Proposed Bill Sparks Controversy in Nigerian Health Scene – Mixed reactions to the bill from within the House of Representatives
Medical and Dental Council of Nigeria Act
A proposed Bill seeking to amend the Medical and Dental Council of Nigeria (MDCN) Act has sparked controversy in the Nigerian health scene. Medical doctors are protesting the Bill, which would require Nigeria-trained medical or dental practitioners to work for a minimum of five years in the country before being granted full licenses.
Doctors Plan Court Action:
The proposed Bill has angered medical doctors, who have planned to take legal action against it. They argue that it is unfair and will further exacerbate the existing brain drain in the country’s health sector. They believe that it will discourage Nigerian doctors from practising in the country and exacerbate the problem of medical brain drain.
Lawyers Back Doctors:
The lawyers in Nigeria are also criticizing the proposed Bill, stating that it is not only contradictory but discriminatory and self-defeating. They question whether the representatives in the House are attempting to legislate on forced labour with this bill. They believe that the bill will not achieve its objectives and that it will be counterproductive in addressing the issue of brain drain in the country.
The proposed Bill has generated considerable controversy in the Nigerian health scene. Medical doctors and lawyers are vehemently opposing it, citing its potential negative impact on the country’s health sector. They believe that the government should instead focus on creating a conducive environment for healthcare professionals to practice in the country.
Lagos lawmaker proposes bill to address brain drain in Nigeria’s health sector
A Lagos lawmaker, Ganiyu Johnson, representing Oshodi Isolo II Federal Constituency in the House of Representatives, sponsored the bill titled “A Bill for an Act to Amend the Medical and Dental Practitioners Act, Cap. M379, Laws of the Federation of Nigeria, 2004 to mandate any Nigeria-trained medical or dental practitioner to practice in Nigeria for a minimum of five years before being granted a full license by the Council in order to make quality health services available to Nigerians; and for related matters (H B.2130).”
Mixed reactions to the bill from within the House of Representatives
Saturday Vanguard gathered that the bill, which aims to address the increasing brain drain in the nation’s health system by doctors in search of better opportunities, was met with mixed feelings even from within the Green Chamber. While some lawmakers supported the bill, others opposed it and called for more flexible options. However, the bill passed for a second reading through a majority voice vote.
The deluge of responses from medical professionals and Nigerians at home and abroad
This development has sparked a deluge of responses from medical doctors, their professional associations, affiliate groups, and several Nigerians at home and abroad. The brain drain in Nigeria’s health sector has been on the rise over the years, with an estimated 13,609 Nigerian doctors migrating to the UK alone in the past eight years. This figure is third behind Pakistan and India. Furthermore, the doctor-to-patient ratio in Nigeria is at one doctor to 5,000 patients, which is far beyond the World Health Organization’s recommended ratio of one doctor to 600 patients.
Nigerian Medical Association Vows to Challenge Proposed Bill in Court
The Nigerian Medical Association (NMA), the umbrella body for medical doctors in Nigeria, has expressed disappointment over a proposed bill that requires medical doctors to complete a mandatory one-year national service in rural areas before being eligible to pursue residency programs. The bill was proposed by a member of the Nigerian House of Representatives, Hon. Tanko Sununu.
The NMA has vowed to challenge the bill in court and warned of an imminent showdown with the government. The NMA President, Dr Uche Ojinmah, has referred to the bill as “dead on arrival” and called it a misplaced priority for lawmakers.
Dr Ojinmah has urged the National Assembly to address the challenges of doctors that include poor remuneration, insecurity, and lack of job satisfaction which are among the reasons doctors leave Nigeria. He has stated that the logic being presented in support of the bill does not make sense.
Challenges Faced by Doctors in Nigeria
Dr Ojinmah has pointed out a number of vices militating against doctors in Nigeria. He has stated that there is no equipment for doctors to work with in most hospitals in Nigeria. He has also pointed out that doctors in Nigeria earn significantly less than their counterparts abroad. According to him, a newly trained doctor abroad earns about £40,000 (about N22 million at the official exchange rate) per annum while doctors in Nigeria earn about N3 million to N3.6 million per annum.
Dr Ojinmah has urged the government to provide jobs and good remuneration to the legion of doctors still seeking employment in the country. He has also called on the government to address the push factors that are pushing doctors out of Nigeria. Poverty, he says, is the main push factor.
The NMA President has also stated that the proposed policy is discriminatory.
He has pointed out that many qualified doctors remain unemployed in Nigeria, regardless of the brain drain in the health sector.
One-for-One Policy
Dr Ojinmah has also spoken out against the proposed one-for-one policy. He has stated that if doctors are leaving, some are still not employed, and it is not right to replace those that leave immediately. He has pointed out that in rural areas, there may be as few as one doctors to 9,000 people. In areas where there is banditry and terrorism, there may be as few as one doctors to 20,000 or more people.
The NMA President has stressed that doctors are important just like other healthcare workers and the solution is to make doctors feel that they belong to the country. The pull factors, he says, are those things that are outside Nigeria that are making doctors leave, and these are not within the control of the government.
The NMA has vowed to challenge the proposed bill in court and has warned of an imminent showdown with the government. Dr Ojinmah has urged the government to provide jobs and good remuneration to doctors in Nigeria and to address the push factors that are pushing doctors out of the country. He has pointed out that the proposed policy is discriminatory and that many qualified doctors remain unemployed in Nigeria, regardless of the brain drain in the health sector.
It is an attempt at modern-day enslavement —NARD
In its own reaction, the Nigerian Association of Resident Doctors, NARD, observed with “shock and disappointment”, what it described as “the infuriating attempts by the Federal House of Representatives to enslave Nigerian-trained medical doctors for five years post-graduation before they can be issued full practising licenses or allowed to travel abroad if they so wished”. At the end of an emergency meeting of the extended National Officers’ Committee, NOC, of the NARD, it admonished the Reps over what it described as its “obnoxious bill” which it said was a clear definition of modern-day slavery and not in keeping with anything civil and so should be thrown away at this point.
Although the house agreed on the palpable dangers of the current menace of brain drain in the health sector and promised to work with the Government to reverse the trend when the Government is ready to come up with genuine solutions to the problem, the NARD was emphatic that any attempt by the government or any of her agencies to enslave Nigerian medical doctors under any guise would be strongly and vehemently resisted.
The proposed bill is illegal – Prof Oladapo Ashiru, President, AMSN
The President of the Academy of Medicine Specialties of Nigeria, AMSN, Prof Oladapo Ashiru remarked that creating a law to address just one group of workers is an exercise in futility. Ashiru, who is also President, of the Africa Reproductive Care Society, described the proposed bill as illegal.
“You cannot make a law that violates fundamental human rights. The law that the Reps are trying to make is illegal, and you cannot make a law to justify illegality. Nigeria cannot say that it is going to create a law to address just one group of workers, it cannot work. There are several issues that have to be considered, if we look at the salaries of all workers in the country, it has been depreciated on a yearly basis by the devaluation of the naira. Government has to ensure that this does not happen.”
Ashiru argued that the naira adjustment has devalued the naira, thus making salaries not to be competitive for doctors, nurses, pharmacists, all health workers, and everyone else.
According to him,” The government should first create an enabling environment for doctors to remain in Nigeria. Take, for example, Canada and America; they make sure that their salaries are competitive so they cannot lose their medical staff to each other. They should look at the productive sectors of the economy of the country and the service sector too. But if we look at the wages in this country, we see that the groups taking the chunk of the money are administrative and the legislative. There is a reversal there, and it requires that government would have a comprehensive look at the strategic balancing of remuneration.
“When I became a professor in 1983, my salary was about the equivalent of almost 2,000 pounds a month. It was in naira, but with that salary, I could buy myself a first-class ticket to go with my wife on vacation. Now, if you are to go to London today, even with a salary of about N500,000, you would not buy a flight ticket which is about $250 as of today. This is why people have to go to where they will be comfortable.”
Nigerian Doctors Resist Attempt at Modern-Day Enslavement: NARD
The Nigerian Association of Resident Doctors (NARD) has expressed shock and disappointment at what it calls “the infuriating attempts by the Federal House of Representatives to enslave Nigerian-trained medical doctors for five years post-graduation.” According to NARD, this move is to prevent them from obtaining full practising licenses or being allowed to travel abroad, if they so wish. In a statement issued after an emergency meeting of the extended National Officers’ Committee, NOC, of the NARD, the association described the proposed bill as modern-day slavery and not in keeping with anything civil. Therefore, it should be discarded immediately.
NARD Resists Enslavement of Nigerian Medical Doctors
NARD’s concern stems from the fact that the proposed bill will enslave Nigerian medical doctors by making it mandatory for them to serve the country for five years before getting full practising licenses. The proposed law is seen as a means of addressing the current brain drain in the health sector, but the association insists that any attempt to enslave Nigerian medical doctors will be strongly and vehemently resisted.
Proposed Bill is Illegal:
Prof. Oladapo Ashiru, President, AMSN
The President of the Academy of Medicine Specialties of Nigeria (AMSN), Prof. Oladapo Ashiru, has described the proposed bill as illegal. Ashiru, who is also President of the Africa Reproductive Care Society, noted that creating a law to address just one group of workers is an exercise in futility. He argued that the proposed law violates fundamental human rights and is therefore illegal.
According to Ashiru, the government should create an enabling environment for doctors to remain in Nigeria. He suggested that the government should ensure that the salaries of doctors and other health workers are competitive, just as it is done in Canada and America. He added that if the government looks at the productive sectors of the economy and the service sector, it will be able to find a way to address the issue of brain drain in the health sector.
Remuneration Balancing: A Way Forward
Ashiru also pointed out that the salaries of workers in Nigeria have been depreciated on a yearly basis due to the devaluation of the naira. He suggested that the government should have a comprehensive look at the strategic balancing of remuneration. According to him, the legislative and administrative sectors are taking a chunk of the money, which requires a reversal. He argued that the government must take a comprehensive look at the salaries of workers to ensure that it is balanced and competitive.
Nigerian medical doctors are concerned about the proposed bill that will enslave them and prevent them from obtaining full practising licenses. The Nigerian Association of Resident Doctors (NARD) has described the proposed law as modern-day slavery and called for it to be discarded immediately. Prof. Oladapo Ashiru, the President of the Academy of Medicine Specialties of Nigeria (AMSN), has also described the proposed bill as illegal and suggested that the government should create an enabling environment for doctors to remain in Nigeria.
Nigerian doctors and medical practitioners have expressed concerns about a proposed law that would require medical graduates to work for five years in Nigeria before they can practice abroad. Many have argued that this policy would not only be ineffective in curbing the brain drain of skilled medical professionals leaving Nigeria but would also exacerbate the existing challenges faced by the health sector in the country.
Academy of Medical Specialties Committee to Make Recommendations
Dr Femi Ashiru, a consultant obstetrician and gynaecologist, and the President of the Guild of Medical Directors in Nigeria has commented on the proposed bill. Ashiru explained that the Academy of Medical Specialties had set up a committee to look into the issue and would make recommendations to the government in due course. However, he noted that for the proposal to be successful, Nigeria would need to establish a proper group of people to compare the country’s salary structure with that of other productive and existential service economies.
The Need to Address Salary Structure to Curb Brain Drain
According to Ashiru, the salary structure in Nigeria needs to be addressed to curb the brain drain. He argued that the National and State Assemblies, as well as the Executive and Legislative arms, are the main drains on Nigeria’s reserves. Despite Nigeria’s relative poverty, its legislators are the highest-paid globally for work that is not transparent. Ashiru suggests that Nigerian legislators should start from the top and follow the model in America, where you must generate something if you are getting something. Ashiru also called on representatives to look at how doctors are well-paid in Saudi Arabia and the UAE, which are oil-producing countries like Nigeria.
Subsidised Training of Doctors in Nigeria
On the issue of training doctors, Ashiru highlighted that training doctors in Nigeria are subsidised by the government. He argued that this is not out of place since the health sector in countries like Britain and America is heavily subsidised, and in Saudi Arabia, the training of doctors is also subsidised. Ashiru debunked the claim that training doctors were being subsidised, saying that if you are an American citizen, what you pay to be trained is less than what a non-citizen would pay. He also criticised the ignorance surrounding this issue and the deliberate effort by foreign governments to promote brain drain.
ANPMP Calls for National Emergency in Health Sector
The Association of Nigerian Private Medical Practitioners (ANPMP) has called for a declaration of a national emergency in the nation’s health sector. ANPMP’s National President, Dr Kayode Adesola, said that declaring an emergency in the health sector would assist in proffering sustainable solutions to attrition of health workers, improve healthcare facilities, and reduce disease burden. Adesola noted that the proposed bill was ill-conceived and would not tackle brain drain, which is multifaceted and requires a more comprehensive approach. He argued that the bill would worsen the brain drain in the country since medical doctors do not need Nigerian licences to practice in other countries. Adesola called attention to the dilapidated state of Nigeria’s hospitals, general hospitals and primary healthcare centres, and the fact that political leaders seek medical treatment abroad while citizens suffer. He pointed out that many health workers left Nigeria due to insecurity, not just poor remuneration or poor working conditions.
Conclusion
The proposed bill requiring medical graduates to work for five years in Nigeria before practising abroad has sparked debate among Nigerian doctors and medical practitioners. Some have called for the declaration of a national emergency in the health sector to address the underlying issues that are causing the brain drain of skilled medical professionals. These include poor remuneration, poor working conditions, insecurity, and dilapidated healthcare facilities. Addressing these issues would require a comprehensive approach, including a review of the salary structure, improved