Pegasus Reporters Issues on the Wing
The medical health practitioners warned that the “Bill has the possible effect of doing the exact opposite: aggravating the exodus which we have been working with the Executive arm of Government to mitigate”
PEGASUS REPORTERS, LAGOS | APRIL 8, 2023
The Medical and Dental Consultants Association of Nigeria, MDCAN, has reacted to the proposed bill by the Federal House of Representatives seeking to bond Nigerian-trained doctors and dental practitioners to a five-year practice within Nigeria before they can seek employment outside the country
A statement DCAN/2021-2023/PRL/007 7, RE: BILL PROPOSING BONDING OF FRESH MEDICAL GRADUATES FOR FIVE YEARS, signed by Dr.Victor Makanjuola and Dr. Yemi R. Raji for the president and the secretary-general respectively, and made available to Pegasus Reporters explained that the association received the Bill with a rude shock. The body said that it’s even more worrisome that the Bill had passed the second reading in the house before it got to the public.
MDCAN said that while, as a body, it is not in limbo as to the deteriorating health care delivery the country is going through, the statement said inter-alia: “While the idea of bonding medical doctors and indeed all health workers is not novel and has been repeatedly whispered in government corridors since the recent escalation in health workforce brain drain, a thorough interrogation of the possible merits and demerits with stakeholders has ensured it remained a whisper which was gradually tailing off.
Condemning the unilateral attempt by the government to bond medical personnel with such a parliamentary act, the statement averred that: “This Bill has released a genie in the bottle. The passion and concern for the health of Nigerians demonstrated by the Honorable Abiodun Ganiyu Johnson in proposing this bill as a panacea for physician brain drain is commendable albeit misdirected, ill-informed, and poorly thought through”
The medical health practitioners warned that the “Bill has the possible effect of doing the exact opposite: aggravating the exodus which we have been working with the Executive arm of Government to mitigate.
It concluded that even the government is aware that none of the suggestions of the inter-ministerial committee on brain drain and bonding of health workers has been implemented to date, wondering if a simple consultation with the primary constituency to be affected by the Bill would not have afforded the Honorable member a clearer understanding of the hydra-headed nature of the problem he is trying to solve.
Concluding, the statement took a swipe at the proposal stating that the “Bill, without making any assumptions about the ill intent from the proposer, simply lacks the basic ingredients of good faith in the sense that it is both discriminatory and harsh, to say the least, and not in the interest of the people. The following reasons underscore our suggestion that further consideration for the passage of Bill will amount to a wild goose chase in addressing the challenge of brain drain”
The association gives a 6-point reason why the proposed action is not acceptable to it. These are:
1. The Bill erroneously assumes that only newly qualified Doctors are emigrating from Nigeria. Recall that MDCAN has, over the past two years, been in the forefront of calling the attention of policymakers in Government and other critical stakeholders to the ongoing, massive health sector brain drain. Our 2022 survey revealed that over 500 consultants were estimated to have left Nigeria over the preceding two years. Along with sister Associations in the health sector, we have provided to the appropriate Agencies of Government both useful and practical suggestions on how to remedy the situation. You may wish to know that fresh doctors work under the supervision of the more senior ones. Without addressing the retention of the more senior doctors, coercion of the fresh doctors to stay in the system will be a futile effort if quality and effective health care delivery is the ultimate desire of the proponents of the Bill. The question now is, are we going to have another Bill to mandate the senior doctors to stay in the system for 10 years?
2. Curiously, the Bill violates the constitution of the federal republic of Nigeria, as Section 34 (1) b states that “no person shall be held in slavery or servitude” while section 34 (1) c states that “no one shall be required to perform forced or compulsory labour”. This Bill is therefore an excellent example of modern-day slavery. It is shocking and very disrespectful to consider this rather odious Bill as a measure for regulating one of the noblest professions.
3. Bonding already exists in the civil service with clear guidelines for its application. The government at both State and Federal levels do provide sponsorship for university education at both undergraduate and postgraduate levels, with a proviso that individuals who benefit from such sponsorship will be bonded for a specified number of years. For this Bill to therefore consider bonding medical doctors who never benefitted from any public sponsorship is therefore an anomaly, and a clear attempt to reap from where one has not sowed.
4. The idea that Nigerian-trained medical doctors received heavily subsidized education is pure fallacy. Tuition has remained part of the fees paid by every medical student, usually higher than that of non-medical students in most universities. The fact that this amount is smaller relative to other countries – especially the developed countries – does not amount to subsidy, as every graduate who is lucky to get gainfully employed afterward pay back by earning salaries far lower than their peers in developed countries. The irony is that the generation that had federal and state governments’ scholarships and meal subsidies on campus are the ones suggesting bonding of students who are self-sponsored.
5. A major reason for the exodus of health workers is unemployment and under-employment. This Bill erroneously assumes the capacity of the federal government to employ all the doctors for the next 5 years post-qualification. This is a capacity which even the most optimistic of analysts know that the government lacks. Is the Bill then trying to increase the pool of unemployed and disenchanted Nigerians?
6. Health care workforce shortage is a global phenomenon that requires international collaboration to address, through well-thought-out, fair, and just guidelines. Hence, enacting a law to address such a global issue with a local quick fix is an overkill. All that the recipient nations need to do is to review guidelines for foreign graduates to include those who are yet to have full registration in their country but with evidence of completing medical education. Such review by recipient countries will render the proposed Bill redundant while hastening the exit of newly qualified doctors. Some jurisdictions are already accepting Nigerian medical graduates with provisional registration for housemanship.
The body said that its doors are wide open to critical engagements that would lead to improved health care delivery for Nigerians and pristine quality of the medical trainees.
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