The President of the World Medical Association, WMA, Dr. Osahon Enabulele, on Sunday kicked against the House of Representative Bill mandating 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.
Enabulele said as one who has engaged the issues of Nigeria’s health system, including the crisis of brain drain, for over 2 decades, he considers the proposition of the sponsors as “not only outlandish but totally retrogressive, unresearched and very ill-formed.”
Enabulele who spoke after attending the 5th Global Forum on Human Resources for Health in Geneva said the sponsor of the Bill claimed there are about 10, 000 doctors practicing in Nigeria, adding that the claim alone clearly showed the unresearched nature of the proposal.
“From the information available to me, as of 30th December 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?
“This Bill sponsored by Hon. Ganiyu Abiodun Johnson shows 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.
“I wonder 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 I have spoken about over the last 2 decades. Indeed, the recently held 5th Global Forum on Human Resources for Health where I spoke at two important sessions, was in total agreement with this, and the need for a sincere approach to the resolution of these challenges.”
Continuing, he expressed shock 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, through prioritized investments in the health system and the health workforce, they sought to come up with a proposition whose remedy is likely to generate a worse ailment and crisis.
“Furthermore, the Bill seeks to achieve its objective through an amendment of the Medical and Dental Practitioners Act. As is well known, a Bill seeking to repeal and re-enact this same Act was passed by the Senate in the year 2021 and awaiting concurrence by the same House of Representatives.
“With the time left for legislative business in the outgoing 9th National Assembly, one wonders how the sponsors hope to achieve their aim.
“The proposition shows a poor appreciation of the mechanisms, operations, and regulatory framework of the medical profession, and the place and role of the practicing license.
He further queried: “Where in the world do you deny someone, who has been duly certified qualified according to the Medical and Dental Practitioners Act, a license to practice? Do the sponsors appreciate the fact that their proposition bristles with grave implications for National development, particularly as it concerns specialist training in Nigeria and the delivery of quality healthcare services? What happens to the doctor’s internship period and NYSC service year? What happens to specialist training in Nigeria? Are they going to be repealed or put in abeyance? “
Enabulele said even though it is a truism that doctors are the leaders of the health team, he found the proposition selective and discriminatory.
“Available statistics clearly show that all types of professionals and workers in all sectors of Nigeria, aside from the health sector, are voting with their feet outside the shores of Nigeria. Indeed, aside from the younger ones, the senior ones are increasingly been carried by the brain through waves.
“I equally find the proposition a gross affront to the fundamental rights and freedoms of medical and dental practitioners in Nigeria, as expressed in the relevant provisions of Nigeria’s 1999 Constitution (as amended). Even the ILO conventions are very clear on this, as it concerns the international migration of labor.
“While I am aware that there may be a public hearing on the Bill to allow for public consultations with stakeholders, it would have made a whole lot of sense if the sponsors had taken the pains to consult with stakeholders in the medical profession to derive an informed view on the real factors responsible for the crisis of brain drain in Nigeria.
“I would therefore like to urge the sponsors of the Bill to reconsider their position and withdraw the Bill, as the cure it offers will undoubtedly be worse than the ailment it seeks to cure.
“I sincerely urge them to dwell more on how to more realistically address the push factors and build a resilient health system with a resilient health workforce,” he stated.
It could be recalled that the House of Representatives had passed for second reading, a Medical and Dental Practitioners Act (Amendment) Bill, 2022, that seeks to make it compulsory for graduates in medical and dental fields to render services within Nigeria for five years before being granted a full license.
Speaking on the Global Forum, Enabulele commended Dr. Tedros Adhanom Ghebreyesus-led World Health Organisation (WHO) for successfully organizing the 5th Global Forum on Human Resources for Health.
Stating that it was well-attended by Member States of the WHO, he regretted that Nigeria was not represented.
“I sadly observed that Nigeria was not represented as a Country. There were many sessions where issues confronting the health workforce were deliberated upon, including the issue of brain drain which I have been highlighting at all international fora, including during my tenure as President of the Commonwealth Medical Association.”
He said the 5th Global Forum came up with very useful resolutions on how to resolve the challenges confronting the health workforce.
“As you are aware, the health workforce is vital to the attainment of Universal Health Coverage, and if the resolutions reached in the forum are given concrete expression, I am sanguine that global health and the well-being of citizens and the health workforce will be more assured in the years ahead,” he added.
