MEDICAL AND DENTAL PROCEDURES

MEDICAL TREATMENT

BY

ODEKUNLE JELIL OLANSILE

The jurisprudence of PSR

ubi jus ibi societas

ubi jus ibi remedium
no one can be punished for an offence not
written, and whose punishment is not
prescribed S.36 (12) CFRN 1999
Key Notes

 Coding of the rules

 Sections
 Sec. 1 with 8 rules (General definitions)
 Sec. 2 with 10 rules (Facilities for Medical Treatment)
 Sec. 3 with 19 rules (Absence from duty on account of
illness)
 Sec. 4 with 2 rules (Burial Expenses)
General
Definitions
 — 'Healthcare Provider (HCP)" means duly appointed Healthcare
Provider in accordance with the National Health Insurance Scheme.
‘Hospital’ means a medical facility run by a duly approved Healthcare
Provider (HCP)
‘Medical Officer’ is a Medical Practitioner who is authorized to render
Healthcare services
‘Private Practitioner’ — means any other Registered Medical or Dental
Practitioner, outside the National Health Insurance Scheme (NHIS)
 130102 – compulsory medical examination on appointment
Every person appointed in any capacity shall be required to present
himself for examination to a recognized Healthcare provider with a
 'Healthcare Provider (HCP)" means duly
appointed Healthcare Provider in
130101 (General Definition) accordance with the National Health
'Healthcare Provider (HCP)“ Insurance Scheme.
"Hospital" ‘Hospital’ means a medical facility run
"Medical Officer" by a duly approved Healthcare Provider
"Private Practitioner"
(HCP)
‘Medical Officer’ is a Medical
Practitioner who is authorized to render
Healthcare services
‘Private Practitioner’ — means any other
Registered Medical or Dental
Practitioner, outside the National Health
Insurance Scheme (NHIS)
  Every person appointed in any capacity shall be required to
130102: Compulsory Medical present himself for examination to a recognized Healthcare
Examination on Appointment provider with aview to ascertainiitg whether he is fit for
Government service. If the candidate is not finally passed as
130103 : Medical Examination in physically fit for service, his appointment shall not be proceeded
service forthwith.

130104: Medical information to  In every five (5) years, an Officer shall present himself to a
be treated as confidential Healthcare Provider for examinatþon to certify that the Officer is
sound in health and fit to continue in Service, without bias to
Government policy on the right of individuals as this peltains to
specific diseases from time to time
 The medical certificates, reports of Medical Boards, dental
treatment records, reports of private practitioners and confidential
health reports of an Officer shall be treated strictly confidential. No
copies of these reports except those mentioned in this Chapter
shall be furnished, except that this rule shall not preclude the
keeping of an Officer's health record in the Ministry of Health or the
transfer of such record to the corresponding office when a staff is
transferred to the Service of another Government
  The Permanent Secretary/Head of Extra-Ministerial Office
may at any time call upon an Officer to present himself to
an approved Healthcare Provider, or to a duly constituted
130105: Special Medical Test Medical Board with a view to ascertaining whether the
Officer is physically and mentally capable Of performing
the duties of his appointment or of any appointment to
which it may be proposed to transfer him.
 At the expiration of an officer’s leave of Absence, he shall
130106: Medical Test for be required to present himself for examination to an
officers on leave of absence approved Healthcare Provider, with a view to obtaining a
report as to the Officer's continued physical and mental
fitness to return to his duties.
 In the case of either of the two preceding rules:
130107: Procedure a. Any fees in respect of the examination, shall in the
absence of any special regulations or arrangement to the
contrary, be paid by the relevant MDAs
b. The person or persons appointed to conduct the
examination shall have discretion to call a specialist into
consultation and any fee due to the specialist for
assistance in rendering a report to the government shall
be paid from public funds
 c.) The report of the examination shall be furnished to the
government and communicated to the officer
concerned by the HCP, if he so desires; and
d.) The Officer shall, however be informed at the earliest
possible date of the decision reached upon his case by
the Government after consideration of the report ; and if
the Officer is dissatisfied with that decision he shall be at
Cont. of 130107 liberty to make representation to this effect, in which
event the Government shall decide at its discretion
whether any further medical evidence shall be called for.
130108: Leave to visit medical  An Officer may be granted leave by his Permanent
specialist/Dentist Secretary/ Head of Extra-Ministerial Office for the
purpose of visiting a Medical Specialist/ Dentist but
only if it is certified by the Healthcare Provider that he
is unable to deal with the case himself and that it will
definitely affect the health of the officer if
consultation is postponed.
An officer granted leave in such circumstances will be
treated for the purpose of free transport facilities (but not
for travelling allowance) as travelling on duty. If no
medical certificate is given, it will be open to an officer to
apply for casual leave under rule 120214
  The medical facilities to provide medical
services to all Officers and their families and
the scale of charges will be accredited by
the National Health Insurance Authority
(NHIA) for medical services rendered shall
Section 2: Facilities for be in line with the Health Policy of the
Government
Medical Treatment
 A staff Who prefers to be treated by a
private practitioner instead of availing
130201: Government Facility in himself of services of authorized Healthcare
Nigeria Provider must himself bear all expenses
incurred through such treatment
130202: Treatment by private
practitioners; patients bear expenses  If an Officer is travelling abroad at the
of medical treatment by private instance of Government or its accredited
practitioners representative in a sea-going vessel or
aircraft as an invalid and placed in the
130203: Treatment on board, charge of the Surgeon, the latter's fees for
ship/aircraft and abroad medical attendance on the Officer during
the journey will be payable by the
Government.
  (i) Government will consider claims for the
refund of medical expenses incurred by Officers
and their families during overseas journey duties
authorized in cases of serious illness occurring
en route and provided that the illness is not
Section 2 cont. attributed to the Officer's or his family's
negligence. Claims unrelated to health incurred
130204: Officer falling seriously ill on
on board ship/aircraft will not however be
voyage to or from Nigeria
entertained ; and
(ii) In the case of Ministers, Permanent Secretaries
130205: Medical Expenses during
and other officials of Government that are involved
overseas leave or on duty in frequent overseas engagements, provision for an
annual International Medical Insurance should be
made by Government.
 The Federal Ministry of Health may recommend
a refund of medical expenses (including
charges for maintenance) incurred by an
Officer while overseas on leave or on duty
provided
 (a) the illness was not due to the Officer's own
negligence ;
(b) the illness was attributable to conditions or
the climate overseas ;
Cont. (c) the Officer sought to avail himself of the
services of the local National Health Insurance
Cont. Service (where applicable) and could not
obtain the requisite attention there under within
a reasonable time ,
(d) the Officer informed the nearest accredited
representative of the Federal Government of
Nigeria at the earliest date possible that he was
unable to obtain the requisite attention through
the National Health Insurance Service ; and
(e) the Officer show reasonable diligence,
expedition and economy in seeking and
obtaining medical attention
 (a) Approval for journeys outside Nigeria for medical
treatment will only be granted by the Head of Civil
Service of the Federation based on the
recommendation Of approved Healthcare Provider,
and certification by the Federal Ministry of Health. In
serious cases where a patient's life is in danger or
Cont. where facilities for medical examination necessary
for diagnosis of difficult cases are not available in the
country, the Officer is treated as an out-patient and
will be entitled to estacode allowance at the
130206: Medical Treatment overseas prevailing rate
(b) Where medical treatment/ examination is to take
place in Nigeria but outside the Officer's duty post,
he shall be entitled to DTA at the prevailing rate: if
the Officer's health condition became such that his
NHIA facility cannot handle the situation and a
referral is made to a better hospital in a separate
town or State, the DTA for the Officer and the
accompanied spouse shall be paid by the
Government.
(c) In exceptional cases where dependents of Officers
are compelled to travel abroad for medical
treatment/ check-up, Government's involvement will
be limited to half of the estimated expenses.
 (d) i. Every application for medical treatment
abroad must be supported by a Consultant's
report from an authorized Healthcare Provider.
It must be submitted to the Permanent
Secretary, Federal Ministry of Health and by the
cont. sponsoring Federal Government Ministries or
Parastatals/ Organizations. The permanent
Cont. secretary will then make his recommendations
to the Head of the Civil Service of the
Federation with copies to the federal Ministry of
Finance the Ministry of Foreign Affairs and
appropriate Nigerian Mission abroad. As a
further control measure, the choice of
Consultants/ clinic abroad will be made by the
Nigerian Mission However, where contact
already exists between a patient and a
Consultant, the Mission may endorse the
arrangement. The mission’s medical consultant
will vet all bills before settlement to ensure that
they are proper and reasonable
.

 Permission may be granted an officer’s

spouse to accompany him at government’s
expense where the ailing officer is
considered to be in “life” or “death”
condition in consequence of which
Cont. immediate medical treatment and
hospitalization abroad is recommended. In
such a case, the commitment of the FG
130207: Condition for spouse shall be limited to the provisions of return air
accompanying ailing officer passage for the two of them, together with
the payment of estacode rate in respect of
only the staff , it being assumed that if the
patient is hospitalized, his spouse will remain
in a hotel or that if the Officer remains as an out-
patient, the two of them will utilize the same hotel
accommodation, Even then this privilege (by which
Spouse is permitted to accompany the Officer) shall
not be automatic, it being a necessary requirement
that a specific approval from the Accounting Officer
shall be obtained prior to the journey abroad
Mandatory
comprehensive (a) Officers on salary grade level 15 and above shall undertake
Medical Check-up mandatory medical check-up locally once a year in Government
accredited Medical facility. If as a result of such check-ups it is
recommended that a further medical consultation and (or treatment
should be undertaken abroad, permission to do so may be granted by
either the President or the Head of the Civil Service of the Federation as
the case may be. Where such Officers happen to be abroad on official
business, they may undertake the once in a year medical check-up
abroad, provided they obtain prior permission from either the President
or Head of Civil Service of the Federation as the case may be, prior to
130208: Officers entitled to their departure abroad
compulsory medical check-up
(b) Officers on grade levels 12 to 15 are entitled to medical check-up
locally locally once in two years. If as a result of such check-ups it is
recommended that a further medical consultation and or treatment
should be undertaken abroad, permission to do so may be granted by
the Head of the Civil Service of the Federation. Where such Officers
happen to be abroad on official business, they may undertake the
once in two years medical check-up abroad provided that they obtain
prior permission from the Head of the Civil Service of the Federation
before the medical consultation takes place, and provided also that
the medical practitioner to be consulted is one that is recommended
by the Nigerian Mission located in or assigned to the particular country
concerned, It should be noted that a local medical check-up may only
be authorized if the applicant chooses a recognized Health Care
Provider ,
 (c) Other Officers in the Service shall be
entitled to medical check-up locally
every three years
(d) The provision for medical check-up
Cont. as stated above shall not be monetized

Cont.
(e) It should be noted that a local
medical check-up may only be
authorized if the applicant chooses a
recognized Healthcare Provider ;
(f) Hospital bills in respect of medical
check-up authorized under this section
shall be settled by relevant MDAs
 Approval for Public Officers to receive periodic
medical check-up at Government expense abroad
will be given by the appropriate authority as stated
Authority to approve below :
•Officers for whom Presidential approval is required :
medical check-up i. Members of the Council of State ,
ii. Members of the Federal Executive Council
iii. The Inspector-General of Police and his Deputies;
130209: Authority to approve iv. Chairman of the Federal Civil Service
medical check-up Commission and all full time Chairmen of
Government Establishments
v. Secretary to the Government of the
Federation (SGF) ;
vi. Head of the Civil Service of the Federation
vii. Permanent Secretaries/ Directors- General/
Chief Executives ;
viii. Officers of the Armed Forces of the rank of
Brig. General (or its equivalent) and above
ix. Auditor-General for the Federation
x. Accountant General of the Federation
 i. Senate President ,
ii. Speaker of the House of Representatives ;
Cont.
iii. Chief Justice of the Federation ;
iv. Members of the National Assembly
Officers for whom the president must v. Justices of the Supreme Court ,
be informed vi. Justices of the Court of Appeal
Officials for whom the approving Authority is the
Head of the Civil Service Of the Federation :
a)all
staff of Ministries and Extra-Ministerial Offices
on Salary Grade Level 12 and above
b)staffin home Ministry and officials in the Ministry
of Foreign Affairs on the same Grade Level
mentioned above.
The Federal Ministry of Health will counter-sign the
Certificate or recommendation issued by a Local
Consultant which shall be attached to the
application
Thank you, for your attention