LAGOS STATE

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LIST OF LAWS OF LAGOS, [ALPHABETICAL]  
A- C G – K M – I R – T
D – F L – L P – P U – Z

HEALTH SECTOR REFORM LAW

ARRANGEMENT OF SECTIONS

PART 1 – Objects of the Law, Responsibility for Health and Eligibility for Free Health Services

1.       Objectives of the Law

2.       Objectives of the Ministry

3.       Responsibilities of the Commissioner for Health

4.       Eligibility for free health services in public health establishments

5.       Establishment of the Lagos State Health Service Commission

PART 2 – Health Service Commission

6.       Composition of the Commission

7.       Quorum of the Commission

8.       Secretariat

9.       Tenure of office of members

10.     Functions of the Commission

11.     Powers of the Commission

12.     Supervisory role of the Commissioner

13.     Secretary to the Commission

14.     Remuneration of Commission members

15.     Annual report

16.     Bank account

17.     Account and audit returns by the Commission

18.     Directorates

19.     Power to make regulations

PART 3 – Hospital Governing Boards

20.     Establishment of hospital Governing Boards

21.     Composition of the Governing Board

22.     Appointment of Secretary to the Board

23.     Functions of the Board

24.     Tenure of office

25.     Remuneration

26.     Meetings

27.     Funds and resources of the Board

28.     Power to borrow money

29.     Loans and grants by the State Government

30.     Duty to disseminate information

31.     Obligation to keep records

32.     Confidentiality

33.     Access to health records

34.     Access to health records by health care providers

35.     Protection of health records

36.     Laying of complaints

PART 4 – Hospital Management Committees

37.     Establishment of Hospital Management Committees

38.     Composition of the Committees

39.     Functions of the Committees

40.     Medical Director

41.     Functions of Medical Director

42.     Appeal

43.     Tenure of office

44.     Non-compliance

PART 5 – Health Facilities Monitoring and Accreditation Agency

45.     Establishment of the Lagos State Health Facilities Monitoring and Accreditation Agency

46.     Composition of the Agency

47.     Objectives of the Agency

48.     Functions of the Agency

49.     Powers of the Agency

50.     Conditions for appointing a franchise company

51.     Funds of the Agency

52.     Meetings

53.     Executive Secretary to the Agency

54.     Quarterly report

55.     Register

56.     Custody of register

57.     Alteration of register

58.     Power to co-opt

59.     Power of the Commissioner to give directives

60.     Registration of health facilities

61.     Condition for registration

62.     Appeal to Commissioner against Agency’s decision

63.     Standard of compliance

64.     Certificate of registration

65.     Renewal of certificate

66.     Display of certificate

67.     Management of health facility

68.     Power of Commissioner to regulate fees

69.     Inspection and supervision

70.     Notice of non-compliance

71.     Power to cancel registration

72.     Obstruction of duly authorised person from the Agency

73.     Offences

74.     Penalties

75.     Powers and attainment of objectives by the Agency

76.     Supervisory control over the Agency

77.     Departments of the Agency

78.     Mass Burial of unclaimed bodies

PART 6 – Lagos State Primary Health Care Board

79.     Establishment of the Lagos State Primary Health Care Board

80.     Composition of the Governing Board

81.     Quorum and voting

82.     Secretariat

83.     Tenure of members

84.     Removal from office

85.     Functions of the Board

86.     Powers of the Board

87.     Supervisory role of the Ministry of Health

88.     Secretary to the Board

89.     Remuneration of the Board Members

90.     Standing Committees

91.     Annual report

92.     Funds and resources of the Board

93.     Power to borrow money

94.     Bank account

95.     Account and audit returns by the Board

96.     Directorates

97.     Power to make regulations

PART 7 – Local Government Health Authority

98.     Establishment of local government health authority

99.     Functions of the local health authority

100.   Composition of the authority

101.   Tenure of office

102.   Meetings

103.   Remuneration

104.   Secretary to the local government health authority

105.   Funds and resources of the Authority

106.   Loans and grants by any Government

107.   Duty to disseminate information

108.   Obligation to keep records

109.   Confidentiality

110.   Access to health records

111.   Access to health record by health care provider

112.   Protection of health records

113.   Laying of complaints

PART 8 – Ward Health Committee and Health Facility Management Team

114.   Establishment of Ward Health Committee

115.   Composition of the Ward Health Committee

116.   Composition of the management team

117.   Functions of Ward Health Committee

118.   Functions of Medical Officer of Health

119.   Officer-in-Charge (OIC) of facility

120.   Non-compliance

PART 9 – The Lagos State Traditional Medicine Board

121.   Establishment of Lagos State Traditional Medicine Board

122.   Composition of the Board

123.   Tenure, resignation and removal from office

124.   Remunerations and allowances of members of the Board

125.   Functions of the Board

126.   Powers of the Board

127.   Registrar of the Board

128.   Contributory Pensions Act

129.   Establishment of State Traditional Medicine Fund

130.   Expenditure of the Board

131.   Power to borrow

132.   Power to accept gifts

133.   Annual reports

134.   Establishment of Traditional Medicine Board Disciplinary Committee

135.   Composition of the Disciplinary Committee

136.   Penalties for professional misconduct

137.   Appeal against direction of the Disciplinary Committee

138.   Establishment of the Lagos State Traditional Medicine Board Investigating Panel

139.   Composition of the State Traditional Medicine Investigating Panel

140.   Direction by the Commissioner, etc., to the Board

141.   Powers to make regulations

142.   Offences and penalties

143.   Interpretation

144.   Registration of health facility having radiographic unit

145.   Power to make regulations

146.   Repeals

147.   Citation and commencement

SCHEDULES

HEALTH SECTOR REFORM LAW

A LAW TO MAKE PROVISION FOR THE REFORM OF HEALTH SECTOR, STATE HOSPITALS MANAGEMENT BOARD, PRIMARY HEALTH BOARD AND TRADITIONAL MEDICINE BOARD IN LAGOS STATE AND FOR CONNECTED PURPOSES

[Commencement]                                                                                                 [16th January 2006]

THE LAGOS STATE HOUSE OF ASSEMBLY enacts as follows-

PART I  – Objectives of the Law, Responsibility for Health and Eligibility for Free Health Services

1.       Objectives of the Law

The objectives of this Law are to regulate health services within the State and to provide uniformity in respect of health services across the State by-

(1)     establishing a State health system which-

(a)     encompasses public and private providers of health services;

(b)     provides the population of the State with the best possible health services that available resources can afford; and

(2)     setting out the rights and duties of health care providers, health workers, health establishments and users.

2.       Objectives of the Ministry

The Ministry of Health, subject to the provisions of this Law, shall be responsible for the formulation, monitoring, evaluation of policies, strategies, plans of action and supervision of health services in the State and shall perform the following functions-

(1)     supervision and control of all health facilities in the State in order to ensure a minimum standard in all public and private health facilities;

(2)     supervision and control of all hospital boards and Government health bodies and agencies including the Traditional Medicine Board;

(3)     formulation of regulations and subsidiary legislations for the approval of the Lagos State House of Assembly;

(4)     approval of long-term plans and variations of such plans;

(5)     development of management, financial guidelines and performance standards for internal control of public hospitals;

(6)     policy approval of rate and scale of charges for services rendered to the public by the hospital boards;

(7)     recommendation for capital and operating budgets for hospital boards (which includes recommendation for major adjustments, increase in salaries, allowances and fringe benefits for hospital employees);

(8)     elevating the quality of health practice in the professional disciplines through the advancement of appropriate standards and research priorities;

(9)     collation and analysis of monthly medical statistical data (attendance, morbidity, mortality and utilisation of services) from hospital boards;

(10)   obtaining annual audited accounts of hospitals and hospital boards within three months after the end of the preceding financial year which must be submitted to the State Auditor-General’s office for verification (applicable only to public hospitals);

(11)   co-ordination and integration of the various hospital services at all levels in the State to ensure that they conform with the State health policies and programmes; and

(12)   maximising the effective use of resources within the health sector in the State.

3.       Responsibilities of the Commissioner for Health

The Commissioner shall, within the limits of available resources-

(1)     endeavour to protect, promote, improve and maintain the health of the population;

(2)     promote the inclusion of health services in the socio-economic development plan of the State;

(3)     determine the policies and measures necessary to protect, promote, improve and maintain the health and wellbeing of the population;

(4)     ensure the provision of such essential health services to the population of the State as may be prescribed after consultation with the National Health Council; and

(5)     prioritise the health services that the State can provide taking into consideration health needs and available resources with the approval of the House of Assembly by a simple majority.

4.       Eligibility for free health services in public health establishments

(1)     The Commissioner may, with the approval of the Governor, prescribe conditions subject to which categories of persons eligible for such free health services at public health establishments as may be prescribed.

(2)     In prescribing any condition contemplated in subsection (1), the Commissioner may have regard to the-

(a)     range of free health services currently available;

(b)     categories of persons already receiving free health services; and

(c)     impact of any such condition on access to health services.

PART 2 – Health Service Commission

5.       Establishment of the Lagos State Health Service Commission

There is established the Lagos State Health Service Commission (referred to in this Law as ―the Commission‖) which shall have overall responsibility for health personnel management.

6.       Composition of the Commission

The Commission shall be on a full-time basis and shall be composed of-

(1)     a Chairman; and

(2)     four (4) other members; who shall be persons of proven integrity with relevant qualification and minimum of fifteen (15) years cognate experience in health sector, preferably health care professionals.

7.       Quorum of the Commission

The quorum of the Commission shall be three members including the Chairman.

8.       Secretariat

There shall be a Commission Secretariat which shall be headed by a Permanent Secretary who shall be a medical/health care professional in the public health sector with a minimum of fifteen (15) years’ post qualification experience in medical practice and experienced in public administration.

9.       Tenure of Office of Members

The Chairman and other members of the Commission shall hold office for a term of five (5) years, renewable for another term of three (3) years as the Governor may deem fit.

10.     Functions of the Commission

The functions of the Commission shall be to-

(1)     recruit and promote public hospital employees on grade level 07 and above;

(2)     implement establishment policies in respect of public hospitals;

(3)     handle pension matters for all hospital employees;

(4)     monitor activities of public hospitals on appointments, discipline and promotion of employees on Grade Level01 to 12 in order to ensure that the guidelines are strictly and uniformly adhered to;

(5)     serve as the appellate body for all dismissal/retirement petitions from aggrieved public hospital employees on Grade Level 07 to 12 and appellate body for Grade Level13 and above for all other disciplinary measures;

(6)     maintain up-to-date personnel records of all public hospital employees;

(7)     maintain a comprehensive data-base of all grades of public hospital employees;

(8)     co-ordinate inter-state, inter-service and inter-hospital transfers of public hospital employees;

(9)     compile for Gazette publication of establishment matters, staff movements, including new appointments, promotions and retirements/dismissals;

(10)   oversee public hospitals joint staff welfare matters including housing and transport;

(11)   ensure manpower planning development and training in the public hospital services; and

(12)   exercise direct responsibility over training and staff development of public hospital employees on Grade Level13 and above.

11.     Powers of the Commission

The Commission shall have the power to-

(1)     set general and uniform guidelines for the establishment of Junior and Senior Personnel Management Committees in public hospitals;

(2)     delegate to the hospital Governing Boards the powers for appointments, promotions, discipline, training and staff development in respect of public hospital employees on Grade Level 01 to 06, and similar functions for employees on Grade Level 07 to 12 with the exception of the powers of appointment;

(3)     delegate to the Governing Boards of public hospitals power to discipline staff on Grade Level 13 and above except for dismissal/retirement and termination;

(4)     delegate to the hospital Governing Board direct responsibility for training and staff development of public hospital employees on Grade Level 12 and below.

12.     Supervisory role of the Commissioner

The Commissioner shall exercise a supervisory role over the Health Service Commission.

13.     Secretary to the Commission

(1)     The Secretary shall carry out the day-to-day administration of the affairs of the Commission in accordance with the provisions of this Law, and without prejudice to the generality of the provisions of this Section and shall be responsible for the following matters-

(a)     making arrangements for meetings of the Commission;

(b)     preparing the agenda and the minutes of such meetings;

(c)     implementing the decisions of the Commission;

(d)     arranging for payment of fees and allowances of meetings and all other matters affecting members of the Commission as may be specifically assigned to him by the Commission; and

(e)     keeping and securing the records of the Commission.

(2)     The Secretariat shall have a variety of distinct and major categories of health professionals as doctors, pharmacists, nurses, etc. at Director/Assistant Director levels.

14.     Remuneration of Commission members

There shall be paid to the Chairman and other members such salary and allowances as are considered reasonable by the Governor and commensurate with the salary scale paid by similar Commissions.

15.     Annual Report

The Commission shall submit an annual report of its activities to the Commissioner and the Committee on Health Services of the Lagos State House of Assembly before the 31st day of March of the following year.

16.     Bank Account

The Commission shall operate bank accounts for its funds with a reputable bank or banks in the State with the advice of the Accountant-General of the State and the signatories to the account shall be the Permanent Secretary or in his absence his designated representative and the Head of Accounts, or in his absence his designated representative or any person duly authorised by the Commission in that behalf.

17.     Account and audit returns by the Commission

(1)     The Commission shall keep proper accounts of all its transactions in such form as it may direct, which shall conform with standard accounting practice.

(2)     The form of accounts shall be such as to ensure the provision of separate information in respect of each of the main activities and divisions of the Commission.

(3)     The accounts shall be audited annually by the Auditor-General or any person authorised in that behalf in accordance with the provisions of the Constitution, Financial Regulations of the State and the State Audit Law.

(4)     The Commission shall establish proper internal control measures to administer its accounts.

18.     Directorates

The Commission shall have the following Directorates

(1) (a) the Directorate of Medical Services which shall handle recruitment of doctors, other health care professionals and appeal on disciplinary issues;

(b)     this Directorate shall be headed by a Director or an Assistant Director who should be a doctor.

(2) (a)the Directorate of Pharmaceutical Services which shall handle the recruitment of Pharmacists and appeals on disciplinary issues;

(b)     this Directorate shall be headed by a Director or an Assistant Director who shall be a pharmacist.

(3) (a)         the Directorate of Nursing Services which shall handle the recruitment of nurses and appeals on disciplinary issues;

(b)     this Directorate shall be headed by a Director or an Assistant Director who shall be a nurse.

(4) (a)         the Directorate of Finance and Administration which shall handle staff welfare matters of all health care workers;

(b)     this Directorate shall be headed by a Director or an Assistant Director.

(5) (a)         there shall be a legal division under this Directorate to provide legal services to the Commission and be headed by a Legal Officer;

(b)     the Legal Officer shall be a representative of the Ministry of Justice with a minimum of six (6) years’ post-call experience.

(6) (a)         the Directorate of Pensions and Establishment Matters which shall be responsible for pension matters of all health care workers and implementation of circulars;

(b)     this Directorate shall be headed by a Director or an Assistant Director.

(7)     The Directorate of Accounts which shall be headed by a Director or an Assistant Director;

(8) (a)         the Directorate of Engineering Services which shall be responsible for-

(i)      recruitment of engineering personnel;

(ii)     promotion of staff;

(iii)    discipline issues and other engineering matters;

(b)     this Directorate shall be headed by a Director or an Assistant Director.

19.     Power to make regulations

The Commission may make regulations in accordance with Regulations Approval Law as may be necessary or expedient for securing the due performance of any duty imposed and the effective exercise of any power conferred upon the Commission by or under the provisions of this Law.

PART 3 – Hospital Governing Boards

20.     Establishment of hospital Governing Boards

(1)     There is established a part-time governing board for each hospital or group of hospitals in the State as specified in the Schedule to this Law as the Governor may deem fit.

(2)     The governing board shall-

(a)     be a body corporate with perpetual succession and a common seal;

(b)     have the power to sue and be sued in its corporate name; and

(c)     be capable of holding, purchasing, acquiring and disposing of property moveable and immovable subject to the approval of the Commissioner for the purpose of carrying out its functions under this Law.

21.     Composition of the Governing Board

(1)     The governing board of a hospital or group of hospitals shall consist of

(a)    a private medical/dental practitioner of proven integrity with a minimum of ten (10) years’ experience;

(b)     a private pharmacist of proven integrity with a minimum of ten (10) years’ experience;

(c)     a private nursing officer of proven integrity with a minimum of ten (10) years’ experience;

(d)     two (2) persons of proven integrity selected from the community within which the hospital is situate;

(e)     a medical officer of health or his representative not below Grade Level14 from one of the local governments in which the hospital is situate;

(f)      the Medical Director(s) of the hospital or group of hospitals; and

(g)     a Director or similar officer in a corporate organisation;

(h)     a private health professional of proven integrity with a minimum of ten (10) years’ experience.

(2)     The Chairman and members of the Board shall be appointed by the Governor on the advice of the Commissioner.

22.     Secretary to the Board

There shall be appointed a Secretary to the Board, who shall be a non-voting member of the Board.

23.     Functions of the Board

Subject to the provisions of this Law, the Board shall perform the following functions-

(1)     set out targets in line with the overall objectives of setting up the hospital(s) and take due cognisance of government policy directives as provided by the Commissioner, in respect of economic, financial, operational and administrative programmes;

(2)     measure performance against set targets;

(3)     implement broad policy measures on hospital and health care development plans;

(4)     supervise and monitor management committees to ensure that targets are achieved;

(5)     be the appellate body for petitions on dismissal/retirement of staff on Grade Level01-06;

(6)     promote and discipline staff on Grade Level07 to 12 who will have right of appeal on all personnel matters to the Health Service Commission;

(7)     exercise powers to discipline staff on Grade Level13 and above, but only make recommendations for dismissal/retirement for Grade Level13 and above to the Health Service Commission;

(8)     consider plans and budgetary proposals of the Hospitals Management Committee before submission to the Budget Office through the Ministry of Health and consequently to defend before the House of Assembly by the Hospitals Management Committee;

(9)     delegate to the Hospitals Management Committee its powers of promotion and discipline including suspension/dismissal of staff on Grade Level01 to 06 (but the staff shall have a right of appeal to the Hospital Governing Board);

(10)   delegate to the Hospitals Management Committee the responsibilities for delivery of health care service that meets community needs and satisfaction;

(11)   appoint committees to which it may delegate any of its functions;

(12)   ensure co-ordination and integration of various hospital services within its jurisdiction; and

(13)   approve expenditure up to a maximum amount as approved by the Governor for each hospital, and delegating as appropriate, any portion of that power to the Hospitals Management Committee;

(14)   consider and accommodate private sector participation in clinical and non-clinical support services in line with approved guidelines issued by the Ministry, e.g. pharmacy, radiology, Laboratory, mortuary and any service(s) that may be necessary for the hospital.

24.     Tenure of Office

The Chairman and members of the Board shall hold office for a period of three (3) years and shall be eligible for re-appointment for a further term of three (3) years.

25.     Remuneration

The Chairman and other members of the Board shall be paid a monthly sitting allowance as the Governor may determine from time to time.

26.     Meetings

The Board shall sit only once a month (except when there is need for an emergency meeting) and shall hold quarterly review meetings with the Ministry.

27.     Funds and resources of the Board

The funds and resources of each Board shall consist of-

(1)     all sums, investments or other property vested in the Board by virtue of the provisions of this Law;

(2)     such sums or other advances by way of loans, or grants to the Board by the Government;

(3)     such sums or other property as may from time to time be advanced by way of loans or grants to the Board by any agency or institution, any international organisation and private foundation or any person whatsoever;

(4)     any investments or other property whatsoever acquired by or vested in the Board; and

(5)     money earned or arising from any investments or other property acquired by or vested in the Board.

28.     Power to borrow money

(1)     The Board may, with the approval of the Governor borrow money by issuing debentures, stocks or other securities or in any other manner for and in connection with the exercise of its functions under this Law as the Board may deem necessary.

(2)     An approval given for the purpose of this section may be either general or limited to a particular borrowing or otherwise and may be subject to conditions.

29.     Loans and grants by the State Government

(1)     It shall be lawful for the Governor to make to the Board the following-

(a)     grants of any sum of money or property deemed necessary; and

(b)     loans upon such terms as to repayment of interest or otherwise as the Government may determine.

(2)     The Governor may, if he deems it expedient to so do, waive in favour of the Board any right or liability to the Government in respect of any property vested in the Board by virtue of the provisions of Section 20 (2)(c) of this Law.

(3)     The Board shall in respect of any money (other than grants) advanced by the Government, create and maintain an advance account in favour of the Government of an amount equal to the total sums of money so advanced.

(4)     The advance account referred to in subsection (3) of this Section shall be subject to such conditions as to interest and repayments as the Governor may determine at the time of taking such loans notwithstanding that the Governor may waive at any time such interest and principal repayments as may become due and payable.

30.     Duty to disseminate information

The Ministry and all hospital Governing Boards must ensure that adequate and comprehensive information is disseminated on the health services for which they are responsible, which shall include-

(1)     the types and availability of health services;

(2)     the organisation of health services;

(3)     operating schedules and time-tables of visits;

(4)     procedures for access to the health services;

(5)     other aspects of health services which may be of use to the public; and

(6)     procedures for laying complaints.

31.     Obligation to keep records

Any person in charge of a health establishment must ensure that a health record containing such information as may be prescribed is created and maintained at that health establishment for every user of health services.

32.     Confidentiality

(1)     All information concerning a user, including information relating to his or her health status, treatment or stay in a health establishment, is confidential.

(2)     Notwithstanding the provisions of Section 30, no person may disclose any information contemplated in subsection (1), unless—

(a)     the user consents to that disclosure in writing; or

(b)     a court order or any law requires that disclosure; or

(c)     non-disclosure of the information represents a serious threat to public health as determined by the Board.

33.     Access to health records

(1)     Any person working for or on behalf of any health establishment or any health care provider who has access to the health records of a user may disclose such personal information to any other person, health care provider or health establishment as is necessary for any legitimate purpose within the ordinary course and scope of his duties where such access or disclosure is in the interest of the user.

(2)     For the purpose of this section, ―personal information‖ means any official information held about an identifiable person, but does not include information that bears on the public duties of public employees and officials.

34.     Access to health records by health care provider

A health care provider may examine a user’s health records for the purposes of

(a)     treatment with the authorisation of the user; and

(b)     study, teaching or research with the authorisation of the user, head of the health establishment concerned and the relevant health research ethics Committee.

35.     Protection of health records

(1)     The person in charge of a health establishment in possession of a user’s health records must set up control measures to prevent unauthorised access to those records and to the storage facility in which, or system by which, records are kept.

(2)     Any person who-

(a)     fails to perform a duty imposed on them in terms of subsection (1);

(b)     falsifies any record by adding, deleting or changing any information contained in that record;

(c)     creates, changes or destroys a record without authority to do so;

(d)     fails to create or change a record when properly required to do so;

(e)     provides false information with the intent that it be included in a record;

(f)      without authority, copies any part of a record;

(g)     without authority, connects the personal identification elements of a user’s record with any element of that record that concerns the user’s condition, treatment or history;

(h)     gains unauthorised access to a record or record-keeping system, including intercepting information being transmitted from one person, or one part of a record-keeping system, to another;

(i)      without authority, connects any part of a computer or other electronics system on which records are kept to-

(i)      any other computer or other electronics system;

(ii)     any terminal or other installation connected to or forming part of any other computer or other electronics system; or

(iii)    modifies or impairs the operation of any part of the operating system of a computer or other electronics system on which a user’s records are kept; or any part of the programme used to record, store, retrieve or display information on a computer or other electronic system on which a user’s record are kept; commits an offence and is liable on conviction to a fine or imprisonment for a period not exceeding one year or both.

36.     Laying of complaints

(1)     Any person may lay a complaint about the manner in which he or she was treated at a health establishment and have the complaint investigated.

(2)     Each hospital governing board shall establish a procedure for the laying of complaints within those areas of the State health system for which they are responsible in compliance with the Ministry’s directive.

(3)     In laying a complaint, the person contemplated in subsection (1) must follow the procedure established by the Ministry.

PART 4 – Hospital Management Committees

37.     Establishment of Hospital Management Committees

There are established Hospital Management Committees to manage the affairs of the hospitals on a day-to-day basis.

38.     Composition of the Committees

A Hospital Management Committee shall consist of-

(a)     the Medical Director who shall be the Chairman;

(b)     all heads of clinical departments;

(c)     the Head of the Nursing Division;

(d)     the Head of Pharmacy;

(e)     all heads of supporting service departments, e.g. accounts, engineering, etc.; and

(f)      the Hospital Secretary, who shall be a member and Secretary to the Committee.

39.     Functions of the Committees

The functions of the Health Management Committee shall be to-

(1)     assist the Chief Medical Director in the day-to-day management of the hospital and to ensure proper medical care of patients in the hospital;

(2)     implement executive decisions of the Governing Board with regard to-

(a)     the overall planning, expansion, development and maintenance of the hospital or health institutions within its jurisdiction;

(b)     the revenues and expenditures of the hospital;

(c)     the purchase of stores, furniture and equipment within the limits approved by the Governing Board;

(3)     (a)     serve as the Personnel Management Committee for the appointment, promotion, discipline, including termination, dismissal of staff on Grade Level06 and below, with a right of appeal on dismissal/retirement to the Governing Board by aggrieved staff on Grade Level0106;

(b)     serve as the Personnel Management Committee for the promotion, discipline including termination/dismissal of staff on Grade Level07–12 but to refer cases of termination/retirement/dismissal to the Governing Board;

(4)     implement staff training programmes and Continuing Medical Education Programmes with the approval of the Governing Board;

(5)     set up standing sub-committees to assist in performing the following functions:

(a)     quality control;

(b)     ethics;

(c)     procurement and supply;

(d)     drugs and therapeutics;

(6)     prepare and submit monthly statistical summaries (on attendance, morbidity, mortality and utilisation of services), financial statements, quarterly reports, annual plans and progress report to the Governing Board and the Ministry; and

(7)     prepare budget and establishment proposals to be cleared by the Governing Board(s) and the Health Service Commission before submission to the Ministry and thereafter present and defend the budget before the House of Assembly.

40.     Medical Director

(1)     Subject to the provisions of this Law, each Medical Director shall be appointed by the Governor on the recommendation of the Commissioner as the Chief Executive and Accounting Officer of the Hospital(s) and the appointment shall be based on capability to manage and not on seniority.

(2)     The appointment shall be open to eligible public and private medical practitioners as further set out in Schedule 1 to this Law. If a private medical practitioner is so appointed, the appointment cannot revert to lower or career grade on leaving the post of Medical Director.

                                                                                                 [Schedule 1]

41.     Functions of Medical Director

The functions of the Medical Director shall be to-

(1)     handle the day-to-day management of human, financial and material resources of the hospital(s) in accordance with the objectives and targets set by the governing board of hospital(s).

(2)     discipline staff on the following grade levels-

(a)     Grade Level12 and below whose conduct is prejudicial to the interest of the hospital, with punishment of between one to two weeks’ suspension;

(b)     officers on Grade Level13 and above (such suspension shall not be carried out if such recommendation is not supported by the governing board of the hospital(s)), provided that officers on Grade Level13 and above may appeal to the Health Service Commission if aggrieved by the disciplinary action while officers on Grade Level0712 may appeal to the Governing Board.

42.     Appeal

A Medical Director who feels that his Governing Board has misdirected itself on a given policy issue, may, on giving due notice to the Board, refer the matter to the Health Service Commission which should then consult with the Commissioner.

43.     Tenure of office

(1)     The Medical Director of the hospital shall hold office for a term of three (3) years which may be renewable for another term based on performance.

(2)     The Medical Director may revert to his former post in the hospital if appointed from a career post.

44.     Non-compliance

(1)     Where the Health Management Committee fails to comply with the provisions of Section 39(6) of this Law, the Ministry may sanction the Committee of the hospital or group of hospitals concerned. Offending Health Management Committees and their Medical Directors will be dissolved by the Board on the recommendation of the Ministry of Health.

(2)     The continued existence of any Health Management Committee and its Medical Director shall be based on its performance and compliance with the provisions of this Law.

PART 5 – Health Facilities Monitoring and Accreditation Agency

45.     Establishment of the Lagos State Health Facilities Monitoring and Accreditation Agency

(1)     There is established the Lagos State Health Facilities Monitoring and Accreditation Agency (referred to in this Law as ―the Agency‖).

(2)     The Agency shall be a body corporate with perpetual succession and a common seal.

(3)     The Agency may sue and be sued in its corporate name.

(4)     The Agency shall be capable of purchasing, leasing, selling, exchanging, holding, acquiring and disposing of movable and immovable properties for the purpose of carrying out its functions in accordance with the provision of this Law.

(5)     The Agency may do all acts and things which a body corporate may by law do and which are necessary for the purpose of this Law.

(6)     The common seal of the Agency shall be kept in such custody as the Agency directs and shall not be used except as authorised by the Commissioner.

46.     Composition of the Agency

(1)     The Governing Board of the Agency shall consist of a Chairman nominated by the Commissioner for Health, being an experienced medical practitioner with a minimum of ten (10) years’ experience of high repute with quality service delivery goals and a representative of the following-

(a)     member nominated by the Nigerian Medical Association (NMA);

(b)     member nominated by the National Association of Nigerian Nurses and Midwives (Lagos State Branch);

(c)     medical laboratory scientist nominated by the National Association of Medical Laboratory Scientists of Nigeria (Lagos State Branch); and

(d)     legal practitioner nominated by the Honourable Attorney-General and Commissioner for Justice and who shall be a person with at least ten (10) years’ post-call experience.

(2)     The appointment of the nominees shall be subject to the approval of the Governor.

(3)     There shall be Secretary who shall be on a full-time basis and a non-voting member of the Agency.

47.     Objectives of the Agency

In performing its functions and exercising its powers, the primary objectives of the Agency shall be to set up necessary standards for both public and private hospitals and other health institutions, improve the quality and efficiency of health care services to the patients by setting adequate standards and ensure strict compliance with same.

48.     Functions of the Agency

The functions of the Agency shall be to-

(1)     set required minimum standards for operations of health facilities both in public and private health sectors as shown in the Schedule to this Law;

(2)     issue a format for registration form to include information on projected patient flow and monitoring chart for actual performance;

(3)     accredit, inspect, monitor and license all health facilities listed in a Schedule to this Law;

(4)     evaluate performance based on set standards by at least a monitoring visit twice a year;

(5)     oversee the Quality Drug Assurance Laboratory;

(6)     disseminate specific performance indicators by way of information to the public from data made available by the Research and Statistics Department at least quarterly and this shall be the responsibility of the Executive Secretary;

(7)     ensure actual performance of the indicators;

(8)     process applications for registration submitted to the Agency from any person;

(9)     inspect the premises to be registered under this Law;

(10)   collate all necessary information on registered health facilities in the State;

(11)   advise the Commissioner on all matters relating to the registration, inspection and supervision of private and public hospitals in the State;

(12)   enforce compliance with the provisions of this Law;

(13)   ensure the authenticity of the credentials of its personnel;

(14)   ensure that the drug prescription and medical examination forms are duly singed and stamped with the accreditation number of the medical facility and full names of the medical issuing personnel boldly written.

49.     Powers of the Agency

The Agency shall have powers to-

(1)     receive applications for registration of premises for health facility;

(2)     inspect any premises to be registered as a health facility;

(3)     supervise private health facilities registered under this Law;

(4)     supervise public health facilities under this Law;

(5)     appoint franchise companies to monitor, inspect and ensure compliance with this Law by all health facilities in the State;

(6)     issue certificate of registration in respect of any premises registered under this Law;

(7)     charge fees payable for application forms and for any other services rendered under this Law;

(8)     suspend, revoke or cancel any certificate of registration issued under this Law;

(9)     set up standards for all facilities;

(10)   monitor strict compliance with the set standards;

(11)   regulate and monitor the issuance of drug prescription and medical examination forms;

(12)   enforce compliance for the improvement of health services to patients; and

(13)   acquire public and private sector resources to achieve the set objectives.

50.     Conditions for appointing a franchise company

(1)     A franchise company shall be a limited liability company with wide experience in health care facilities establishment and management including quality assurance.

(2)     A franchise company shall have a registered office and staff complement to include all categories of health workers and shall be assisted by staff of the local government.

(3)     An appointed franchise company shall carry out the monitoring and inspection of public and private health facilities in the State.

51.     Funds of the Agency

The funds of the Agency shall consist of

(1)     such sums of other monies advanced by way of subvention or loans to the Agency by the State Government;

(2)     revenue from inspection and penalties and charges;

(3)     fees from other services rendered;

(4)     such sums of other monies advanced by way of subvention or loans to the Agency by any government or donor agency; and

(5)     such sums or other property as may from time to time be advanced by way of loan or grant to the Agency by the State Government;

(6)     all monies paid for registration shall be payable into an account to be managed by the Agency; and

(a)     the Agency shall retain 30 per cent for its running costs;

(b)     the Agency shall pay 50 per cent to the franchise company or agent; and

(c)     the Agency shall retain the remaining 20 per cent to be paid as bonus in the first quarter of the new year to the franchise company or agent who brought in the revenue based on performance.

52.     Meetings

(1)     The Agency shall meet at least three times a month and at any other time deemed necessary by it.

(2)     The Agency may regulate its own proceedings at its meeting.

(3)     Every meeting of the Agency shall be presided over by the Chairman.

(4)     A record shall be kept of the members present and of the business transacted.

(5)     The quorum of meetings shall be three members including the Chairman.

53.     Secretary to the Agency

(1)     Secretary to the Agency shall in addition to his functions under this Law have such other administrative functions as may be assigned by the Chairman.

(2)     Where under this Law any function or power is conferred on the Agency, any exercise of such function or power by the Agency may be signified under the hand of the Secretary.

(3)     The Secretary shall be a civil servant on a Grade Level not lower than Grade Level 13, preferably a health care professional with administrative experience to be appointed by the Commissioner.

54.     Quarterly report

The Secretary to the Agency shall render quarterly reports on the activities of the Agency to the Ministry.

55.     Register

The Secretary shall cause an up-to-date register to be kept and maintained containing details of all public and registered health facilities under the Agency and such other particulars as the Commissioner may prescribe.

56.     Custody of register

The Secretary shall secure the safety of the register which shall be in his custody and when not in use, the register shall be kept in such a way as the Secretary may direct.

57.     Alteration of register

No person may insert, delete, alter or cause to be altered any material particular in the register relating to any registered health facility unless the Agency so directs such alteration, deletion or insertion in writing.

58.     Power to co-opt

(1)     Where the Agency desires to obtain advice of any person upon any matter, it may co-opt such person to be a member for such meeting or meetings as may be required and any such person shall, whilst so co-opted, have all the rights and privileges of a member of the Agency except that he shall not be entitled to vote on any question or count towards a quorum.

(2)     The Agency shall be assisted by such members of staff from the State Civil Service as may be required to assist in the execution of its duties under the Law.

59.     Power of the Commissioner to give directives

Subject to the provisions of this Law, the Commissioner may give to the Agency, general or specific directives as to the policy to be followed in the exercise of its functions, and the Agency shall comply with and give effect to all such directives.

60.     Registration of health facilities

As from the commencement of this Law, no person shall establish, carry on or run a health facility in the State in any premises not registered with the Agency under the provisions of this Law, and also to review licences already issued and inspect their facilities.
                                                                                                      [Schedules]

61.     Condition for registration

Subject to the provisions of this Law, premises intended to be used as a health facility shall only be registered by the Agency if the Agency is satisfied that-

(1)     the medical practitioner in charge of, and any other medical practitioner connected with the health facility or any part thereof is qualified to practice any special branch of medicine there dealt with and is in all other respects a fit and proper person;

(2)     the registered nursing staff is adequate;

(3)     the Matron or other person in charge of the nursing staff is a qualified nurse and holds a diploma or certificate of training in nursing recognised by the Nursing and Midwifery Council of Nigeria;

(4)     the premises (i.e. the site, building and general amenities) are satisfactory and in conformity with the requirements approved by Authority;

(5)     the equipment is suitable and sufficiently adequate to meet the requirements of such health facility as may be laid down by the Agency;

(6)     the provisions of this Law or regulations made hereunder are complied with insofar as registration of premises for health facilities with in-patient facilities and health facilities with out-patient facilities are concerned;

(7)     the health facility with in-patient facilities contains the maximum number of beds allowed under this Law;

(8)     where a health facility or a clinic in operation engages in compounding of drugs, such health facility or clinic shall employ and retain the services of a qualified pharmacist who shall be registered and licensed by the Pharmacy Board of Nigeria; and

(9)     the health facility complies with the provisions of this Law.

62.     Appeal to Commissioner against Agency’s decision

(1)     Any person aggrieved by a decision of the Agency in accordance with the provisions of this Law may appeal in writing to the Commissioner against such decision.

(2)     Such appeal shall-

(a)     be lodged within sixty (60) days from the date on which written reasons for the decision were given by the Agency or such later date as the Commissioner permits; and

(b)     set out the grounds of appeal.

(3)     After considering the grounds of appeal and the Agency’s reason for the decision, the Commissioner shall as soon as practicable—

(a)     confirm, set aside or vary the decision;

(b)     substitute any other decision for the decision of the Agency.

63.     Standard of compliance

The Agency shall-

(1)     keep the Commissioner informed of the quality of health services provided throughout the State as measured against prescribed health standards;

(2)     advise the Commissioner on standards for quality in health services;

(3)     recommend to the Commissioner any changes which should be made to the prescribed health standards;

(4)     recommend to the Commissioner new systems and mechanisms to promote quality of health services;

(5)     monitor compliance with prescribed health standards by health establishments, health care providers and health agencies;

(6)     report to the Commissioner any violation of a prescribed standard where such violation poses an immediate and serious threat to public health and make recommendations to the Commissioner on the action to be taken in order to protect public health;

(7)     prepare an annual report to the Commissioner concerning its findings with regard to compliance with prescribed standards;

(8)     institute monitoring activities and processes for quality assurance in health facilities;

(9)     inspect health facilities in order to determine levels of compliance with prescribed health standards; and

(10)   instruct a health officer in compliance with section 49 to inspect health facilities in order to-

(a)     investigate any complaint, allegation or suspicion relating to the prescribed health standards; and

(b)     report to the Chairman on the findings of any investigation contemplated in paragraph (a).

64.     Certificate of registration

(1)     The Agency shall issue a certificate of registration to any person who applies under this Law and has satisfied the conditions in section 61 of this Law, in respect of premises to be used for a health facility.

(2)     A certificate of registration issued by the Agency shall be signed by the Secretary and shall contain the Seal of the Agency.

(3)     Subject to the provisions of this Law, no medical practitioner shall be in charge of more than one registered health facility.

65.     Renewal of certificate

(1)     A certificate of registration may be renewed every twelve (12) months on the provision of medical records and statistics.

(2)     The Agency shall recommend any defaulting hospital governing board for sanctions for non-provision of the specified medical records and statistics or non-compliance with set standards.

66.     Display of certificate

The following certificates shall be displayed in a conspicuous place in any health facility-

(1)     certificate of registration;

(2)     current licence to practise; and

(3)     professional certificate of the head of the facility.

67.     Management of health facility

(1)     Subject to the provisions of this Law-

(a)     every health facility shall be under the management, control and supervision of a medical practitioner referred to in this Law as the medical practitioner-in-charge;

(b)     every laboratory or diagnostic centre shall be under the management, control and supervision of other suitably qualified personnel who shall be responsible for carrying into effect the provisions of this Law or any other Law in the health facility concerned.

(2)     Where more than one medical practitioner is connected with a health facility one of such medical practitioners shall be nominated as medical practitioner-in-charge.

(3)     Every medical practitioner-in-charge of every health facility shall be registered with the Agency.

68.     Power of Commissioner to regulate fees

Subject to the provisions of this Law, the Commissioner may give to the Agency general or specific direction as to what fees to charge for the initial registration and subsequent renewal of registration of health facilities in the State and the Agency shall comply and give effect to all directives.

69.     Inspection and supervision

(1)     The Agency or its duly authorised agent or franchise companies may between the hours of 8a.m.5p.m. enter premises in respect of which the Agency had received application for registration as health facilities, for the purpose of inspection and to ensure that conditions for registration under section 61 of this Law are being complied with.

(2)     The Agency or franchise company may between the hours of 8a.m.5p.m. enter any registered health facility in the State for the purpose of supervision and may require to be produced to it, all or any of the records, registers and other documents required to be kept under the provisions of this Law and the medical practitioner-in-charge shall take such steps as may be necessary to facilitate such supervision and inspection, provided that nothing in this section shall be deemed to authorise the inspection of any medical record relating to a particular patient in a health facility.

(3)     The Agency or duly authorised franchise company may enter any health facility in the State for ascertaining if it has been registered or whether it is being run in accordance with the provisions of the Law.

(4)     The Agency, its duly authorised agency and franchise company shall inspect every health facility at least twice a year to ensure compliance with this Law, but may conduct announced or unannounced inspections of health facilities at any time.

(5)     An order issued with respect to subsection (4) above must be in writing and issued to the head of the health facility in question.

70.     Notice of non-compliance

(1)     The Agency shall issue a written notice of non-compliance to the head of the health facility if the Agency determines that the health facility does not comply with-

(i)      any provision of this Law;

(ii)     building regulations; or

(iii)    the provisions of any other law.

(2)     A notice of non-compliance shall be issued to the person responsible for any condition contemplated in subsection (1) above stating the nature and extent of the non-compliance and directing the appropriate corrective action to be taken within a specified period in respect of the health service practice or to minimise or rectify the non-compliance.

(3)     A notice of non-compliance contemplated in subsection (1) above remains in force until the relevant provisions of this Law has been complied with and the Agency has issued a compliance certificate in respect of that notice.

71.     Power to cancel registration

(1)     Where it appears to the Agency or any franchise company that the provisions of this Law are not being carried into effect in a health facility or that the health facility is not being conducted in the best interest of the health or wellbeing of the patients admitted or that any medical practitioner connected with the health facility has ceased to be fit and proper person, the Agency may by order publish in the State Gazette

(a)     suspend the registration of such health facility until the conditions which caused the order of suspension to be issued have been rectified; or

(b)     cancel the registration of such health facility if the conditions that warranted the suspension is not rectified within six (6) months.

(2)     The Agency shall temporarily close down a health facility pending the order of the court if-

(a)     the health facility has not been duly registered with the Agency;

(b)     the health facility is being run by unqualified personnel or persons not registered with the appropriate professional body.

(3)     When an order of suspension, temporary closure or cancellation of registration of a health facility has been made under the provisions of subsection (1) of this Section, such health facilities shall be closed and the in-patients shall, in the discretion of the Agency, be discharged or transferred to another private hospital or retained in the said health facility which has been so closed until, in the opinion of the Agency they are fit to be discharged or transferred and such retention of in-patients shall not be deemed to constitute an offence under the provisions of this Law. The cost incurred in effecting such transfer shall be borne by the offending health facility.

(4)     A person aggrieved by a suspension, temporary closure or cancellation made under the provisions of this section may appeal to the Commissioner.

(5)     Any order of suspension, temporary closure or cancellation made under the provisions of this section shall be in addition to any proceedings which may be instituted in respect of any contravention or failure to comply with the provisions of this Law and to any penalties which may be imposed on conviction in such proceedings whether or not such conviction is heard on the facts on which the order of suspension, temporary closure or cancellation was made, provided that no such order of suspension or cancellation of registration shall be made until the medical practitioner in charge of such health facility has had an opportunity of defending himself either personally or in writing before the Agency.

72.     Obstruction of duly authorised person from the Agency

Any person who wilfully delays or obstructs a person duly authorised by the Agency in the performance of its functions under this Law, or fails without reasonable excuse to give any information which he is duly required to give, commits an offence and shall be liable on conviction to a fine as specified in a Schedule to this Law.

73.     Offences

Where an offence has been committed against this Law as regards the establishment or the conduct of health facility and such health facility is owned by a person then, in addition to the medical practitioner-in-charge, such person or in the case of a company, every director, company secretary who knowingly being a party to such offence, commits an offence and liable on conviction to the penalty provided under the provisions of this Law.

74.     Penalties

(1)     Any person who establishes or operates a health facility without registering it with the Agency commits an offence and liable on conviction to a fine of Two Hundred and Fifty Thousand Naira (N250,000.00) only or imprisonment not exceeding three (3) years or both in case of an individual; and in case of corporate body, Five Hundred Thousand Naira (N500,000.00) only and the Directors shall each be liable to a term of imprisonment of three (3) years and a fine.

(2)     Any person who for the purpose of procuring the registration of health facility, makes a false statement or presents any document which is false commits an offence and liable on conviction to a fine of Two Hundred and Fifty Thousand Naira (N250,000.00) only or two (2) years imprisonment or both.

(3)     Where health facilities are being run by unqualified persons, such persons commits an offence and liable on conviction to two (2) years imprisonment or a fine of One Hundred Thousand Naira (N100,000.00) only or both.

(4)     Where a health facility has employed the services of an unqualified person, both the proprietor and the medical practitioner-in-charge commits an offence and shall each be liable to a fine of Five Hundred Thousand Naira (N500,000.00) ) only or imprisonment for six (6) months or both.

(5)     Any person who for the purpose of registration of health facility under this Law falsely represents himself or assumes any title of a health care practitioner for which he is not qualified or is not duly registered with the appropriate professional body, commits an offence and shall be liable on conviction to a fine of not less than Five Hundred Thousand Naira (N500,000.00) only or imprisonment for a term not exceeding three (3) years or both, and such impersonation shall invalidate the registration of the health facility if already approved.

(6)     Any person whose premises is used as an illegal health facility commits an offence and liable to a fine of Fifty Thousand Naira (N50,000.00), and for any subsequent offence shall be liable to a fine of One Hundred Thousand Naira (N100,000.00) only or six (6) months imprisonment or both.

(7)     Any person contravenes or fails to comply with any of the provisions of this Law shall on conviction in addition to other penalties forfeit any equipment and instrument impounded from such health facilities to the State Government.

(8) (a) Any person contravening or failing to comply with any of the provisions of this Law for which no penalty has been provided commits an offence and liable to a fine of not less than One Hundred Thousand Naira (N100,000.00), only or imprisonment for six (6) months or both; and

(b)     for any subsequent offence

(i)      in the case of an individual, a fine of not less than One Hundred Thousand Naira (N100,000.00) only or imprisonment for six (6) months or both;

(ii)     in the case of a company, a fine of not less than Two Hundred and Fifty Thousand Naira (N250,000.00) .

75.     Powers and attainment of objectives by the Agency

Subject to the provisions of this Law, the Agency shall have power to perform all acts necessary in connection with the performance of its functions and to enable it achieve its objectives under this Law.

76.     Supervisory control over the Agency

The Ministry shall exercise supervisory control over the Agency.

77.     Departments of the Agency

The Departments of the Agency shall include—

(1)     the Administrative/Personnel Department which shall be headed by a civil servant on an equivalent position of a Chief Administrative Officer (grade level14);

(2)     the Department of Enforcement and Legal Services which

(a)     shall be headed by a Legal Officer not below Grade Level12 from the Ministry of Justice with appropriate experience in civil litigation/corporate law experience;

(b)     shall be responsible for issuance of advice on all legal matters including enforcement of patients’ rights and responsibilities even when the defects in the practices occur in public institutions and ensure the prosecution of offenders by the Ministry of Justice;

(3)     the Department of Finance and Internal Audit which shall be headed by an equivalent of a civil servant not lower than grade level10 with appropriate experience in finance and accounts;

(4)     the Department of Research and Medical Statistics which-

(a)     shall be under a head who shall be an equivalent of a chief statistician or medical doctor with wide experience in medical statistics and health management information systems not below Grade Level14;

(b)     a medical doctor with public, health degree shall be considered an advantage for the post.

(5)     the Inspectorate Department which-

(a)     shall be under a head who shall be an experienced medical doctor not below Grade Level14 with wide experience in general practice, medical administration and health management.

(b)     shall be under a head who shall be capable of making decisions on specialised units e.g. E.M.S, mortuary services, company clinics, diagnostic facilities and the ability to co-opt other specialists like ophthalmologists, optometrists, radiologists, physical medicine consultants, physiotherapists, reproductive health specialists and alternative medicine practitioners;

(c)     shall have powers to co-opt any person(s) into carrying out its activities under this Law.

78.     Mass burial of unclaimed bodies

(1)     The operator of a mortuary shall have powers to carry out mass burial of unknown persons and destitute where no relations show up to identify and claim the bodies after a period of six (6) weeks, provided the consent of the Hospital Management Committee has been obtained in writing.

(2)     The Ministry shall monitor mass burials emanating from all mortuaries in the State.

PART 6 – Lagos State Primary Health Care Board

79.     Establishment of the Lagos State Primary Health Care Board

(1)     There is established the Lagos State Primary Health Care Board (referred to in this part as ―the Board‖) which shall have the overall responsibility for Primary Health Care Management.

(2)     The Board shall-

(a)     be a corporate body with perpetual succession and a common seal;

(b)     have power to sue and be sued in its corporate name; and

(c)     be capable of holding, purchasing, acquiring and disposing of property movable and immovable for the purpose of carrying out its functions under this Law.

80.     Composition of the Governing Board

(1)     The Board shall be composed of

(a)     the Chairman;

(b)     four (4) other members, who shall be persons with extensive experience in the health sector, preferably health care professionals;

(c)     the Director of Public Health, State Ministry of Health;

(d)     representatives of the following Ministries

(i)      Finance;

(ii)     Budget and Planning;

(iii)    Information; and

(iv)    Local Government and Chieftaincy Affairs;

(e)     a Permanent Secretary who shall be the Board Secretary; and

(f)      the Chairman, Traditional Medicine Board or his representative.

(2)     The Chairman and other non-ex-officio members shall be appointed by the Governor on the recommendation of the Commissioner.

81.     Quorum and voting

(1)     The quorum of the Board shall be eight members including the Chairman.

(2)     All questions at any meeting of the Board shall be determined by a majority of votes of members present and voting.

(3)     When there is equality of votes at a meeting, the Chairman or any member presiding at such meeting shall have a casting vote.

82.     Secretariat

(1)     There shall be a Board Secretariat which shall be headed by a Permanent Secretary who shall be a medical professional with a postgraduate qualification in public health with a minimum of fifteen (15) years’ post qualification experience in medical practice.

(2)     He shall be appointed from among the body of serving medical officers of health in the State.

83.     Tenure of members

The Chairman and other members of the Board shall hold office for a term of three years, renewable for another one term of three years as the Governor may deem fit but not more than two (2) terms.

84.     Removal from office

A member may be removed from office by the Governor on the occurrence of the member becoming bankrupt, convicted, disqualified or suspended by professional body, or of unsound mind.

85.     Functions of the Board

Subject to the provisions of this Law, the Board shall-

(1)     be responsible for the coordination of the planning, budgeting, monitoring and evaluation of all the Primary Health Care (PHC) services that affect the residents of the State and other matters incidental thereto;

(2)     advise the Commissioner and the leadership of the local government area on any matter regarding PHC services in the State;

(3)     pay salaries and allowances to PHC staff in the State;

(4)     disburse funds provided to it from both the NPHCDA and other sources;

(5)     recruit, promote PHC employees on Grade Level07 and above;

(6)     improve/establish policies in respect of PHC implementation matters;

(7)     handle pension matters for all PHC employees;

(8)     monitor activities of local government health authority on appointments, discipline and promotion of employees on Grade Level01 to 06 in order to ensure that the guidelines are strictly and uniformly adhered to;

(9)     serve as the appellate body for all dismissal/retirement petitions from aggrieved PHC employees on Grade Level 01 to 06;

(10)   maintain up-to-date personnel records of all PHC employees;

(11)   maintain a comprehensive database of all grades of PHC employees;

(12)   coordinate inter-state, inter-service and inter-facility transfers of PHC employees;

(13)   compile for Gazette publication of establishment matters, staff movements, including new appointment, promotions and retirement/dismissals;

(14)   oversee PHC joint staff welfare matters including housing and transport;

(15)   ensure manpower planning development and training in the PHC services;

(16)   exercise direct responsibility over training and staff development of PHC employees on Grade Level07 and above; and

(17)   approve promotions for PHC employees on Grade Level01 to 06 as recommended by each local government health authority.

86.     Powers of the Board

The Board shall have the power to-

(1)     set general and uniform guidelines for the establishment of Junior and Senior Personnel Management Committees;

(2)     delegate to the Local Government Health Authority (LGHA) the powers for appointments, promotions, discipline, training and staff development in respect of primary health care employees on Grade Level01 to 06; and

(3)     delegate to the Governing Boards of LGHA power to discipline staff on Grade Level7 to 12 except for dismissal/retirement.

87.     Supervisory role of the Ministry of Health

The Ministry of Health shall exercise a supervisory role over the Board.

88.     Secretary to the Board

(1)     The Secretary shall carry out the day-to-day administration of the affairs of the Board in accordance with the provisions of this Law, and shall be responsible for the following matters—

(a)     making arrangements for meetings of the Board;

(b)     preparing the agenda and the minutes of such meetings;

(c)     implementing the decisions of the Board;

(d)     arranging for payment of fees and allowances of meetings and all other matters affecting members of the Board as may be specifically assigned to him by the Board;

(e)     keeping and securing the records of the Board.

(2)     The Secretariat shall have a variety of distinct and major categories of health professionals as doctors, pharmacists, community health workers, nurses, health-educators, environmental health officers, etc. at director/ assistant director levels.

89.     Remuneration of the Board Members

There shall be paid to the Chairman and other members of the Board such salary and allowances as are considered reasonable by the Governor.

90.     Standing committees

The Board shall set up standing committees to assist in performing the following functions—

(1)     quality control;

(2)     ethics;

(3)     procurement supply;

(4)     drugs and therapeutics.

91.     Annual report

The Board shall submit an annual report of its activities to the Commissioner and the House of Assembly before the 31st day of March of the following year.

92.     Funds and resources of the Board

The funds and resources of the Board shall consist of-

(1)     all sums, investments or other property vested in the Board by virtue of the provisions of this Law;

(2)     such sums or other advances by way of loans, or grants to the Board by any Government;

(3)     such sums or other property as may be advanced by way of loans or grants to the Board by any agency or institution, any international organisation and private foundation or any person whatsoever;

(4)     any investments or other property acquired by or vested in the Board;

(5)     money earned or arising from any investments or other property acquired by or vested in the Board; and

(6)     the funding shall be in accordance with the National Health Act.

93.     Power to borrow money

(1)     The Board may with the approval of the Governor borrow money by issuing debentures, stocks, or other securities or in any other manner for and in connection with the exercise of its functions under this Law.

(2)     An approval given for the purpose of this section may be either general or limited to a particular borrowing or otherwise and may be subject to conditions.

94.     Bank account

The Board shall operate bank accounts for its funds with a reputable bank or banks in the State and the signatories to the account shall be the Permanent Secretary or in his absence his designated representative and the Head of Accounts, or in his absence his designated representative.

95.     Account and audit returns by the Board

(1)     The Board shall keep proper accounts of all its audit transactions in such form as it may direct, and which shall comply with standard accounting practice.

(2)     The form of accounts shall be such as to ensure the provision of separate information in respect of each of the main activities and divisions of the Board.

(3)     The accounts shall be audited annually by the Auditor-General or any person authorised by him in that behalf in accordance with the provisions of the Constitution.

(4)     The Board shall establish proper internal control measures to administer its accounts.

96.     Directorates

The Board shall have the following directorates-

(1)     the Directorate of Medical and Disease Control Services;

(2)     the Directorate of Nursing Services;

(3)     the Directorate of Pharmaceutical Services;

(4)     the Directorate of Community Health;

(5)     the Directorate of Health Education and Promotion;

(6)     the Directorate of Environmental Health Services;

(7)     the Directorate of Health Planning, Research and Statistics;

(8)     the Directorate of Finance and Administration;

(9)     the Directorate of Accounts;

(10)   the Directorate of Pension and Establishment matters.

97.     Power to make regulations

The Board may make regulations in accordance with the Regulations Approval Law as may be necessary or expedient for securing the due performance of any duty imposed and the effective exercise of any power conferred upon the Board by or under the provisions of this part.

PART 7 – Local Government Health Authority

98.     Establishment of local government health authority

(1)     There is established a part-time health authority for each local government in the State as specified under this Part.

(2)     The authority shall-

(a)     be a body corporate with perpetual succession and a common seal;

(b)     have power to sue and be sued in its corporate name; and

(c)     be capable of holding, purchasing, acquiring and disposing of property movable and immovable.

99.     Functions of the Local Health Authority

Subject to the provisions of this part, the Authority shall perform the following functions

(i)      set out targets in line with all overall objectives of setting up the Primary Health Committee (PHC) facilities and taking due cognisance of government policy directives as provided by the Executive Chairman of the local government area in respect of economic, financial, operational and administrative programmes;

(ii)     measure performance against set targets;

(iii)    implement broad policy measures on primary health care development plans;

(iv)    supervise and monitor management committees to ensure that targets are achieved;

(v)     exercise powers to discipline staff on grade level01to 06;

(vi)    consider plans and budgetary proposals of the Ward Health Committee (WHC) before submission to the Ministry of Health through the Board;

(vii)   delegate to the WHC the responsibilities for delivery of healthcare services that meet community needs and satisfaction; and

(viii)   ensure coordination and integration of various health services within its jurisdiction.

100.   Composition of the authority

(1)     The Local Government Health Authority (LGHA) shall consist of:

(a)     a part-time Chairman who shall be a qualified medical/health practitioner of proven integrity with a minimum of ten (10) years’ experience;

(b)     a representative of the private healthcare providers in the local government area;

(c)     two (2) persons of proven integrity selected from the community within the local government area one of whom shall be a female;

(d)     the Medical Officer of Health of the local government area; and

(e)     a representative of the Traditional Medicine Board.

(2)     The Chairman and members of the Authority shall be appointed by the Commissioner on the recommendation of the local government area Chairman.

101.   Tenure of office

The Chairman and members of the Authority shall hold office for a period not exceeding three (3) years and shall be eligible for re-appointment for one other term as the Executive Chairman may deem fit.

102.   Meetings

(1)     The Authority shall meet only once a month (except when there is need for an emergency meeting) and shall hold biannual review meetings with the Ministry.

(2)     The Authority shall hold a quarterly review meeting with the Board.

103.   Remuneration

The Chairman and other members of the Authority shall be paid a monthly sitting allowance as the Executive Chairman may determine.

104.   Secretary to the Local Government Health Authority

The Medical Officer of Health shall be the Secretary to the Authority and shall be the Administrative Head of the Authority.

105.   Funds and Resources of the Authority

The funds and resources of each Authority shall consist of

(1)     all sums, investments or other property vested in the Authority by virtue of the provisions of this Law;

(2)     such sums or other advances by way of loans, or grants to the Authority by the Government;

(3)     such sums or other property as may from time to time be advanced by way of loans or grants to the Authority by any agency or institution, any international organisation and private foundation or any person whatsoever;

(4)     any investments or other property whatsoever acquired by or vested in the Authority; and

(5)     money earned or arising from any investments or other property acquired by or vested in the Authority.

106.   Loans and grants by any Government

(1)     It shall be lawful for the Government through the Ministry of Health to make to the Authority the following-

(a)     grants of any sums of money or property deemed necessary; and

(b)     loans upon such terms as to repayment of interest or otherwise as the Government may determine.

(2)     The Government may, if it deems it expedient, waive in favour of the Authority any right or liability to the Government in respect of any property vested in the Board.

(3)     The Authority shall in respect of any money (other than grants) advanced by the Government, create and maintain an advance account in favour of the Government of an amount equal to the total sums of money so advanced.

(4)     The advance account referred to in subsection (3) of this section shall be subject to such conditions as to interest and repayments as the Governor may determine at the time of taking such loans notwithstanding that the Governor may waive at any time such interest and principal repayments as may become due and payable.

107.   Duty to disseminate information

The Ministry, the Board and all local government health authorities must ensure that adequate and comprehensive information is disseminated on the health services for which they are responsible, which shall include-

(1)     the types and availability of health services;

(2)     the organisation of the health services;

(3)     operating schedules and timetables of visits;

(4)     procedures for access to the health services;

(5)     other aspects of health services which may be of use to the public; and

(6)     procedures for laying complaints.

108.   Obligation to keep records

Any person in charge of a health establishment must ensure that a health record containing such information as may be prescribed is created and maintained at that health establishment for every user of health services.

109.   Confidentiality

(1)     All information concerning a user, including information relating to his or her health status, treatment or stay in a health establishment is confidential.

(2)     Subject to the provisions of this Law, no person may disclose any information contemplated in subsection (1), unless —

(a)     the user consents to that disclosure in writing; or

(b)     a court order or any law requires that disclosure; or

(c)     non-disclosure of the information represents a serious threat to public health.

110.   Access to health records

(1)     Any person working for or on behalf of any health establishment or any health care provider has access to the health records of user and may disclose such person’s information to any person, health care provider or health establishment as is necessary for any legitimate purpose within the ordinary course and scope of his duties where such access or disclosure is in the interest of the user.

(2)     For the purpose of this Section, ―personal information‖ means any information held about an identifiable person, but does not include information that bears on the duties of public employees and official.

111.   Access to health record by health care provider

A health care provider may examine a user’s health records for the purpose of —

(1)     treatment with the authorisation of the user; and

(2)     study, teaching or research with the authorisation of the user, head of the health establishment concerned and the relevant health research ethics committee.

112.   Protection of health records

(1)     The person in charge of a health establishment in possession of a user’s health record must set up control measures to prevent unauthorised access to those records and to the storage facility in which, or system by which, records are kept.

(2)     Any person who-

(a)     fails to perform a duty imposed on them in terms of subsection (1);

(b)     falsifies any record by adding, deleting or changing any information contained in that record;

(c)     creates, changes or destroys a record without authority to do so;

(d)     fails to create or change a record when properly required to do so;

(e)     provides false information with the intent that it be included in a record;

(f)      without authority, copies any part of a record;

(g)     without authority, connects the personal identification elements of the user’s record with any element of that record that concerned the user’s condition, treatment or history;

(h)     gains unauthorised access to a record or record-keeping system including intercepting information being transmitted from one person, or one part of a record-keeping system, to another;

(i)      without authority, connects any part of a computer or other electronics system on which records are kept to-

(i)      any other computer or other electronics system;

(ii)     any terminal or other installation connected to or forming part of any other computer or other electronics system; or

(iii)    modifies or impairs the operation of any part of the operating system of a computer or other electronics system on which a user’s records are kept, or any part of the programme used to record, store, retrieve or display information on a computer or other electronic system or which a user’s record are kept; commits an offence and is liable on conviction to a fine or to imprisonment for a period not exceeding one year or both.

113.   Laying of complaints

(1)     Any person may lay a complaint about the manner in which he or she was treated at a health establishment and have the complaint investigated.

(2)     Each health facility shall establish a procedure for the laying of complaints within those areas of the primary health system for which they are responsible.

(3)     In laying a complaint, the person contemplated in subsection (1) must follow the procedure established by the health facility concerned.

PART 8

Ward Health Committee and Health Facility Management Team

114.   Establishment of Ward Health Committee

There is established a Ward Health Committee (WHC) in each ward of the local government area.

115.   Composition of the Ward Health Committee

(1)     The Committee shall be composed of-

(a)     a part-time Chairman;

(b)     three (3) persons representing the Community; and

(c)     the officer in-charge of the Management Team as member.

(2)     The Chairman and members of the WHC shall be appointed by the Chairman on the advice of the Supervisor for Health.

116.   Composition of the Management Team

The Management Team shall be composed of—

(1)     the officer in charge as team leader;

(2)     all heads of units;

(3)     all heads of interrelated units, e.g. accounts, engineering, agriculture, education, etc.

117.   Functions of Ward Health Committee

The functions of the WHC shall be to—

(1)     assist the Medical Officer of Health in the day-to-day management of the health facility and to ensure proper medical care of patients;

(2)     make proposals with regard to—

(a)     the overall planning, expansion, development and maintenance of the health institutions within the jurisdiction;

(b)     the revenues and expenditures of the facility;

(c)     the purchase of stores, furniture and equipment within the limits approved by the Authority;

(3)     implement staff training programmes and continuing medical education programmes with the approval of the Authority;

(4)     prepare and submit monthly statistical summaries (on attendance, morbidity, mortality and utilisation of service), financial statements, quarterly, annual plan and progress report as required by the Authority and the Board; and

(5)     prepare budget and establishment proposals for approval by the Authority before submission to the Board.

118.   Functions of Medical Officer of Health

The functions of the Medical Officer of Health shall be to—

(1)     handle the day-to-day management of human, financial and material resources of the health facility(ies) in accordance with objectives and targets set by the local government health authority.

(2)     discipline staff whose conduct is prejudicial to the interest of the Authority.

(3)     carry out all other duties as stated in Schedule 15 of this Law.

119.   Officer-in-Charge (OIC) of facility

(1)     The Officer-in-Charge shall be appointed from among the body of serving health workers.

(2)     He shall be the most senior health worker within the health workers posted to the facility and Community Health Officer qualification may be an added advantage.

(3)     The officer in charge of the health facility shall hold office for a term of three (3) years, which may be renewable for another term based on performance.

120.   Non-compliance

(1)     Where the WHC fails to comply with the provisions of Section 100 (vii) of this Law, the local government health authority may sanction the committee of the facility concerned.

(2)     The continued existence of any WHC and its officer-in-charge shall be based on performance and compliance with the provisions of this Law.

PART 9

The Lagos State Traditional Medicine Board

121.   Establishment of the Lagos State Traditional Medicine Board

(1)     There is established a body to be known as the Lagos State Traditional Medicine Board (in this part referred to as ―the Board‖).

(2)     The Board is a body corporate with perpetual succession and a common seal and may sue and be sued in its corporate name.

122.   Composition of the Board

(1)     The Board shall consist of twelve (12) members listed as follows

(a)     a Chairman who shall be a university graduate registered with the Traditional Medicine Board and with a minimum of ten (10) years’ experience;

(b)     one (1) person each who shall represent the five divisions of the State who shall be a registered practitioner with a minimum of five (5) years’ experience, and shall be nominated by his Association;

(c)     two (2) representatives with considerable experience in traditional medicine who shall be appointed from-

(i)      the Health Service Commission; and

(ii)     the Pharmaceutical Society of Nigeria, Lagos State Branch;

(d)     a legal practitioner of not less than ten (10) years’ post-call experience representing public interest;

(e)     one (1) representative each from

(i)      the Ministry of Education; and

(ii)     the Lagos State Drug Quality Assurance Laboratory;

(f)      the Registrar of the Board who shall be a university graduate with considerable experience in traditional medicine and also a registered traditional medicine practitioner for at least five (5) years.

(2)     The Chairman and members of the Board specified in subsection (1) of this section shall be appointed by the Governor on the recommendation of the Commissioner.

(3)     The supplementary provisions set out in the First Schedule to this Part shall have effect with respect to the proceedings of the Board and other matters contained therein.

123.   Tenure, resignation and removal from office

(1)     The Chairman and members of the Board, other than ex-officio members, shall each hold office for a period of three (3) years on such terms and conditions as may be specified in their letters of appointment and may be reappointed for one further period of three (3) years and no more.

(2)     Notwithstanding the provisions of subsection (1) of this Section, the Chairman or any member of the Board may, at any time, be removed from office by the Governor, on the recommendation of the Commissioner, for inability to discharge the functions of his office (whether arising from infirmity of mind or body or any other cause), or for corrupt practices or any act of misconduct.

(3)     The Chairman or any member of the Board may, at any time resign his office by a letter addressed to the Governor, or if the Governor is satisfied that it is not in the interest of the Board or in the interest of the public for the person appointed to continue in office, the Governor, on the recommendation of the Commissioner, may notify the person in writing to that effect.

(4)     Where the office of the Chairman or any member of the Board has become vacant, the authority by which he was appointed shall appoint another person in his place for the unexpired term of office in accordance with the provisions of this Law.

124.   Remunerations and allowances of members of the Board

(1)     The Chairman and members of the Board shall be paid such remunerations, allowances and benefits as may be determined by the State Government.

(2)     The Chairman and members of the Board, other than ex-officio members shall not, while holding office, hold any other office of emolument in any of the public services of the State.

125.   Functions of the Board

The Board shall-

(1)     facilitate, coordinate and harness all efforts aimed at the development of traditional medicine in the State;

(2)     establish institutional framework and propose policies for the practice of traditional medicine in the State;

(3)     liaise with the relevant regulatory authorities on traditional medicine at the Federal and local governments with respect to implementation of the national policies and guidelines on traditional medicine;

(4)     encourage and promote the establishment of model services and institutions on traditional medicine such as clinics, schools, botanical gardens, herbal centres, drug manufacturing units, etc. in the State;

(5)     collect, publish, disseminate and exchange information on traditional medicine and develop a State traditional medicine information system;

(6)     establish and maintain a register of persons entitled to practise traditional medicine in the State and publish annually, a list of persons so registered;

(7)     prepare and review, from time to time, code of practice for practitioners of traditional medicine in the State;

(8)     in collaboration with the relevant agencies or bodies, develop curricula of studies, and determine the standards of knowledge and skills for training in traditional medicine in the State;

(9)     in collaboration with relevant agencies or bodies, accredit institutions properly organised and equipped for conducting the whole or any part of a course of training on traditional medicine approved by the Board;

(10)   compile and maintain a register of all traditional birth attendants, nurses, midwives and traditional medicine ingredients/product sellers or other practitioners of traditional medicine in the State; and

(11)   perform such other functions as are necessary for carrying out its objectives under this Part.

126.   Powers of the Board

(1)     The Board shall have power to—

(a)     set standards for certifying persons seeking registration with the Board as traditional medicine practitioners;

(b)     make regulations for the discipline of erring traditional medicine practitioners;

(c)     set guidelines for the establishment of Committees for the regulation and practice of traditional medicine in the State;

(d)     establish and periodically review and update the guidelines for the regulation of traditional medicine practice in the State with a view to protecting the population from quackery, fraud and incompetence;

(e)     have right of access to all records of any institution or bodies to which this Law applies;

(f)      enter into collaborative and cooperative agreements or arrangements with agencies and bodies with similar objectives within and outside the State;

(g)     consider for approval or otherwise any qualification in traditional medicine obtained from foreign institutions or training schools recognised by government of the countries where the institutions or schools are located and the Board may withdraw such approval in line with the provisions of this Law;

(h)     standardise training in traditional medicine and type of medical service to be rendered;

(i)      establish within the State registration offices for purposes of registering traditional herbalists, birth attendants, and other practitioners in traditional medicine practising within the State;

(j)      lay down conditions to be followed by traditional herbalists, birth attendants and other practitioners in traditional medicine in clinics and hospitals, within the State;

(k)     regulate the code of conduct and practice of traditional herbalists or healers, birth attendants or other practitioners in traditional medicine in the State;

(l)      charge fees for and collect fees for registration and to review such fees;

(m)    regulate the code of conduct and practice of traditional herbalists;

(n)     regulate the conduct and practice of traditional medicine ingredients/products sellers;

(o)     make regulations with respect to sale of herbal products within the State; and

(p)     do anything generally which in its opinion shall ensure the achievements of the purposes of this Part.

(2)     The Board shall be responsible for the overall supervision of traditional medicine, hospitals, clinics and traditional institutions owned by traditional herbalists or healers, birth attendants or other practitioners in traditional medicine within the State and the supervision and maintenance of any traditional clinic, health centres and hospitals that the Board may set up and operate by virtue of this Part.

(3)     In addition to any powers conferred on the Board under this Part the Board shall have the following powers—

(a)     subject to the approval of the Commissioner to borrow money and to invest the funds of the Board;

(b)     to charge and collect fees for any facilities provided by or by arrangement with the Board;

(c)     such other powers as the Commissioner may by order confer on the Board.

127.   Registrar of the Board

(1)     There shall be for the Board a Registrar who shall-

(a)     be appointed by the Governor on the recommendation of the Commissioner;

(b)     be responsible for the execution of policy and the day-to-day running of the affairs of the Board as directed by the Chairman and the Board;

(c)     be the head of the Secretariat of the Board;

(d)     issue notices of meetings of the Board;

(e)     keep and secure the records of the Board;

(f)      be responsible for the preparation of the minutes of the Board; and

(g)     perform such other functions as may be determined, from time to time by the Board.

(2)     The Registrar shall hold office in the first instance for a term of four (4) years and may be re-appointed for a further term of four years and no more on such terms and conditions as may be specified in his letter of appointment.

(3)     The Board shall appoint such other category of staff as it may deem necessary for the purpose of performing the functions of the Board under this Part.

(4)     The Board shall, with the approval of the Commissioner, determine the terms and conditions of service including remunerations, allowances, benefits, etc., of officers and employees of the Board.

128.   Contributory Pensions Act

Service in the Board shall be approved service for the purpose of the Contributory Pensions Act, and accordingly employees of the Board shall be entitled to pensions and other retirement benefits in respect of that office as applicable in the Civil Service of the State.

129.   Establishment of State Traditional Medicine Fund

There is established for the Board, a Fund to be known as the Traditional Medicine Fund (in this Part referred to as ―the Fund‖). The Fund established pursuant to this section shall consist of the following-

(a)     such sums as may be appropriated, from time to time, to the Board by any Government;

(b)     money paid to the Board by way of grants, subsidies, donations, gifts, charges, fees, subscriptions and interest; and

(c)     all other sums of money accruing to or vested in the Board in respect of any matter incidental to its powers or functions under this Law.

130.   Expenditure of the Board

The Board may apply the proceeds of the Fund established under section 129 of this Law to

(a)     offset the cost of administration of the Board;

(b)     offset the payment of emoluments, allowances and benefits of members of the Board and for reimbursing members of the Board or of any committee set up by the Board and for such expenses as may be expressly authorised by the Board;

(c)     offset the payment of salaries, fees or other remuneration or allowances, gratuities and pensions, and other benefits payable to the staff and other employees of the Board.

(d)     to develop and maintain of any property vested in or owned by the Board;

(e)     maintain general financial reserves subject to general or special directives that may be given in that behalf by the Governor in accordance with the provisions of this Law; and

(f)      carry out in connection with all or any of its functions under this Part.

131.   Power to borrow

The Board may, with the approval of the Commissioner or in accordance with the general authority given by the State Government, borrow by way of loan or overdraft from any source any monies required by the Board to meet its obligations and its functions under this Part.

132.   Power to accept gifts

(1)     The Board may accept gifts of land, money or other property on such terms and conditions, if any, as may be specified by the person or organisation making the gift.

(2)     The Board shall not accept any gift if the conditions attached by the person or organisation making the gift are inconsistent with the objectives of the Board under this Part.

133.   Annual Reports

(1)     The Board shall, not later than the 30th day of September in each year, submit to the Commissioner an annual report of the estimate of its income and expenditure during the succeeding year and such report shall include a copy of the audited accounts of the Board for that year and the auditors’ report on the accounts.

(2)     The Board shall keep proper accounts in respect of each year and proper records in relation to those accounts and shall cause its accounts to be audited within six months after the end of each year by auditors appointed by the Board from the list and in accordance with the guidelines supplied by the Auditor-General of the State.

134.   Establishment of Traditional Medicine Board Disciplinary Committee

There is established for the Board, a Committee to be known as the Traditional Medicine Board Disciplinary Committee (in this Law referred to as ―the Disciplinary Committee‖) which shall be charged with the duty of considering and determining any case referred to it by the Investigating Panel established in the State and any other case of which the Disciplinary Committee has cognisance under the provisions of this Part.

135.   Composition of the Disciplinary Committee

The Disciplinary Committee shall consist of

(a)     the Chairman of the Board as Chairman;

(b)     four (4) traditional medicine practitioners;

(c)     two (2) representatives of the Board; and

(d)     two(2) persons to represent public interest to be appointed by the Commissioner, one of whom shall be a legal practitioner with a minimum of five years post-call experience.

136.   Penalties for professional misconduct

(1)     Where-

(a)     a person practising under this Law is deemed by the Disciplinary Tribunal to be guilty of infamous conduct in any professional respect; or

(b)     a person practising under this Law is convicted by a law court or Committee in the State or elsewhere having power to award imprisonment, of an offence (whether or not an offence punishable with imprisonment) which in the opinion of the Disciplinary Committee is incompatible with the status of a traditional medicine practitioner; or

(c)     the Disciplinary Committee is satisfied that the name of any person has been fraudulently registered;

(d)     the Disciplinary Committee may, if it deems fit, make a recommendation to the Board to give a direction reprimanding that person or ordering the Registrar of the Board to strike his name off the relevant part of the register.

(2)     The Disciplinary Committee may, if it deems fit, defer or further defer its decision as to the giving of a direction under subsection (1) of this Section until a subsequent meeting of the Disciplinary Committee provided—

(a)     no decision shall be deferred under this subsection for periods exceeding two years in the aggregate; and

(b)     no person shall be a member of the Disciplinary Committee for the purposes of reaching a decision which has been deferred or further deferred, unless he was present as a member of the Disciplinary Committee when the decision was deferred.

(3)     For the purpose of subsection (1) of this Section, a person shall not be treated as convicted, as therein mentioned, unless the conviction stands at a time when no appeal or further appeal is pending or may (without extension of time) be brought in connection with the conviction.

(4)     When the Disciplinary Committee gives direction under subsection (1) of this Section, the Disciplinary Committee shall cause notice of the direction to be served on the person to whom it relates.

137.   Appeal against direction of the Disciplinary Committee

(1)     A person to whom a direction relates may, at any time within twenty eight (28) days from the date of service on him of notice of the direction, appeal against the direction to the High Court and the Disciplinary Committee may appear as respondent to the Appeal and, for the purpose of enabling directions to be given as to the costs of the Appeal and of proceedings before the Disciplinary Committee, the Disciplinary Committee shall be deemed to be a party thereto whether or not it appears on the hearing of the Appeal.

(2)     A direction of the Disciplinary Committee under subsection (1) of this Section shall take effect-

(a)     where no appeal under this section is brought against the direction within the time limited for such an appeal, or on the expiration of that time;

(b)     where an appeal is brought and is withdrawn or struck out on the withdrawn or striking out of the appeal;

(c)     where an appeal is brought and is not withdrawn or struck out as aforesaid, if and when the appeal is dismissed and shall not take effect in accordance with the foregoing provisions of this subsection.

(3)     A person whose name is struck off the register in pursuance of a direction of the Disciplinary Committee under this section shall not be entitled to be registered in that register again except in pursuance of a direction in that behalf given by the Disciplinary Committee on the application of that person.

(4)     A direction under Section 136 (1)(d) of this Law for the striking off of a person’s name from the register, may prohibit an application under this section by that person until the expiration of such period from the date of the direction (and where he has duly made such an application from the date of his last application) as may be specified in the direction.

138.   Establishment of the Lagos State Traditional Medicine Board Investigating Panel

(1)     There is established for the Board a body to be known as the Lagos State Traditional Medicine Board Investigating Panel (in this Law referred to as ―the Investigating Panel‖), which shall be charged with the duty of-

(a)     conducting preliminary investigation into any case where it is alleged that a person practising traditional medicine has misbehaved or committed an act of misconduct or breached any of the ethics or code of practice of traditional medicine or should for any other reason be subject of proceedings before the Disciplinary Committee; and

(b)     deciding whether the case should be referred to the Disciplinary Committee.

(2)     Subject to the provisions of subsection (1) of this Section, the Investigating Panel shall, upon conclusion of its investigation and if it is of the opinion that the matter shall be the subject of proceedings before the Disciplinary Committee, refer the matter to the Disciplinary Committee.

139.   Composition of the State Traditional Medicine Investigating Panel

(1)     The members of the Investigating Panel established under this section shall be appointed by the Board and shall consist of—

(a)     two (2) registered traditional medicine practitioners who are resident in the State;

(b)     two (2) representatives of the Board; and

(c)     two (2) other persons who shall not be members of the Board, and one of whom shall be a legal practitioner of not less than five (5) years’ post qualification experience to represent public interest.

(2)     The provisions of the 23rd Schedule to this Part shall, insofar as they are applicable to the Investigating Panel, have effect with respect to it.

140.   Direction by the Commissioner, etc., to the Board

The Commissioner may give to the Board such directives of a general nature or relating generally to matters of policy with regard to the exercise of its or his functions or with respect to the maintenance and securing of public safety and order.

141.   Powers to make regulations

The Commissioner may, in accordance with the Board’s guidelines and on the advice of the Board, make regulations in accordance with the Regulations Approval Law generally for the purposes of this Part or for giving effect to the functions of the Board and in particular prescribe-

(a)     for the performance of any duty imposed under this Part; and

(b)     standards and guidelines for maintenance, management, organisation, administration and operation of traditional medicine, clinics, health centres and hospitals or any facilities for traditional medicine of any description owned or operated by the Board or any private individual or corporate body in the State;

(c)     the Commissioner may give to the Board or the Registrar such directives of a general nature or relating generally to matters of policy with regard to the exercise of its or his functions or with respect to the maintenance and securing of public safety and order.

(d)     the Commissioner may, on advice of the Board, make regulations generally for the purposes of this Part or for giving effect to the provisions of this Part.

142.   Offences and penalties

(1)     As from the commencement of this Law, a person who is not a registered traditional medicine practitioner who-

(a)     for or in expectation of reward, practices or holds himself out as a registered traditional medicine practitioner or practices as a traditional medicine practitioner, or

(b)     takes or uses the title, of traditional medicine practitioner, commits an offence.

(2)     If any person for the purpose of procuring the registration of any name, qualification or other matter-

(a)     makes a statement which he believes to be false in a material particular; or

(b)     recklessly makes a statement which is false in a material particular, commits an offence under                           this Section.

(3)     If the Registrar or any person employed by the Board wilfully makes any falsification in any matter relating to the register he commits an offence under this Section.

(4)     A person who commits an offence under this Section shall be liable on conviction-

(a)     on first conviction, to a fine of Fifty Thousand Naira (N50,000.00) , and on subsequent conviction or indictment to a fine of One Hundred Thousand Naira (N100,000.00) ; or

(b)     imprisonment for a term not exceeding five (5) years or both.

(5)     Where an offence under this section which has been committed by a body corporate is proved to have been committed with the consent or connivance of, or to be attributable to any neglect on the part of any director, manager, secretary or other similar officer of the body corporate, or any person purporting to act in any such capacity, he as well as the body corporate, shall be deemed to be guilty of that offence and shall be liable to be proceeded against and punished accordingly.

143.   Registration of health facility having radiographic unit

In addition to the conditions stipulated under Schedule 41 of this Law, no premises shall be registered as a health facility by the Agency, unless

(1)     the radiographic or x-ray unit shall be constructed with solid concrete of adequate thickness, and be lead lined with density and consistency capable of protecting adjoining rooms and spaces from ionising, radiation leakage above the maximum permissible level, and this shall be without prejudice to the use of modern mobile radiographic equipment;

(2)     the equipment installed shall meet internationally accepted safety requirements in respect of x-ray tube leakage, electrical and mechanical risks; and

(3)     the staff operating the equipment and handling the patients shall satisfy the minimum standard of education, training, and adequate protection.

144.   Power to make regulations

The Commissioner may make regulations in accordance with the Regulations Approval Law in respect of the establishment, registration, conduct, supervision and inspection of health facilities within the State and generally for the carrying into effect the purposes of this Law and without prejudice to the generalities of the power so conferred in particular for-

(1)     prescribing any matter or thing required to be prescribed under the provisions of this Law;

(2)     prescribing the standards of sanitary arrangement;

(3)     regulating the accommodation for in-patients;

(4)     regulating the accommodation and equipment for operating theatres, laboratories, sterilisation and disinfections, pharmacies and other similar purposes;

(5)     prescribing the number of qualified nurses or midwives and other medical staff to be employed, in proportion to the number of beds available;

(6)     regulating the preparation and storage of food and drugs and where drugs are compounded in health facilities, the number of qualified pharmacists to be employed;

(7)     regulating the arrangements for disinfections and the prevention of the spread of infection;

(8)     prescribing the arrangements for the prevention and control of fire and for the safety of patients and staff in the event of fire;

(9)     prescribing the records and statistics to be kept and mode of keeping them as well as regular returns of such records and statistics to the Agency;

(10)   prescribing the registers and records to be kept in respect of patients as well as biannual returns of such records to the Agency;

(11)   prescribing the monthly notification of deaths, births, still-births, miscarriages and abortions and also infectious diseases and notifiable puerperal pyrexia;

(12)   prescribing the records to be kept when a child born in a health facility discharged or removed therefrom;

(13)   prescribing the conditions or requirements applicable for the registration of health facilities under this Law;

(14)   prescribing or approving the maximum fees and charges allowable; and

(15)   prescribing the mode of execution of the provisions of this Law.

145.   Repeals

The Private Health Facilities Inspection Law Cap. P14, 2003, Private Hospital Law Cap. P 15 of 2003, the Lagos State Hospitals Management Law Cap. L 27 of 2003 of Lagos State, Lagos State Board of Traditional Medicine Law Cap. L 49 of 2003, and the Free Health Services (Miscellaneous Provisions) Law Cap. 10 of 2003 are repealed.

146.   Interpretation

In this Law, unless the context otherwise requires—

“Board” means the Lagos State Traditional Medicine Board;

“Chairman” means the Chairman of the Lagos State Traditional Medicine Board;

“charitable basis” means non-profit making basis;

“company” means a duly registered company under the provisions of the Companies and Allied Matters Act and any other company, association or partnership of any number of persons;

“Commissioner” means the Lagos State Commissioner for Health;

“communicable disease” means a disease resulting from an infection due to pathogenic agents or toxins generated by the infection, following the direct or indirect transmission of the agents from the source to the host;

“corporate body” means anybody incorporated under the provisions of any law;

“diagnostic centre” includes a clinic for radiography, pathology or physiotherapy;

“Disciplinary Committee” means the Disciplinary Committee established under section 134 of this Law;

“Director” means the Director of Health Services;

“duly authorised person” means any staff of the Commission or any other person duly authorised by the Commissioner or Governor;

“Governor” means the Governor of Lagos State of Nigeria;

“health agency” means any person other than a health establishment

(a)     whose business involves the supply of health care personnel to users or health establishments;

(b)     who employs health care personnel for the purpose of providing health services;

(c)     who procures health care personnel or health services for the benefit of a user, and includes a temporary employment service involving health workers or health care providers;

“health care personnel” means health care providers and health workers;

“health care provider” means a person providing health services under the provisions of this Law or any other Law;

“health establishment” means the whole or part of a public or private institution, facility, building or place, whether for profit or not, that is operated or designated to provide inpatient or outpatient treatment, diagnostic or therapeutic interventions, nursing, rehabilitative, palliative, convalescent, preventive or other health services under section 60;

“health research” includes any research which contributes to knowledge of

(a)     the biological, clinical, psychological or social processes in human beings;

(b)     improved methods for the provision of health services;

(c)     human pathology;

(d)     the causes of disease;

(e)     the effects of the environment on the human body;

(f)      the development or new application of pharmaceuticals, medicines and related substances; and

(g)     the development of new applications of health technology;

“health services” means health care services that are preventive, protective, curative and rehabilitative in respect of physical, mental and social wellbeing;

“health worker” means any person who is involved in the provision of health services to a user, but does not include a health care provider;

“infectious disease” shall have the same meaning as from time to time contained in the Public Health Law;

“in-patient care” referred to in this Law means the provision of health care service by a duly registered private hospital on a twenty-four hour basis;

“Investigating Panel” means the Investigating Panel of the State Traditional Medicine Board;

“local government health authority” means any authority established under section 98;

“medical practitioner” means a medical practitioner or a dental practitioner, as the case may be, fully registered under the Medical and Dental Practitioners Act;

“member” means a member of the Board and includes the Chairman;

“Ministry” means the Ministry with the responsibility for health matters;

“national health policy” means all policies relating to issues of national health as approved by the Federal Executive Council on the advice of the National Council on Health through the Minister;

“national health system” means the system within the Federal Republic of Nigeria, whether in the public or private sector, concerned with the financing, provision or delivery and regulation of health services;

“non-communicable disease” means a disease or health condition that cannot be contracted from another person, an animal or directly from the environment;

“organ” means any part of the human body adapted by its structure to perform any particular vital function, including the eye and its accessories, but does not include skin and appendages, flesh, bone, bone marrow, body fluid, blood or a gamete;

“person” means an individual and shall include a limited liability company or an organisation duly registered under the Companies and Allied Matters Act, a charitable organisation or association or a partnership of a number of persons;

“premises” means any building, structure or tent together with the land on which it is situated and the adjoining land used in connection with it and includes any land without any building, structure or tent and any vehicle, conveyance or ship;

“primary health care services” means such health services as may be prescribed by the Minister to be primary health care services;

“private health establishment” means a health establishment that is not owned or controlled by an organ of the State;

“public health establishment” means a health establishment that is owned or controlled by a government body;

“private hospital” includes a hospital, convalescent home, nursing home or clinic, all establishments providing in-patient or out-patient care irrespective of whether or not bed accommodation is provided, or any premises used or intended to be used for the reception of persons suffering from any sickness, injury or bodily or mental infirmity and for the reception of women in antenatal, childbirth or immediately after childbirth for the purposes of providing such persons with nursing, medical, surgical, radiological, pathological or physiotherapeutic attention including persons and companies providing home-based health care services and also includes hospitals, convalescent homes, nursing homes, clinics and all other establishments controlled by the State or the State hospital Governing Boards or a local government council or Board of Traditional Medicine or any other Agency of the State;

“Registrar” means the Registrar of the Board appointed under section 127 of this Law;

“rehabilitation” means a goal-oriented and time-limited process aimed at enabling impaired persons to reach an optimum mental, physical or social functional level;

“State” means the Lagos State Government;

“tertiary hospital” means a public or private hospital approved by the Minister to provide health services at a tertiary specialist level of care;

“traditional medicine” means the total combination of knowledge and practices, whether explicable or not, used in diagnosing, preventing or eliminating physical, mental or social diseases and which may rely exclusively on past experience and observation handed down

from generation to generation, verbally or in writing; and includes diverse health practices, approaches, knowledge and beliefs incorporating plant, animal and/or mineral based medicines, spiritual therapies, manual techniques and exercises applied singularly or in combination to maintain wellbeing, as well as to treat, diagnose or prevent illness;

“Traditional Medicine Association” means any group of persons and/or association who join together as one for the main purpose of promoting the practice and/or development of traditional medicine anywhere in the world particularly in Lagos State irrespective of whatever name the association, or group of persons is called;

“traditional medicine clinic” means a premises registered with the Board by a traditional medical practitioner for the sole purpose of practising traditional medicine and/or treating patients with traditional medicine on an out-patient basis;

“ traditional medicine hospital and maternity home” means premises registered with the Board by a traditional medical practitioner for the sole purpose of practising traditional medicine and/or treating patients with traditional medicine on an in and out-patient basis;

“traditional medicine ingredient/product seller” means a traditional medicine ingredient/product seller registered with the Board to sell traditional medicine ingredients and products in the State;

“traditional medicine midwife” shall be taken to refer to traditional ―birth attendant‖ as contained in the provisions of this Law and means a traditional medicine midwife who has registered with the Board to practise traditional medicine midwifery;

“traditional medicine nurse” shall be taken to refer to traditional herbalist attendant and means a traditional medicine nurse who has registered with the Board to practise traditional medicine nursing;

“traditional medical practitioner” shall be taken to refer to ―traditional herbalist and healer‖ as appear in the Traditional Medicine Board Law and means a traditional medical practitioner duly registered with the Board to practise traditional medicine in the State;

“user” means the person receiving treatment in a health establishment, and where the person is—

(a)     below the maturity age includes the person’s parent or guardian or another person authorised by law to act on the first mentioned person’s behalf;

(b)     in the absence of (a) above, the grandparent, adult child, brother, sister or another;

(c)     a person authorised by law to act on the first mentioned person’s behalf;

“Ward Health System” means the organisation and delivery of primary health care services at the Ward and Village levels.

147.   Citation and commencement

This Law may be cited as the Lagos State Health Sector Reform Law and shall come into force on the 16th day of January 2006.

SCHEDULE 1

Criteria for Appointment of a Medical Director

The desired candidate is required to possess the following qualities/qualifications (among others). He must-

(a)     be a medical doctor of at least ten (10) years’ post qualification experience;

(b)     possess a postgraduate degree in any field of medicine (possession of a postgraduate degree in business administration will be an added advantage);

(c)     have relevant and adequate experience in top management of a large hospital with not less than 25 beds;

(d)     maintain high professional standards, discipline and communications skills.

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