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Proposed Bill: Is it the solution to doctors exodus?

The proposed bill to stop doctors’ migration is causing panic in the medical community.

On Friday, April 7, a bill 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 passed second reading at the House of Representatives.

The bill was sponsored by Mr. Ganiyu Johnson of the APC from Lagos state. He argued that, it was only fair for medical practitioners, who enjoyed taxpayer’s subsidies on their training, to give back to the society by working for a minimum number of years before exporting their skills abroad.

The proposed bill has however been greeted with concerns as medical experts say it did not only underscore the underlying challenges in the health sector but that it will trigger faster flight from the country.

Some doctors are already leaving for better opportunities abroad, fearing that they will be trapped when the bill is passed.

In addition to the bill causing fear, it has also triggered discussions and debate across the country around the main issues in the health sector such as better funding, increased pay for health workers, and more resources to address the root causes of the migration crisis.

In 2022, the President of the Nigeria Association of Resident Doctors, Dr Dare Ishaya revealed that six out of 10 doctors in the country plan to leave the country for greener pastures.

The Association also put the ratio of doctors to patient at one to between 4,000 and 5,000 patients, which is well over the one to 600 patients recommended by the World Health Organisation.

Meanwhile, Nigeria has only 24,000 licensed medical doctors serving its over 200 million people.

The Bill

The bill 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 practice in Nigeria for a minimum of five before being granted a full license by the Council in order to make quality health services available to Nigeria, and for related matters.”

The bill when passed into law according to the sponsor, Ganiyu Johnson will ensure that the country is not short of health practitioners as well as steam the latest trend of doctors’ migration.

With the recent exodus of doctors, it has become a common thing to see a doctor managing two or more health facilities and People wait for long hours to see a consultant.

Concerns about the bill

Some lawmakers are not in support of the bill. They argued that the bill was tantamount to enslavement and that aspiring doctors should be allowed to dictate the pace of their career.

The bill could also discourage future aspiring doctors, when already the number of students studying medicine in our universities are low.

There is also the fear that the anti-migration bill will pave the way for quacks to infiltrate the profession as well as forcing more doctors to want to leave the country sooner.

Other stakeholders who disapprove of the move including the Nigerian Medical Association and National Association of Resident Doctors (NARD) have described the bill as dead on arrival and vowed to challenge the development in court.

Similarly, the Diaspora Medical Associations has also written to the National Assembly asking the legislative arm of government to rather tackle the underlying problems that has led to the present brain drain in the health sector.

The letter read in part, “The major cause of brain drain includes a poor care delivery framework from a failure to invest in the health care to foster a conducive environment. The system does not promote professionalism, growth, work satisfaction, or a high-reliability culture. Other major drivers include very poor welfare packages, high levels of insecurity, limited opportunities for employment, subspecialty training, socio-political and economic instability. The majority of these issues stem from outside the health care system and are outside of an individual’s control. Indeed, good governance and commitment to future investment in health care would improve conditions in the country that will allow security, good education for children, improved compensation, as described in the Abuja Declaration.” 

The way forward

As already highlighted by the Doctors in Diaspora, for government to solve the problem of brain drain in the health sector, it needs to invest more in the sector not only in the area of renumeration but the facilities themselves.

Fixing the facilities will also make these lawmakers use the local hospitals instead of engaging in medical tourism.

In 2021, Nigeria lost $1.2 billion to medical tourism which could have been invested in the country, according to the National Association of Resident Doctors (NARD). This was barely N100 billion less than the budgetary allocation to the health sector (N632.7billion) at that time.

The health sector got N1.58 trillion out of the total of N20.5 trillion for the 2023 fiscal year.

Perhaps the National Assembly should redirect its focus on curbing medical tourism. There is also the need for government to garner the political will to end the menace for the development of the health sector.

Writing by Chinasa Ossai; Editing by Annabel Nwachukwu