MANAGEMENT THEORETICAL HORIZON GUIDING

THE OPERATION OF JOS UNIVERSITY TEACHING

HOSPITAL.

INTRODUCTION

Theories are ideas, but every theory is not brought to actualization without

practicing and every practice is backed up by an operating theory. Most firms do

have more than one or two theoretical framework that guides their operation,

which is keen to their survival. The Jos University Teaching Hospital has a

theoretical framework which guides it operation and has been causing it to survive

over the period of existence.

As researcher, we are not only going to study the theoretical concept adopted by

Jos University Teaching Hospital but we are going to identify the weakness that is

associated with the present theoretical practice put into use and also formulate a

possible theory that, if adopted will speed up the rate of accomplishment of the

mission of the institution.

HISTORY OF JOS UNIVERSITY TEACHING HOSPITAL

The hospital was established 34years ago as one of the second generation Teaching

Hospital in Nigeria with a 620 beds capacity for in – patients in view at the

beginning of operation, but started small. It offers diverse and specialized services

in various aspects of healthcare, training and research. The Hospital was first

established by the colonial administration and was called General Hospital in 1929

as a native hospital to serve the general public. In 1976, the General Hospital was

renamed Murtala Muhammed General Hospital in Honour of the then head of state.

The Jos University Teaching Hospital as it is currently called was established by an

act of parliament in 1981 by the then President Shehu Shagari administration. The

Hospital is located at Gengere, of the Murtala Muhammed way leading to the

popular market called Terminus. The Gengere site of the hospital is the temporary

site of the Teaching hospital from inception until recently when it moved to the

permanent site located at Lamingo in the year 2010.

The Hospital is under the Federal Ministry of Health of the federal government of

Nigeria, as such all his activities are carried out as a government institution.

THE VISION OF JOS UNIVERSITY TEACHING HOSPITAL

To be a world class Teaching Hospital devoted to improving the quality of life of

people.

THE MISSION STATEMENT

Our focus is to pursue excellence in the provision of tertiary health services

training, using appropriate technology and research, supported by a disciplined and

dedicated staff in a conducive environment for patient care to enhance the health

status of our community.

FUNDING

The source of financial funding of Jos University Teaching Hospital is the Federal

Government through the Federal Ministry of Health with an allocation given to the

institution. The institution is also expected to generate about 25% of the internal

revenue and remit to the consolidated account of the federation. But from our

finding, the 25% is not usually generated by the institution this is actually due to

the fact that most in patient who have made a consultation for treatment of an

ailment, when told the cost find it difficult to pay and as such retrieve from getting

the treatment from the institution and this was due to the fact that the populace are

civil servant.

CURRENT DEVELOPMENT AND PRACTICE

From investigation and information gathered from the Director of the Office of

Research, Statistics and Planning, the institution is not undergoing any current

development presently basically, because it is a federal government owned

organization and any development that will take place cannot be decided by the

management rather it is what happens at the federal ministry of health that they are

expected to follow.

From our investigation, we identified the management practice that was used in the

institution and this is not in any way related to the modern day’s theory of

management practice rather, it strictly adopted the Bureaucratic Style of

management theory practice. We as a group figured out some drawbacks of the

Bureaucratic management style of leadership that was used in the institution.

Below are some drawbacks we identified:

1. It limited the organizational flexibility and ability to take decision even

when the decision will tentatively solves the issues at hand.

2. It ignores the importance of people and creates a blockage for interpersonal

relationships to exist.

3. Accumulation of power can lead to authoritarian management and, such an

individual will act the way he want not minding if there is any damage to the

organization or not.

4. Rules become ends in themselves.

5. It is difficult to dismantle when already established.

Most information we wanted to obtain from the staff and management was not

given as we were told to go through the due processes of carrying out

investigation, which is the filling of a code of ethic and conduct form and the

payment of two thousand naira before we can be given access to some information

about the institution.

From our observations, we came to discover that this is the reason why most

government institutions/organizations are inefficient in the running of their

expected activities towards the achievement of their set goals and objectives. We

also observed that the application of the bureaucratic style of management does not

only run in the administrative section of the institution but also across the clinical

section of the hospital and it has affected the lives of Nigerians who go there to

receive treatment because of the protocol that they need to follow before they can

get attention from the Doctors even if the patient is needing an emergency attention

that should be addressed immediately, they are still bent on protocol procedure

before giving such patient treatment.

TESTING METHOD/TECHNIQUES

This research paper adopted the use of both primary and secondary data to obtain

information used.

1. Primary Data: We engaged the Head of Planning, Research and Statistic

department in an interview/interactive session. Although it was not a smooth

interactive session as most of the questions asked were not answered directly

by the Head of Department. Also, we obtained more information from other

members of staff who requested that their names should not be mentioned

and it was from there that we got a go ahead as to how to get adequate

information.

2. Secondary Data: We also used secondary data to update our investigation

as the primary data was not sufficient to get us all the information needed.

The following are the secondary data used

i. Annual Report for the year 2010

ii. Annual Report for the year 2011

iii. Nigeria Vanguard newspaper of the 14th June, 2015 online source

iv. Jos University Teaching Hospital official website

CHALLENGES

On our part as researchers, a lot of challenges were encountered during the course

of visiting the institution to retrieve information about them. According to

management theory as a course of study in higher educational level, the theory of

bureaucracy was brought bare before us. This was a major challenge that we found

with the Jos University Teaching Hospital (JUTH) as information requested for by

researchers must first pass through the administrative and get to the appropriate

offices before they can get the information released to us. To be precise in our

discretion of this challenge, we make it bold to say that every information in Jos

University Teaching Hospital are highly classified, that is not a single information

can be given to an individual/researchers who need it for research purposes can get

it without undergoing stress as they play strictly by and beyond the bureaucracy

theory propounded by Max Weber.

For the institution, it became paramount that they have the challenges of late

coming of its senior management staff to office. With the right time for resumption

in every government institution been 8am and expected time of departure is 4pm

but, we discovered that the senior management staff do not resume work at the

stipulated time of 8am and at whatever time they choose to be in the office, they

leave the office before the closing hour to attend to other business issues which are

personal and not related to their expected office work. This we believe has made

the institution inefficient in performing its major work which is the purpose of

existence.

At the time of conducting this research, the hospital was not in full operation

because its Resident Doctors were on strike due to some cogent reasons as outlined

by the Chairman of the Association of Resident Doctors revealed in Vanguard

Nigeria Newspaper dated 14th June, 2015 by Marie – Therese Nanlong.

“The strike, Vanguard learnt is as the result of the refusal of Management of JUTH

to comply with the Federal Government directive on the “implementation of

skipping for doctors” among others grievances.

It would be recalled that the Association of Resident Doctors, NARD issued the

notice of strike dated June 8, 2015 and signed by the Chairman, Joseph Nankat and

Secretary, Kumtap Cashmir stressing that “Medical doctors in JUTH are being

denied of “skipping” even when non doctors enjoy this privilege among others.”

They noted that their members are “working under difficult conditions in JUTH

because of lack of consumables such as hand gloves and some emergency drugs

such as oxytocin”

NARD also decried the non-payment of training allowances to resident doctors,

shortage of House officers and under payment of the few available ones which led

to many moving out of the hospital.

Among their demands are the resumption of “skipping” payment, provision of

essential consumables in the hospital, immediate payment of outstanding training

allowances owed members, employment of House officers and payment of their

entitlements”.

Events of activities are not accurate in Jos University Teaching Hospital (JUTH).

The compilation of the information in this research work was done using outdated

data from the Annual Report of the institution from 2010 to 2011, and this we were

told are the very current report that showed the happenings in JUTH presently. As

a way of identifying this as a challenge, we observed that effectiveness and

efficiency does not exist in JUTH because presently we are in the year 2015 not

only that but at half of the year and the annual report of the year 2012, 2013 and

2014 are not ready. It shows a sign of lack of commitment to work by management

of JUTH and we can assume that any report that will be use to measure their

performance of recent will be the 2012 Annual report which is not accurate and up

to date to show the true state of event in JUTH.

From the annual report we were able to obtain that, the institution has some

challenges which is peculiar to its operation as expressed below:

1. Some departments are still operating from the temporary site and the

management is hopeful that very soon they will move to the permanent site

where facilities are provided for them, because running between the old and

new sites is expensive and inconvenient to patients, management and staff.

The 20% of operation at the old site will have to up with extensive

maintenance of dilapidated facilities which will disrupt the effectiveness of

the institution.

2. Housing Facilities: The permanent site was built with provision for very few

housing facilities whereas it is situated between 20 to kilometer away from

town and just few houses has been built by the management in other to have

them attend to emergencies and this has limited the number of capable hand

who should attend to emergency cases when it arises.

3. Diesel Consumption: Nigerian Electricity Supply Company (NESCO) is the

first line of electricity supply use by the institution, but the quality of power

supplied has been adjudged unsuitable for some of the equipment and as

such the hospital had to rely on giant generators for running the sensitive

equipment and this has made it necessary for the hospital to rely heavily on

generator and in turn diesel which has proved to be expensive for the

hospital at its current level of funding.

4. Inadequate Staff: The institution usually engage medical personnel under

training in various departments to help augment its staff shortage but

recently, it was able to employ about 300 new staff for replacement as many

staff has been exiting the service. The hospital is therefore making do with

the few available hands, which makes it quiet difficult to maintain efficient

standards.

5. Finances: Federal government funding has been unstable for the institution,

and there have been financial policy changes which have affected the

revenue of the hospital negatively for a few years now. The internally

generated revenue has not been sufficient enough to help the hospital meet it

obligation.

PROBLEM AND PROSPECT

We were able to identify that the problem of the institution is not only with the

institution primarily but also with it moderator that is the Federal ministry of

Health.

Below some of the problems identified

1. Slow rate of development within the organization this is as a result of its

reliance on the moderator of it service which is the Federal Ministry of

Health

2. Political instability has made the institution to remain on the same spot for

27years without development and due attention for its growth because it

establishment was not natured by the successor of the then Head of State

Chief Olusegun Obasanjo.

3. Poor planning of the moderator of the institution which is the federal

government to see to the rapid growth of the institution.

Having outlined these problems, below are some possible prospects that we believe

will be adopted to address the problems

1. Developmental autonomy should be given to the institution in it primary

place of existence as this will help fast track the rate of development while

government serve as a check on it developmental activities.

2. Continuity in government established project: Every government who

initiate a project plans has a good course of initiating such a plan. That such

government is not on sit to bring the full fruition into reality does not call for

abandonment, rather continuity should be given to such idea to see it

materials as this will bring about a rapid development to the country.

3. Adequate planning, implementation and evaluation of all the plans for

federal institution should be made and fulfilled in other to make the

institution effective and efficient to accomplished it purpose of

establishment.

ACHIEVEMENT OF JOS UNIVERSITY TEACHING HOSPITAL FROM

INCEPTION TO DATE

Jos University Teaching Hospital achievement that is major to its existence is the

movement of it Temporary site to the permanent site which it now has a bigger

space to accommodate and carryout 80% of its activities, which occurred in 2009.

Although, some department were left behind at the temporary site as a result of

insufficiency of space at the new site (Annual Report 2010, pp. 5 – 6).

Completion of 4 numbers of 3 bedroom doctors’ quarters at Gwafan, 2 number

block of 6 numbers of 2 bedroom flats were completed for doctors at the

permanent sites premises for the doctors to be able to attend to emergency cases

when called upon. Also, 3 main laboratory blocks for Morbid Anatomy, Blood

Transfusion and Hematology has been completed in 2010.

Other achievement of the institution can be generalized as outline by the

department of administration in the annual report where it achievement are

recounted annually base on a yearly plan. Below are the general achievements:

1. Electricity supply: This is paramount to the operation of the institution and

this has made the permanent site to be connected to NESCO for it power

supply and there are two (2) number of 1500 KVA generating power plant

that serves as a standby should in case of power failure.

2. Water Supply: The hospital relies on a dam close to the hospital and this

provides about 500 cubic meters of water per month to the hospital. In view

of ensuring the stability of the water supply, the hospital had to purchase a

transformer and generator for the dam to boost the smooth flow of the water

supply and also to meet up with the expected expansion of service in the

hospital.

3. Regular procurement of vital equipments, drugs, reagents and materials to

enhance service delivery were procured through awards and direct purchases

as recommended by the procurement unit and as approved by the Chief

Medical Director and appropriate authority.

POSSIBLE THEORY

Thus, as a group having seen the way administrative work are run in Jos University

Teaching Hospital, and identifying the channels and manner of approach they give

to individuals such Visitor who come seeking information, and Patients who are

seeking treatment, a possible theory was propounded called “Flexibility Theory”.

This can also be related to contingency approaches as outlined by Gareth Morgan

(2006); describes the main ideas underlying contingency in a nutshell:

1. Organizations are open systems that need careful management to satisfy and

balance internal needs and to adapt to environmental circumstances

2. There is no one best way of organizing. The appropriate form depends on

the kind of task or environment one is dealing with.

3. Management must be concerned, above all else, with achieving alignments

and good fits

4. Different types or species of organizations are needed in different types of

environments

Therefore, as a group we believe we can propound a theory that will help the Jos

University Teaching Hospital and other institution to get it goals achieved. Thus

we are saying that “Flexibility is keen to effectiveness and efficiency”

CONCLUSION

The institution and its management happen to be a very rigid and not flexible in

nature and this has hindered the progress of it achievement from inception till date,

and will continue to if they happen not to be flexible in the approach they adopt

both to administrative and clinical services. Their achievement will not be because

of the government input alone but also their sole responsibility of what they can

contribute to the development of the institution in achieving it purpose of

establishment.

RECOMMENDATION

As a group of researcher who are doing this basically for academic purpose, we

recommend that the Jos University Teaching Hospital should be flexible in it

approach to activities and services rendered as it is key to the achievement of it

mission and purpose of existence considering the fact that in the 21st century, we

are in a dynamic environment and this changes affect both the private and public

institution of which they are not an exception. Also, we make bold to say that the

achievement of its mission is not only tied to finance but also application of the

ingenuity of it staff to reason out the best contribution that they can make either as

individual or as a collective group to better the life of the individual who come to

the institution to seek better health care with or without money as life is more

paramount than the money as such an individual when properly cared for can

return to pay up his debt.

Reference

Gareth Morgan. (1986, 1997, 2006). Images of Organization, Newbury Park, CA:

Sage Publication.

Annual Report (2011). Jos University Teaching Hospital Annual Report. Hamtul

Press Ltd. Plateau State, Nigeria.

Annual Report (2010). Jos University Teaching Hospital Annual Report. Hamtul

Press Ltd. Plateau State, Nigeria.

History of JUTH (2015). Retrieved from http://juthnigeria.org/ on the 26th June,

2015.

Franklin Otorofani (2007): President Obasanjo commission Jos university teaching

Hospital Retrieved from http://www.nigerian-newspaper.com/jos-

university.htm on 16th June, 2015.

Therese Nanlong (2015). Patients Stranded in JUTH as Doctor embark on strike

Retrieved from http://www.vanguardngr.com/2015/06/patients-

stranded-in-juth-as-doctors-embark-on-strike