Global Courant 2023-04-28 17:18:20
On April 6, 2023, the House of Representatives of Nigeria announced that a bill to require new doctors trained in Nigeria to work in the country for five years had passed its second reading. The bill aims to halt the mass exodus of doctors from Nigeria. If the bill becomes law, this category of doctors will not be fully licensed by the profession’s regulatory body for five years.
The ostensibly nationalistic account is gross violates Sections 34 and 35 of the Nigerian Constitution, which guarantee Nigerians’ right to dignity and personal liberty, respectively. Also, like the bad thought redesign of naira policy, this bill spells enormous danger for Nigerians. It could catalyze the brain drain in the country’s health sector, negatively impacting access to healthcare for more than 200 million Nigerians.
Nigerian lawmakers should ditch slavery law. Civil Society Organizations (CSOs) should support Nigerian health workers who oppose the bill. To lawfully and effectively address the mass exodus of healthcare workers from Nigeria, the government must be ready to overhaul and invest in the country’s healthcare systems.
From current billing phase to change of medical and dental practice, Nigeria law frame requires the bill to go through a public hearing and a third reading. After this, it would need the Senate’s consent before going to the president’s table for a final decision. These stages allow Nigerians to pressure lawmakers to abolish the law before it becomes law.
Section 34 of the Nigerian constitution says: “Every individual has the right to the dignity of his person. No one shall be subjected to torture, enslavement or forced labor.” The amendment simply calls for doctors to be forced to work against their will. Section 35 of the same constitution gives every Nigerian citizen the right to personal liberty, including deciding where to provide their services and for how long. Legislators in good conscience should reconsider and quash the bill.
Organized unions should not leave doctors alone to fight the unconstitutional bill; trade unions such as the Nigeria Labor Congress and civil society organizations should form a coalition with health professionals to pressure the legislature to scrap the bill. Right from the public hearing, the alliance must crack the erroneous concoction that forms the basis of the bill. The argument of Lagos House of Representatives member Ganiyu Johnson, who is sponsoring the bill, about the reason for the emigration of healthcare workers is false.
Nigeria has indeed witnessed a massive brain drain in its health sector, but there is nothing the doctors can do about it. Johnson’s argument that doctors are trained with tax dollars and should give something back to their country is also weak and a cover to deprive doctors of their freedom. The Medical and Dental Consultants Association of Nigeria (MDCAN) has reproached that argument.
MDCAN’s response to the bill explains dat “The idea that doctors trained in Nigeria received heavily subsidized education is pure misconception. Tuition has remained a portion of the tuition paid by each medical student, usually higher than that of non-medical students at most universities. The fact that this amount is smaller compared to other countries – especially the developed countries – does not amount to a subsidy, as any graduate who is lucky enough to get a paid job afterwards will pay back by earning salaries that are much lower than their peers in developed countries.”
The reasons why doctors are leaving the country is a web of multiple factors. These reasons are rooted in poor government investment in health systems. The fruit is the brain drain. Governments at all levels, including policymakers, must understand the complexity of the situation and be prepared to act accordingly to resolve the problem. A fire service approach that stifles freedom will not solve the problem. Instead, it will make the situation worse.
If scaled through legislation, the bill could institutionalize a five-year “work to raise money for migration” syndrome among physicians. In this way, doctors only have to wait five years to emigrate. During forced labour, these doctors are not motivated to give their best, which can have a negative impact on the quality of service provided to patients.
The problem with the bill can start while it is still in the pipeline. The bill could prompt other non-medical health professionals to initiate and expedite a migration process. They will do so because they fear other unfavorable policies that the government may then unleash. Ultimately, the health outcome deteriorates. Nigeria can legally solve these problems in a sustainable way.
From medical education and training to health infrastructures, the government must work with private organizations such as insurance banks, health-oriented non-governmental organizations, international donors and other corporate bodies to achieve sustainable sector financing. These partners can provide funding, in the form of loans or as corporate social responsibility, to revitalize the health sector.
Nigerian Medical Schools conflict to train students and GPs due to a lack of basic infrastructure. The government needs to spend more on healthcare to show commitment and encourage investors and the private sector.
National budgets for health care in 2022 turned down from 11 percent in the previous year to 4.65 percent. Lagos State allocated 2.76 percent to health care that year. Nigeria can only build sustainable health systems with significant financial commitments to health care. With 5.75 percent to go for health care, the sector received the bulk of the federal government budget for 2023. It’s not enough.
By 2050, Nigeria is expected to surpass the United States as the third most populous country. With 400 million people by then, the country’s healthcare system will have to serve double the number of patients it has today.
To save Nigeria from appalling health outcomes now and in the future, the legislature must scrap unfavorable policies that could increase the health sector’s brain drain. If legislators fail in their duty, the president must refuse to pass the bill to avoid violating the constitution.
David Adetula is a writer at African Liberty.
