Monday Column By Hameed M. Bello, PhD
hamdbelo@yahoo.co.uk
Two sets of events recently brightened the hope for a possible containment of the worrisome brain flight in the very critical medical profession in Nigeria. One happened on the floor of the House of Representatives, while the other took place in the United Kingdom. Both events were landmarks in their own right and have the potential to cut down on the intractable brain flight of health workers out of the country.
Year in, year out, medical doctors and other health workers trained in Nigeria jet out to overseas in search of greener pastures giving rise to shortage of medical personnel to attend to the burgeoning local population.
The United Kingdom Government had in a report early April stopped active recruitment of medical doctors, nurses and other health workers from Nigeria by health and social care employers in the UK. The UK disclosed this in its updated ‘Code of Practice’ for the international recruitment of health and social care personnel’ posted on its website. The implication of this is that Nigeria has now been included in the red list of countries facing critical shortage of health workers as contained in the World Health Organisation (WHO)’s health workforce support and safeguards list.
In March, the WHO published the safeguards list comprising 55 countries, including Nigeria, struggling with a shortage of health workers.The UK government said that Nigeria and other countries on the red list should be prioritised for health personnel development and health system-related support as well as provided with safeguards that discourage active international recruitment of their workers.
The code of practice reads: “Consistent with the WHO Global Code of Practice principles and articles, and as explicitly called for by the WHO Global Code of Practice 10-year review, the listed countries should be prioritised for health personnel development and health system-related support, provided with safeguards that discourage active international recruitment of health personnel.
“Countries on the list should not be actively targeted for recruitment by health and social care employers, recruitment organisations, agencies, collaborations, or contracting bodies unless there is a government-to-government agreement in place to allow managed recruitment undertaken strictly in compliance with the terms of that agreement.
“Countries on the WHO Health Workforce Support and Safeguards list are graded red in the code. If a government-to-government agreement is put in place between a partner country, which restricts recruiting organisations to the terms of the agreement, the country is added to the amber list.”
It said that if a country is not on the red or amber list, then it is green. The amber countries where international recruitment is only permitted in compliance with the terms of the government-to-government agreement are Kenya and Nepal.
Recall also that a bill to prevent Nigeria-trained medical and dental practitioners from being granted full licences until they have worked for a minimum of five years in the country, passed second reading in the House of Representatives middle of April this year.
The bill was aimed at addressing the increasing number of medical doctors leaving Nigeria for greener pastures, and making quality health services available to Nigeria.
Sponsored by Ganiyu Abiodun Johnson, it is titled ‘The Bill for an Act to Amend the Medical and Dental Practitioners Act 2004’.
Johnson said it was only fair for medical practitioners, who enjoyed taxpayer’s subsidies on their training, to “give back to the society” by working for a minimum number of years in Nigeria before exporting their skills abroad. Many lawmakers supported the bill though a number of them called for flexibility and options in the envisaged law.
Uzoma Nkem-Abonta said tying a doctor down for five years in Nigeria before seeking employment outside is akin to enslavement.
However, a majority voice vote passed the bill for second reading at the plenary presided by Speaker Femi Gbajabiamila. As it stands, the bill may require the House to call for a public hearing to take inputs from the public, if need be. Otherwise it is set to be passed for a third reading which marks the end of the legislative process. The bill will then be sent to the Senate for concurrence and subsequently for the assent of the President of Nigeria, Muhammadu Buhari. Once this is achieved, it becomes an offence for medical workers to take their trade overseas without practising substantially for at least five years or more within the country. The likely benefit of the bill is that it will control unrestricted emigration of medical personnel which could lead to a breakdown in healthcare delivery to the average and the ordinary Nigerians. The elite can always find their way.
One food for thought is that the emigration and engagement of Nigerian medical personnel shows that there is something good about the quality of our medical graduates which is why there is the demand for their services in Europe and America. However, not many foreign doctors immigrate into Nigeria in search of greener pastures in the medical profession which suggests that the conditions of service may not be competitive, aside from the question of availability of tools of work.
In occupations with a surplus of graduates, immigration of foreign-trained professionals can aggravate the underemployment of domestic graduates, whereas emigration from an area with a surplus of trained people leads to better opportunities for those remaining. But emigration may cause problems for the home country if the trained people are in short supply there. In occupations with a surplus of graduates, immigration of foreign-trained professionals can aggravate the underemployment of domestic graduates, whereas emigration from an area with a surplus of trained people could lead to better opportunities for those remaining. But emigration may cause problems for the home country if the trained people are in short supply there, as it is turning out to be the case now in Nigeria.
A column on this page on October 31, 2022 with the title, “Rising brain drain and our collective inertia” had recalled how a week earlier then, the Nigerian Medical Association (NMA) revealed that the country was battling with its worst situation of brain drain in history, as no fewer than 10, 296 Nigerian-trained doctors were practising in the United Kingdom alone. Dr Uche Ojinmah, the National President of the association, raised the concern at a press briefing to mark the 2022 Physicians’ Week in Ibadan. Ojinmah, represented by Dr Wale Lasisi, the NMA Chairman in Oyo State was quoted to have said inter alia:
“Currently, Nigeria has the third highest number of foreign doctors working in the UK after India and Pakistan.
“While we are losing our human resources to health in geometric progression, Lassa Viral Hemorrhagic fever, Malaria, COVID, Ebola, Marburg, and so on, are still very much available in the face of worsening incidences of Systemic Hypertension with or without complications, Diabetes mellitus with or without complications, osteoarthritis and so on.
“We call on our governments, at all levels, to quickly declare emergency action in Nigeria’s health sector for the sake of its citizens,” he said.
