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Oloriegbe Speaks on The Bill Seeking Mandatory Five Years Stay in Nigeria For Qualified Medical Doctors

 

The Chairman of the Senate Committee on Health and Senator Representing Kwara Central, Dr Ibrahim Yahaya Oloriegbe has joined other critical stakeholders in Nigeria’s health sector to express reservations on a legislative proposal before the Green Chambers of the National Assembly, “A Bill for an Act to Amend the Medical Doctors 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 (5) years before being granted a full license by the Council to make quality health services available to Nigeria; and for related matters (HB.2130),” sponsored by the House of Representatives member representing Oshodi Isolo II Federal Constituency of Lagos State, Hon. Ganiyu Abiodun Johnson, and which has passed the second reading at the plenaries.

The medical practitioner cum legislator made his reservations known in an opinion statement he signed and released to the press, captioned: “My position on the Bill to make it mandatory for Medical and Dental practitioner not to be given full practising license until five years after graduation to stem brain drain.”

He expressed that the legislation is not strong enough to curb the menace of brain drain in the country’s health sector resulting from the quest of medical doctors to seek better working conditions abroad.

The statement reads:

1. As the Chairman Senate Committee on Health, a stakeholder in Nigeria’s Health Sector, and a health system specialist, I am of the view that the legislative proposal, “A Bill for an Act to Amend the Medical Doctors 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 (5) years before being granted a full license by the Council to make quality health services available to Nigeria; and for related matters (HB.2130),” sponsored by Hon. Ganiyu Abiodun Johnson, the legislator representing Oshodi Isolo II Federal Constituency of Lagos State, is not enough as a strategy to address the challenge of brain drain in the health sector. This is because the factors responsible for brain drain are multifaceted and the mere denial of full practice license to medical practitioners as contained in the proposal will never resolve and may even aggravate them. Besides, it is not only medical doctors that are leaving the country for greener pastures abroad, there are other health workers, as well as professionals in other fields of human endeavour, trained but leaving the country on daily basis for similar purposes, consequently, focusing attention only on the medical doctors is like curing one of many ailments that are threatening the life of a dying patient without finding solutions to the others.

In addition, with all due respect, the issues and facts related to granting of practising license are not understood by the sponsor of the bill, thus, it becomes imperative for me as a stakeholder in the health sector to offer my perspective, this time as a medical practitioner of many years and not particularly as a senator with the privilege of heading the Senate Committee on Health.

2. The piece of the proposed legislation at a minimum violates the right to the “Freedom of Movement” (Sec. 41) and “The right to freedom from discrimination” under (Sec. 42) as guaranteed by the Constitution of the Federal Republic of Nigeria (CFRN) 1999, as amended. These rights cannot be ordinarily denied by any person or government. Thus, we can’t be seeking legal redress through an illegal procedure.

3. A person who is “qualified as a Medical Doctor” cannot be denied a license to practise having been certified qualified, except if he is found wanting in the ethics of the profession. Labour laws will come into place here.

4. Furthermore, before the bill can be considered for legislative passage and executives’ approval, the following fundamental issues are important to scrutinise:

a) When does the 5-year period start, before or after the housemanship?

b) What sort of license will be awarded to a fully trained doctor instead of a full license to practise under the proposal?

c) Is there going to be a limit in the doctor’s scope of practice, and to what extent are the limits during the five years waiting period? And we need to establish why we are putting such limits; is it for lack of skills, or political expediency?

d) What happens after the five years of denial of rights to practise?

e) Consequently, how will this law advance the quality of clinical services, education, and research in any system, let alone, a crippled one like ours?

Given the above reasons, it is my considered opinion that resolving the challenge of brain drain in the country’s health sector cannot be achieved through this bill. Rather, we need to address the various factors that make skilled health workers desire to migrate out of Nigeria.

I, therefore recommend that rather than enacting laws that will curtail the rights of the citizens to free movement and seek better opportunities through legal means, we should advocate for an improved system that will be very attractive and make them unwilling to travel abroad to seek better living conditions. That is, we have to make our pastures to be greener so that other people’s pastures won’t be tempting to them.

We can achieve this through the following recommendations:

i. Medical students could be obliged to choose between paying the standard market rate for their training or opting for government-subsidized training. Quality education in its real sense can’t be free.

Those who however opted for subsidized training after their qualification would in return be compelled to work in Nigeria for a certain time or refund the subsidies. This is a practice obtainable even in advanced countries such as the UK.

ii. To achieve the goal of a mandatory work scheme, we can enable a system that will guarantee employment opportunities for medical professionals after their qualification and provide inflation-adjusted living earnings for a few years after graduation on the condition that they stay in Nigeria to practice. Apart from providing attractive remunerations, their work environment and career expectations should also be prioritized. Incorporating both measures should give us satisfactory results.

iii. Lastly and importantly, we need to improve our health system with sustainable investments to make it conducive for the various health workers to work. We can be assured of better outputs only if what we input is in good condition.

Sen. Dr Ibrahim Yahaya Oloriegbe,
Chairman, Senate Committee on Tertiary and Secondary Health,
Kwara Central.

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