Curtailing brain drain amidst health challenges in Nigeria

It has been widely reported of the bill seeking to curb brain drain by mandating Nigerian medical doctors to practice for, at least, five years in the country before going abroad.

The bill is said to have received majority support from members of the House or Representatives and have passed for second reading in the House of Representatives.

According to the sponsor of the bill, Ganiyu Johnson, the bill when passed into law will checkmate the mass exodus of doctors abroad. It is my personal opinion that such law is not only obnoxious and negates the fundamental human right and freedom of movement of citizens, it is also counter-productive and against labour laws.

Notwithstanding the fact that the patient-to-doctor ratio in Nigeria is amongst the lowest in the world with one doctor serving ten thousand Nigerians, It is also worrisome that the healthcare facilities in Nigeria are not well equipped to handle most medical conditions in Nigeria which gives rise to medical tourism.

There have also been historic disputes between the government and the health workers in matters pertaining to welfare of health workers and the infrastructural deficit in the health sector leading to strikes and health workers down tooling. Despite the several resolutions reached between health workers and the Federal Government, there is no evidence to show improvement in the health sector. The budgeting for health sector remains abysmally low with the highest not exceeding 6 per cent of the total budget.

The federal government has also failed to implement its own policies that have potential for crystallizing growth and development in the health sector. Working documents like the National Health Policies, the SDGS and the National Health Insurance Law have been haphazardly implemented. Also the lack of accountability, transparency and public finance management of the health budget leaves one with many concerns.

The issues highlighted here should be the major focus of the legislators rather than introducing an obnoxious bill that will further deepen the problems of Nigeria Medical practitioners. The bill to amend the Medical and dental practitioner Act 2004 to mandate any Nigeria-trained medical or dental practitioner to practice in Nigeria for a minimum of five years before being granted a full license by the council is inconsistent with the rights of the medical practitioner and against the labour laws. It is tantamount to occupational enslavement.

It is my candid opinion that every professional who have gone through academic training for the stipulated period of time scheduled in accordance to his or her profession and have passed all required courses to obtain a degree in the profession is qualified for a certificate. In the case of the medical and law profession, the compulsory one-year houseman ship or law school, as the case may be, exposes such students to practical assessment that qualifies them to receive a practising license. It is the right of the licensed practitioner to determine where he or she chooses to practice the profession. If the bill sails through and become a law and the health challenges that makes doctors leave Nigeria are not swiftly tackled, it would further complicate the problems in the health sector.

First, it would give rise to a handful of unmotivated health workers who are only trying to please the government for such period of time and deliver such eye service treatment to their patients; such dispassionate treatments can expose patients to the risk of losing their lives.

Secondly, I fault the government’s claim to have spent money in training medical workers throughout the period of their schooling.

I am not aware of any free tuition for medical students or any form of subsidy or rebate for a medical fee in any Nigerian university, either government-owned university or private. If the government have not in any way subsidized or given free tuition privileges to medical students, it has no right to decide where such a student decides to live and work. If this bill becomes law, it might make intending medical student to change their country of study.

Instead of studying medicine in Nigeria, such intending students might choose to study abroad, thereby increasing the capital flight of our Naira to dollar exchange, which makes the policy counterproductive.

Finally, the bill does not pass a logical and legal test and can be challenged under the labor laws. I, therefore, propose that the bill should not be given any further attention. To solve brain drain in the medical sector, the Federal Government should continue to liaise with the leadership of the health workers to determine the challenges in the health sector and work together with them to improve the welfare of the health workers.

Government should create enabling environment for health workers by providing necessary health infrastructure and facilities that would motivate health workers. More Nigerians should be encouraged to take up medicine as their course of study in the University and should be offered immediate employment opportunities upon satisfactory performance from medical school. To generate funds for the health sector, the federal government should commence outright implementation of mandatory health insurance enrolment so that the pool of funds required for the health sector would have been established.

Emejuiwe, programmes manager (Good Governance) wrote from the Centre for Social Justice, Abuja (Tel. 08068262366).