A measure that would forbid doctors from leaving Nigeria for better opportunities before five years have passed since they graduated from medical school has made headlines in Nigeria.
The parliament’s response to the recent flight of medical professionals was to take action.
Health personnel is leaving Nigeria in large numbers for other nations, creating a severe dilemma for the country’s health sector.
Government officials are overburdened by this impending crisis, and there is no plan in place to deal with it effectively.
Nigeria has a doctor-to-patient ratio that is more than five times lower than what is recommended by the World Health Organization, and WHO and is also short on medical professionals.
Health officials estimate that over the past eight years, at least 5,600 Nigerian physicians have immigrated to the United Kingdom (UK).
The Nigerian Medical Association (NMA) warned that the health system is on the verge of utter collapse in August 2022 if immediate action is not taken to stop the brain drain.
The association demanded an immediate remedy and added that given the trend of doctors leaving the nation, it might be necessary to engage medical professionals from other nations in the future.
Almost 500 medical consultants have left the country in the previous two years, according to Dr. Victor Makanjuola, National President of the Medical and Dental Consultants of Nigeria, MDCAN.
At a meeting of the Association’s National Executive Committee in Enugu, Makanjuola stated, “This figure is as of March last year; thus, it is far more than that.”
“We are not where we should be,” he continued, “because of inadequate budgetary allocation, subpar infrastructure, a lack of incentives that causes brain drain, and problems with power generation and distribution in the majority of our facilities.
The smooth operation of the facilities and effective delivery of medical treatment to the population has become challenging for the administration.
Also, the Kaduna State Chapter of the Nigeria Medical Association, NMA, sounded the alarm in October of last year, warning that immediate action was required to stop the ongoing brain drain of medical professionals from Kaduna State.
The union said that in the previous seven years, no less than 10,000 doctors had left Nigeria in search of “greener pastures,” which it said had become concerning.
Parallel to this, late last year, governors from the 36 states included by the Nigeria Governors’ Forum, or NGF, voiced worry over the frequency of brain drain in the health sector.
Aminu Waziri Tambuwal, the governor of Sokoto State and the forum’s chairman discussed the worries of the group with Dr. Osagie Ehanire, the minister of health, in Abuja.
“Brain drain has been happening for years. It is disturbing, and I think it has to do with how the medical staff is doing.
Tambuwal urged the federal government to act immediately to address the issue.
The WHO listed 55 nations in March of this year, including Nigeria, as having the most urgent workforce issues related to Universal Health Coverage.
Following the event, the UK added Nigeria and 53 other nations to its list of nations that companies in the health and social care sector should avoid actively trying to hire from.
Although complicated and numerous, some elements have been identified as the root causes, including low pay, unfavorable working conditions, a lack of professional options, insufficient infrastructure and resources, political unrest, and insecurity.
The House of Representatives had put out a bill to solve the situation because it was concerned about the impending threat of brain drain in the country’s health sector.
Healthcare professionals have continued to oppose the plan, which has now reached the second reading stage of the legislative process.
The bill, sponsored by Ganiyu Johnson, a representative for Lagos State’s Oshodi-Isolo Federal Constituency 2 in the House of Representatives, seeks to amend the Medical and Dental Practitioners Act by delaying the issuance of full licenses to individuals with Nigerian training in medicine or dentistry until they have practiced there for at least five years.
Johnson asserts that “it was only right” for doctors to contribute back to society after receiving state funds for their education.
Uzoma Nkem-Abonta, who represents Abia State on the Peoples Democratic Party (PDP) platform, opposed the measure and claimed that it would “tie down” doctors in Nigeria for five years before they can seek employment in a foreign country.
Also, Mark Gbillah, a senator from Benue, rejected the bill because it included provisions that would violate the fundamental human rights of medical professionals with Nigerian training.
“How do you grant a temporary license to someone in such a crucial subject as medicine? In order to practice, you would require a license.
Should we strive to limit these people and violate their fundamental human rights, or do we allocate more funding to the medical industry? said Gbillah.
The National Association of Resident Doctors (NARD), nevertheless, rejected the legislation.
In a statement released following the association’s lengthy National Officers’ Committee (NOC) meeting, NARD clarified its position.
The statement read, “The extended NOC observed with shock and disappointment the vexatious attempts by Honourable Ganiyu Abiodun Johnson and the Federal House of Representatives to enslave Nigerian-trained Medical Doctors for five years post-graduation before they can be issued full practicing licenses or allowed to travel abroad if they so desired.”
Dr. Okwudili Obayi, Public Relations Officer for the Association of Psychiatrists in Nigeria and Consultant Psychiatrist at the Alex Ekwueme Federal University Teaching Hospital, Abakaliki, told Daily Post in an interview that it was regrettable that the National Assembly had proposed such a bill.
Obayi contended that it violates people’s right to freedom to not grant young health professionals licenses until they had been in practice for at least five years.
The bill, according to the health expert, will make the brain drain issue worse rather than fix it.
It is a really awful thought for anyone to have, he remarked, because it means that you are violating people’s right to freedom.
“Even if the person was sponsored or trained for free by the nation, the nation cannot order the person to stay until a bond has been signed. Examine it; why choose doctors? Why should only doctors be prohibited from traveling when everyone else has the right to do so?
“Brain drain occurs in every area. Doctors, nurses, pharmacists, and other professionals have been leaving the health sector in recent years in greater numbers than in the past. The solution, however, is not to refuse them a license unless they have been in practice for at least five years.
The doctor asserted, “We know the main causes of brain drain, and they are significant. If one were to examine the factors that cause people to leave the health industry, they might include the following: services, pay, incentives, unfavorable working conditions, general insecurity (doctors have been kidnapped more frequently than any other profession in the nation), unemployment of young doctors despite this mass exodus, and many others.
In order to stop the brain drain, Obayi further encouraged the government to foster an enabling atmosphere and tackle the problem of insecurity head-on.
It is sad that a typical person should consider the proposed bill. The bill is embarrassing, to put it mildly.
“They should consider the working conditions, supportive environment, and take home an average worker if they want to provide a solution to brain drain in the health industry. Due to overwork, doctors are known to have shorter lifespans than those in any other profession.
Doctors, nurses, and other healthcare professionals all experience high levels of burnout. These are the main justifications given by individuals who assert that they should relocate to an area where their services are more valuable.
“When people depart, it has a significant and massive influence. Any country that has young graduates departing in large numbers would benefit from this.
He argued that the government ought to foster a secure atmosphere and tackle the problem of insecurity head-on.
Moreover, Dr. Robsam Ohayi, a health specialist, stated to DAILY POST regarding the contentious law, “There is no place where anybody has to wait for five years before he would be awarded a license to practice medicine.”
Professor Ohayi, who also serves as the Dean of the Faculty of Basic Clinical Sciences at the Enugu State University College of Medicine, Parklane, Enugu, and the Chief Consultant Pathologist at the Enugu State University Teaching Hospital, called the proposed legislation “modern-day slavery.”
According to the Consultant Pathologist, it is against the law to make someone perform a specific task, go to a specific location, or operate in a specific environment.
“Well, I think the bill initially betrays the ignorance of the individual who proposed it. I’ve tried to study the bill, but it doesn’t even appear to be written by someone who is familiar with the dynamics of the medical field.
“I’ll provide one example: Nowhere in the world does somebody have to wait five years to be granted a license to practice medicine. It anticipates a sort of five-year period of housekeeping; however, this does not occur in any part of the world. The maximum anywhere anybody has done is a year.
In fact, individuals in some countries decrease this time frame when there is a catastrophe, even one as recent as the Ebola crisis. Medical students were sometimes brought out to assist in the workforce without even being evaluated.
“What it means is that if you say someone would spend five years before receiving a license, you are claiming that individual is incapable of managing a patient, according to the definition. Because you finish training the individual for another five years as a post-training, but he is not a doctor; he is a supervisee to be overseen, the brain he is seeking to gain is instead being lost.
Hence, he cannot be held accountable for a patient. But what benefit does a person receive who merely exists in name and does nothing else?
The labor law prohibits forcing someone to perform a certain task, work in a specific location, or perform a specific task under any circumstances. This is the enslavement of today. People are being forced to say, “You must work here,” as a result of this. Their ability to move is actually being usurped by this.
“Labor mobility is well known around the world; individuals can choose their location.”
He contends that the proposed bill will do more to exacerbate brain drain than to address it.
Before offering a viable solution to the situation, the health expert thought the government should determine the causes.
What even is their financial standing in relation to their pay? In Nigerian medical practice, where we have several levels of employment, they won’t have any status. What do you refer to them as? Every three years, someone is promoted, even if they are fully employed.
So when will they receive promotions? After three years, are you going to promote them or what? because they don’t actually begin their careers until they get a complete license. These, therefore, are the problems.
“When discussing bursaries, it is claimed that medical students receive government subsidies and are compensated with public dollars. Has anyone ever been to a public university that got a different treatment vis-a-vis expenses from the rest?
“Let’s pretend there was a subsidy, and everyone who attended the public universities in Nigeria—engineers, attorneys, sociologists, teachers—enjoyed it. How do you specifically target medical professionals and say things like, “Well, you can’t move around; you can’t select where to go since the government sponsored your schooling.” Whose education was not government-funded?
This is the same National Assembly that just rejected a bill that sought to prevent them from sending their kids to study abroad. The same National Assembly is refusing to allow the Medical and Dental Council of Nigeria to control the influx of medical professionals with foreign training into this nation. I refer to Nigerians with foreign education.
“Some people have attended schools where they received subpar medical instruction. Additionally, the National Assembly has refused to allow the MDCN to re-examine these individuals before granting them licenses. I am unable to articulate their viewpoints on how our nation delivers healthcare. The reality of what they are recommending will exacerbate brain drain rather than addressing it.
The bill targets recent graduates, but professors, consultants, and highly experienced medical doctors are also emigrating.
“The causes of brain drain were not even mentioned in the bill. You cannot propose a good solution unless the causes are known. And this law has specifically failed to do that- to recognize and accurately diagnose the problem and proffer a very good solution,” he said.