MANY medical doctors who dumped Nigeria for the United Kingdom to practise are facing hard times in private hospitals where they work, the BBC has reported.
The media house exposed how the practitioners work throughout the week without being allowed by their employers to rest.
If they choose to rest, they forfeit part of their salary, which their employers say would go to persons who replace them.
But working such long hours is not allowed by the National Health Service, which has doctors in government-funded facilities.
The report showed authorities expressing shock at the challenges the doctors and their colleagues recruited from developing countries face.
NHS doctors can only work up to 48 hours, or upon their request, up to 72 hours a week. Their counterparts in private facilities, recruited from developing countries, including Nigeria, could work over 150 hours at a stretch.
A document the BBC obtained revealed that 92 per cent of non-UK doctors were recruited from Africa, out of which 81 per cent were from Nigeria.
The doctors said working without rest put their health at risk and threatened the patients they manage.
Because of the joy of leaving their countries where working conditions and remunerations are poor, many doctors from Nigeria and other developing countries do not bother to read the conditions of work they are offered in the UK before jetting off to the “greener pasture.”
The UK comprises four nations, namely England, Scotland, Wales and Northern Ireland.
Nigerian doctors share their pains
One of the doctors, Augustine Enekwechi, described his experience working in a UK hospital as living in prison.
He said he was “on call 24 hours a day for a week at a time – and he was unable to leave the hospital grounds.”
A private company, NES Healthcare, which specialises in employing doctors from overseas, including Nigeria, hired him for Nuffield Health Leeds Hospital, where he worked.
But the hospital denied his claim. The hospital said its doctors enjoyed regular breaks, time off between shifts and could swap duty when needed.
Doctors like him from developing countries work as Resident Medical Officers, or RMOs – live-in doctors in the private sector.
“I knew that working tired puts the patients at risk and puts myself also at risk, as well for litigation,” he told the BBC, adding, “I felt powerless… helpless, you know, constant stress and thinking something could go wrong.”
Another doctor, Femi Johnson, said, “It’s not humanly possible (in the UK) to do that (work) every day for seven days.”
Though he worked in a different hospital from Enekwechi, his employer expected him to work 14 to 16-hour days and then be on call overnight.
“I was burnt out. I was tired, I needed sleep,” he said.
If he had to rest, he must be ready to part with his pay. He said in reaction to this decision, “In situations like that, I always make that internal discussion with my inner self – ‘Femi, are you doing right by yourself and are you doing right by the patient?’. Unfortunately, I haven’t always been able to answer that question.”
World Health Organization frowns at health workers recruitment in Nigeria, others
Before the coronavirus pandemic, the World Health Organization (WHO) had a Global Code of Practice on the International Recruitment of Health Personnel.
The code urged developed nations to allow health professionals in developing countries to remain where they are and not recruit them. This is to let those countries battling a shortage of health workers (including doctors) have the manpower to provide services.
But the COVID-19 pandemic made the WHO review the code in 2020, after the 73rd World Health Assembly.
The agency listed Nigeria and 32 other African countries as nations with low health workforce, which should be protected against foreign recruitments.
The countries were among the 47 nations so listed by the WHO globally.
UK’s government incorporated the list into its code of practice and termed it a ‘red list’, which should exclude Nigeria and other countries on the list from recruitment by any of its agencies or firms operating in the country.
But the UK has continued to poach some of the best hands on the African continent and countries from other regions on the list, leaving those nations with lesser human resources for health, with accompanying worse health indices, morbidities and deaths.
However, NES denied breaching the code and claimed it was not a recruitment agency.
According to the BBC, the firm engages with doctors from overseas once they’ve already committed to practising in the UK.
But the Department of Health and Social Care told the BBC that the UK code of practice did apply to NES, meaning that the company breached the code.
Recruitment mode from Nigeria into UK hospitals
Doctors in Nigeria write a Professional and Linguistic Assessments Board test – or PLAB 1, conducted by the General Medical Council in London.
Writing the test is the first step to making the British medical authorities approve a work licence in the UK.
Other activities follow the test, and those who scale through the processes and get their visa land in the UK to work.
Doctors Association in UK reacts
The Doctors’ Association, through its chair, Jenny Vaughan, said some doctors engaged by NES had received help from his association, adding that they lodged many complaints for their workplaces.
“No doctor in the NHS does more than four nights consecutively because we know that it’s frankly not safe,” Vaughan told the BBC.
He added, “This is a slave-type work with… excess hours, the like of which we thought had been gone 30 years ago.
“It is not acceptable for patients for patient-safety reasons. It is not acceptable for doctors.”
The ICIR reports that brain drain has been a huge challenge to the Nigerian health system.
In 2021, The ICIR reported how the country lost nearly 9,000 doctors to the UK and others in three years.
A report by the Punch in 2021 also showed how the UK engaged 353 doctors from Nigeria within 100 days.
Before COVID-19, the newspaper reported how the UK employed at least 12 Nigerian doctors weekly.
Multiple reports by The ICIR, including those on the Federal Medical Centres, Jalingo and Makurdi, and the Modibbo Adama University Teaching Hospital, Yola, Adamawa State, revealed the rapidly depleting number of doctors in Nigerian hospitals.
Marcus bears the light, and he beams it everywhere. He's a good governance and decent society advocate. He's The ICIR Reporter of the Year 2022 and has been the organisation's News Editor since September 2022. Contact him via email @ [email protected].