The move by the House of Representatives to stem mass migration of Nigerian-trained medical doctors to other parts of the world in search of greener pastures has been raising dust, Daily Trust reports.
The Nigerian healthcare sector is facing a series of challenges due to the shortage of health personnel on account of brain drain and inadequate health infrastructure.
It is estimated that at least 2,000 medical doctors leave Nigeria yearly and no fewer than 5,407 Nigerian trained doctors are currently working with the British National Health Service in the United Kingdom. The figure is besides those who are working in the USA and other parts of the globe.
A recent report by the World Health Organisation (WHO) has revealed that for every 10,000 persons in Nigeria, there are four doctors available to treat or attend to them.
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While the World Health Organisation (WHO) puts the doctor to patient ratio at 1:600 standard; Nigeria’s doctors to patients’ ratio of 4:10,000 falls below the global recommendation.
Many people believe there is a need to stem the exodus of our medical personnel, especially doctors, to other countries.
Most probably in line with this argument, the House of Representatives recently passed for second reading, a bill seeking to prevent Nigerian-trained medical or dental practitioners from being granted full licences until they have worked for a minimum of five years in the country.
The bill, which is sponsored by Rep. Ganiyu Abiodun Johnson from Lagos State, is 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 Practise in Nigeria for a Minimum of Five (5) before being granted a full licence by the Council in order to make Quality health Services available to Nigeria; and for Related Matters (HB.2130).”
The bill, he said, was part of the measures to halt the increasing number of medical doctors leaving Nigeria for other countries in search of ‘greener pastures.’
Johnson told the House that it was only fair for medical practitioners, who enjoyed taxpayers subsidies on their training, to “give back to the society” by working for a minimum number of years in Nigeria before exporting their skills abroad.
The majority of lawmakers supported the bill, though a number of them called for flexibility and options in the envisaged law.
Rep. Uzoma Nkem-Abonta, opposed the bill on the grounds that it was more like enslavement to tie a doctor down for five years in Nigeria, post-graduation, before seeking employment in a foreign country.
He called for the choice of where to practice to remain optional.
But Rep. Ganiyu Johnson in exercising his right of reply stated that the bill seeks to save Nigeria from the current brain drain in the medical sector.
He stated that as the government invests much in training the medical personnel in study subsidies, such investments should be protected.
Rep. Abdullahi Abdulkadir, in supporting the bill, said that the high rate of brain drain in Nigeria is truly alarming.
He recommended an option to pay back the government the money subsidised for the training of those yearning to leave before the five years to be put into the Bill.
Rep. Bamidele Salame said it was unfortunate that other countries reap from Nigeria’s efforts to train its medical practitioners.
Rep. Amos Magaji in his contribution called for a state of emergency in the health sector and to provide the needed work tools to our medical practitioners.
The Speaker of the House, Rep. Femi Gbajabiamila said that the Nigerian Constitution in section 45(1) has a provision for setting aside fundamental rights of individuals for the sake of the greater good.
In the end, a majority voice vote passed the bill for second reading at the plenary presided by Speaker Femi Gbajabiamila.
The bill will now be subjected to a public hearing to enable critical stakeholders and members of the public make their inputs.
But the proposed legislation has been raising ripples since it scaled second reading at the lower chamber of the National Assembly.
The Medical and Dental Consultants’ Association of Nigeria (MDCAN), in its response, rejected the bill.
The association in a statement signed by its president, Dr Victor Makanjuola and the Secretary General, Dr Yemi R. Raji said the bill was discriminatory, and not in the interest of the people.
They said while the passion and concern for the health of Nigerians demonstrated by the bill’s sponsor, Abiodun Ganiyu Johnson in proposing the legislation as panacea for physician brain drain is commendable, the bill was however “misdirected, ill-informed, and poorly thought through”.
The association said the bill has the possibility of doing the exact opposite by aggravating the exodus which it has been working with the executive arm of government to mitigate.
“It is pertinent to state that none of the suggestions of the inter-ministerial committee on brain drain and bonding of health workers has been implemented till date.
“Perhaps, a simple consultation with the primary constituency to be affected by the bill would have afforded the honourable member a clearer understanding of the hydra-headed nature of the problem he is trying to solve.
“It is even more worrisome that the bill has passed through the second reading. While the idea of bonding medical doctors and indeed all health workers is not novel and has been repeatedly whispered in government corridors since the recent escalation in health workforce brain drain, a thorough interrogation of the possible merits and demerits with stakeholders has ensured it remained a whisper which was gradually tailing off. This bill has released a genie in the bottle”, they said.
The association said the bill erroneously assumed that only newly qualified doctors are emigrating from Nigeria.
“Our 2022 survey revealed that over 500 consultants were estimated to have left Nigeria over the preceding two years. Along with sister associations in the health sector, we have provided to the appropriate agencies of government both useful and practical suggestions on how to remedy the situation.
“You may wish to know that fresh doctors work under supervision of the more senior ones. Without addressing the retention of the more senior doctors, coercion of the fresh doctors to stay in the system will be a futile effort if quality and effective health care delivery is the ultimate desire of the proponents of the bill.’’
They also said the bill violated the constitution as Section 34 (1) b states that “No person shall be held in slavery or servitude” while section 34 (1) c states that “No one shall be required to perform forced or compulsory labour”.
Similarly, the Association of Nigerian Private Medical Practitioners (ANPMP) also kicked against the compulsory five-year service licensing of a doctor.
The association said a national emergency should be declared in the health sector instead of the proposed compulsory five-year service.
The National President of the association, Dr Kayode Adesola said the proposed bill would have an adverse effect on the health sector as it was premised on the wrong notion that such a measure would solve the brain drain in the sector.
The Chairman, Senate Committee on Health, Senator Ibrahim Oloriegbe, said the proposed bill would not curb the brain drain.
Oloriegbe, who has chaired the health committee in the senate for four years, argued that most of the doctors leaving are not young ones.
He said, “Firstly, it’s not only doctors that are leaving even within the medical profession, we have nurses that are leaving. They are also critical to delivering quality health services.
“Two, the doctors that are leaving are not the new graduates. Most of the doctors that are leaving that are more critical to us are those that have been trained beyond the basic training; they are specialists. Those are the ones that give us much more concern.
“The third issue is that the solution being proffered will not solve the problem, it will rather create more problems for us. The cause of why doctors are leaving cannot just be solved by saying you will deny them a licence. You have to address the cause.”
Oloriegbe called on the federal government to rather invest more in the health sector, pay doctors better and give them some incentives and motivation such as mortgage and car loans, adding that these would encourage them to stay back in the country.
“The other thing which is very critical is the working environment”, he added, saying that not having the tools to work is a major reason the medical practitioners were leaving the country.
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