UK revises foreign health workers’ recruitment, returns Nigeria to red list countries

Some days after the World Health Organisation (WHO) tweaked the Health Workforce Support and Safeguard list, the United Kingdom has also revised its policy on recruitment of health workers from overseas.
 
The code of practice for the international recruitment of health and social care personnel in England, recently updated, has Nigeria returned to the red list countries, which means, “no active recruitment is permitted”.
 
In a related development in-country, there is already an outrage against the Federal Government’s plot to forcefully keep doctors in Nigeria through a new bill proposing a five-year pre-licensing practice for Nigeria-trained doctors.
 
Renowned practitioners and medical associations were at the weekend, unanimous that arm-twisting or “enslaving” healthcare professionals is not the solution to acute brain drain.
 
By the updated WHO’s workforce safeguard list, and now adopted by the UK government, Nigeria and the likes of Benin, Cameroun, Ghana, Senegal, Zimbabwe, and 47 others – mostly African countries – are now in the no recruitment list.
 
According to the UK Home Office, “If a government-to-government agreement is put in place between the UK and a partner country, it will restrict UK employers, contracting bodies, recruitment organisations, agencies and collaborations to the terms of the agreement. The country will be added to the amber list and recruitment can happen only on the terms of the agreement .
 
“Changes to the red and amber country list may be made on an ad hoc basis as government-to-government agreements are signed. All agreements will take WHO guidance on the development of bilateral agreements into account.
 
“It is recommended that employers, recruitment organisations, agencies, collaborations and contracting bodies check the red and amber country list for updates before any recruitment drive.”
 
However, the President, World Medical Association (WMA) and former President, Nigerian Medical Association (NMA), Dr Osahon Enabulele, yesterday, joined the list of medical professionals kicking against the Bill to mandate any Nigeria-trained medical or dental practitioner to practice in Nigeria for a minimum of five years before being granted full registration/license by the Medical and Dental Council of Nigeria (MDCN).
  
A bill seeking to mandate Nigerian-trained medical and dental practitioners to practice for a minimum of five years in the country, before being granted a full licence, on Thursday, last week, passed second reading at the House of Representatives.
 
Sponsored by Ganiyu Johnson, an All Progressives Congress (APC) lawmaker from Lagos, the bill seeks to amend the Medical and Dental Practitioners Act 2004, to address the brain drain in the Nigerian health sector. If passed into law, medical and dental practitioners trained in the country will have to practice for at least five years before they are granted a full licence.
 
Indeed, there has been concern in recent times over the relocation of many healthcare workers in Nigeria to foreign countries — a development that has retrograded the state of the country’s health sector.
 
In August 2022, the Nigerian Medical Association (NMA) said a total collapse of the health sector was imminent, if urgent steps were not taken to address the brain drain in the sector.
 
The association called for an emergency solution to the issue in the health sector, adding that with the trend of medical doctors leaving the country, there might be a need to hire doctors from foreign countries in the future.  Enabulele told The Guardian yesterday: “As one who has engaged the issues of Nigeria’s health system, including the crisis of brain drain, for over two decades, I must state with the greatest respect to the sponsors of the Bill, that I really consider their proposition as not only outlandish, but totally retrogressive, unresearched, and very ill-formed.
 
“I am told that the sponsor of the Bill claimed that there are about 10,000 doctors practicing in Nigeria. This alone clearly shows the unresearched nature of the proposal. From the information available to me, as at December 30, 2022, there were 104, 327 medical and dental practitioners on the register of the Medical and Dental Council of Nigeria, with the number of practicing doctors put at 56, 829. So, where did he get the figure of 10, 000 from?”
  
Enabulele, who, last week, participated in the 5th Global Forum on Human Resources for Health organised by the WHO, in Geneva, Switzerland, said the Bill also showed a clear lack of understanding of the push and pull factors buoying the crisis of brain drain in Nigeria, and other parts of Africa – the region worst hit by the crisis.
   
The physician wondered how this proposition will solve the problem of brain drain, which is largely traceable to the indecent and disabling working conditions and infrastructure, insecurity, uncompetitive wages, unemployment and underemployment of medical and dental practitioners, amongst other known factors, most of which he has spoken about over the last two decades.
 
Enabulele added that the recently held 5th Global Forum on Human Resources for Health was in total agreement with this, and the need for a sincere approach to the resolution of these challenges.
 
“I am, therefore, shocked that rather than come up with purposive and progressive solutions on how to transparently and comprehensively address the push factors accelerating the crisis of brain drain in Nigeria, particularly through prioritised investments in the health system and the health workforce, the sponsors of the Bill sought to come up with a proposition whose remedy is likely to generate a worse ailment and crisis,” he said.