NMA threatens court action, strike over bill to stop doctors’ migration

NIGERIA’s health sector may be heading for another round of crisis as the Nigeria Medical Association (NMA) has vowed to ensure a House of Representatives bill seeking to deny doctors full licence until they have worked in Nigeria for five years after graduation does not sail through.

On Thursday, April 6, the Green Chamber announced that the bill, sponsored by Rep. Ganiyu Abiodun Johnson, representing Oshodi/Isolo Federal Constituency (Lagos State), has passed through second reading.

The bill seeks to amend the Medical and Dental Council of Nigeria (MDCN) Act to prevent Nigeria-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 is part of the measures to halt the increasing number of medical doctors leaving Nigeria for other countries in search of greener pastures. 

“The bill 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 before being granted a full licence by the Council in order to make quality health services available to Nigeria; and for related matters (H B.2130).” 

Sponsor of the bill, Johnson told the House plenary, presided over by the Speaker Femi Gbajabiamila, that it was only fair for medical practitioners, who enjoyed taxpayer subsidies on their training, to give back to society by working for a minimum number of years in Nigeria before exporting their skills abroad. 

Most lawmakers supported the bill, though many of them called for flexibility and options in the envisaged law. 

One member, Rep. Uzoma Nkem-Abonta, opposed the bill, claiming it was more like enslavement to tie a doctor down for five years in Nigeria, after graduation, before seeking employment abroad. 

A majority voice vote passed the bill for second reading. 

NMA reacts

Responding to the proposal, the President of the NMA, Uche Ojinma, laughed at the bill and described it as dead on arrival.

He said the bill was a misplaced priority for lawmakers he said were eating fat on the nation’s revenues.

Ojinma, who spoke to The ICIR, vowed that the doctors would challenge the development in court and through a showdown with the government.

“These guys will not stop making me laugh. I heard about it today. For all we know, that is a knee-jerk response. Let me make it clear. The solution to a problem is finding out the origin of the problem. You find the cause of the problem, and you sort it out. Under international labour law, you do not restrict a worker from migration as long as he did not commit a crime or he is running away, owing you.

“Why can’t the members of the National Assembly serve us (Nigerians) five years for free before we start paying them?”

He challenged the lawmakers to compare what they earn in salary and allowances with what other categories of workers in Nigeria, including doctors, earn.

He said nobody would force doctors to remain in Nigeria.

“I will encourage them not to try it because we will officially find a way to depart (Nigeria) together. Everybody will go. Let’s see what they will do. It is a very wrong step. What I expect the National Assembly to do is pass a bill to say these people must be paid this amount as salary as essential staff, and these people must be given a car loan. If I have a car loan that will run for the next five years, can I leave Nigeria? Of course, I will stay till I finish paying my loan. 

“I expect the National Assembly to say people should be given houses, even on a mortgage, so that they can stay. I expect them to tell the Federal Government to buy equipment and make the hospitals’ environments friendly for people to stay.

“I’m sorry to tell you; I’m totally upset with what I heard. I know that some of them with good heads will not allow the bill to scale through because it can never work. It is like putting fire to fuel. That is what they will achieve.”

He listed poor remuneration, insecurity and lack of job satisfaction as reasons doctors leave Nigeria.

He recalled one of the doctors who was murdered in Oghara, Ethiope West Local Government Area of Delta State, on December 29, 2022, while treating a patient. The NMA leader said the Police were yet to apprehend his killers.

He urged the National Assembly to fix the challenges he listed to keep doctors in the country.

Responding to the claim by the Nigerian government that it subsidises medical doctors’ training in the university and expects them to give back to society after graduation, the NMA President claimed every Nigerian student goes through the same university system.

While giving his final verdict on the bill, he stated, “We will test it in court. Simple. There are international labour laws. Nobody can do that in Nigeria. If it requires going on industrial action to stop it, we will do it, and nothing will happen.”

How strikes in hospitals hurt Nigerian health system

The ICIR reports that medical workers in public health facilities have used strikes to compel the government to accede to their demands at different times in Nigeria.

Such actions often paralysed hospital services, resulting in preventable deaths, complications of ailments, self-medication or high patronage of private hospitals, whose bills are usually unaffordable to the poor.

In December 2021, The ICIR revealed how incessant strikes by doctors and other health workers working in Federal Government hospitals resulted in the loss of about 300 working days between 2013 and 2021.

Will there be a similar bill for other health professionals who migrate?

The ICIR reports that all categories of health professionals leave Nigeria to work abroad.

Such workers include doctors, nurses, midwives, pharmacists, and medical laboratory scientists.

The ICIR reports that all these workers have been leaving Nigeria in the past years, especially since 2020, when the COVID-19 pandemic destroyed nations’ economies, burdened health infrastructures and claimed nearly seven million lives

The ICIR reporter’s efforts to reach the lawmaker who proposed the bill failed last night, as his telephone number could not connect.

A true picture of brain drain in Nigeria health sector

In October 2022, The ICIR reported how psychiatrists in Nigeria reduced from around 300 in 2021 to nearly 200 in 2022.

In 2021, this organisation reported how the country lost nearly 9,000 doctors to the UK and others in three years.

Before COVID-19, The ICIR reported how the UK employed at least 12 Nigerian doctors weekly.

Multiple reports by The ICIR, including those on the Federal Medical Centres, Jalingo,  Makurdi, and the Modibbo Adama University Teaching Hospital, Yola, Adamawa State, revealed the rapidly depleting number of doctors in Nigerian hospitals.

In August 2021, this organisation published a report on how hundreds of doctors thronged a popular hotel in Abuja to participate in an interview for jobs in Saudi Arabia.

However, it has not been very rosy for the doctors abroad. On October 11, this newspaper reported how the BBC exposed the agonies of Nigerian doctors in the UK.

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. Contact him via email @ mfatunmole@icirnigeria.org.

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