As the Ninth National Assembly winds down its session, the House of Representatives has commenced deliberations on a bill to halt the perceived mass exodus of Nigerian doctors to other countries in search of the proverbial greener pasture.
Specifically, the lawmakers, in a bill sponsored by Ganiyu Johnson (APC, Lagos), seek to amend the Medical and Dental Practitioners Act to stop the migration abroad of Nigerian-trained medical practitioners. The bill proposes that Nigerian-trained medical doctors must serve in the country for five years before being given a full practicing licence.
During the debate on the general principle of the bill, Johnson said it was only fair for doctors, whose training was subsidized by the federal and state governments, to give back to the society. It is on record that Nigeria’s doctor- patient ratio is estimated to be 1:10,000. As a matter of fact, that is even believed to be a national average with the situation worse in most states. It is reported that while in some states in the south, only one doctor is available to treat 30, 000 patients, in the North, it is one doctor to 45,000 patients.
The World Health Organisation’s (WHO’s) established minimum threshold stipulates that a country needs a mix of 23 doctors, nurses and midwives per 10,000 Population to deliver essential maternal and child health services.
At the present rate, it is our belief that Nigeria is facing a serious emergency as far as availability of health personnel is concerned. In 2022, the Medical and Dental Consultants Association of Nigeria (MDCAN) said more than 100 of its members left the country in less than two years. This is even as the National Association of Resident Doctors (NARD) said at least 12 doctors left Nigeria every week in 2018, to practice overseas.
There are records indicating that Nigeria lost over 9,000 medical doctors to the UK, Canada and the United States between 2016 and 2018 with yet another report disclosing that no fewer than 727 medical doctors trained in Nigeria relocated to the UK alone in six months, between December 2021 and May 2022.
Similarly, it is also reported that in December 2022 alone, more than 1,800 healthcare workers left the country in search of the proverbial greener pasture. Only recently, the Nigerian Medical Association (NMA) appealed to the government at both the federal and state levels to declare a state of emergency in the health sector and specifically address the worrisome issue of brain drain.
We recall that in a 2017 survey it conducted in partnership with the Nigerian Polling Organisation (NOIPolls), Nigeria Health Watch revealed that about 88 per cent of medical doctors in Nigeria were seeking work opportunities abroad at the time. For a nation that has one of the worst doctor-patient ratios, to say this mass and seemingly endless exodus of doctors and other health workers is a source of concern, is an understatement.
To the extent that the nation continues to grapple with mass exodus of doctors and other health workers, the move by the Lower House, though coming at the twilight of its term, looks commendable.
However, plausible as the move sounds on the face value, for failing to ask the fundamental question of why this mass exodus, the planned amendment by the lawmakers is, in our considered opinion, a mere window dressing.
Any genuine move to confront the mass exodus of doctors and other health workers must first for all address the cause of the migration. Doctors and other health workers migrate in search of a good working environment where there is availability of working tools and a guaranteed prompt payment of salaries and other emoluments.
Rather than chase shadows, the House must first of all ensure the enforcement of relevant legislations that will accord priority to the health sector at both the national and sub-national levels. In most states, health workers are working under difficult conditions with low pay and obsolete equipment.
Only recently, health workers in Abia state embarked on total and indefinite strike to demand payment of their 21 months’ salary arrears owed them by Governor Okezie Ikpeazu.
Instead of contemplating a legislation that will impugn on health workers’ right to practice their profession freely anywhere they deem fit, the lawmakers should ensure the enforcement of laws already in place to make the working environment conducive for the health workers.
In our considered opinion, the proposed law is akin to putting the cart before the horse. The state of the nation’s health facility was exposed during the Covid era. The situation has not improved. Instead of chasing shadows, the lawmakers should focus attention on the allocation to the health sector and also make laws that will ensure that budgeted money is judiciously applied.
