FG, states should address doctors’ exodus – Punch Newspapers


AMID increasingly poor medical services, fresh fears have been voiced that Nigeria’s health sector might crumble soon with the reported spike in the emigration of health professionals. Health sector unions said the rate at which their members were relocating abroad had intensified, thereby depriving the country of the services of this skilled cadre. New data shared by the Nigerian Medical Association, and the Medical and Dental Consultants’ Association of Nigeria indicates that thousands of doctors, including consultants, have dumped the local health system for overseas pastures in the past two years. This is alarming because the best crop of Nigeria’s medical professionals is involved. The government at every level should pay attention and take measures to halt the exodus.

According to the MDCAN, which convened a summit on this issue on Tuesday, no fewer than 500 consultants quit Nigeria for jobs overseas in the past two years. “A further exploration of data by the association’s Medical Education Committee showed that nine out of every 10 medical and dental consultants with less than five years experience on the job have plans to leave the country,” Victor Makanjuola, the MDCAN National President, said.

Consultants are not only clinicians, but they are also experienced and are responsible for teaching residents in the medical colleges. By losing consultants to better environments, Nigeria will soon become even shorter of critical manpower to train doctors. In recent years, stakeholders have been complaining of the shortage of personnel in critical specialties.

On its part, the NMA warned that over 2,000 doctors left the country to practise overseas within the same period; more are set to leave. Although the NMA has 80,000 doctors on its register, the organisation says only about 24,000 are working in the country currently.

Their main destinations are the United Kingdom, the United States, and Canada. The British General Medical Council states that 10,387 Nigerian doctors are working in the UK, the third largest medical contingent there after those from India and Pakistan. The UK’s Nursing and Midwifery Council says it licensed 2,946 nurses and midwives from Nigeria in the 10 months to October. Of late, Saudi Arabia has been actively recruiting consultants/doctors from Nigeria.

That leaves Nigeria extremely shorthanded. With a population of 216 million, it currently has a ratio of between 8,000 and 10,000 patients to one doctor. This falls far short of the World Health Organisation’s recommendation of 600:1 patient-to-doctor ratio. In contrast, a WHO factsheet lists Austria, Sweden, San Marino, Monaco, and Cuba as having the world’s best five patient-to-doctor ratios. While Austria has 10,000:51.44, Sweden records 10,000:54.0; San Marino 10,000:61.5, Monaco 10,000:65.6, and Cuba 10,000:81.9. Describing it as the best, the WHO recommends Cuba’s health system to other countries.

The inescapable conclusion is that Nigeria’s political leadership at all levels has been grossly irresponsible. Lacking effective plans, some state governments build gigantic hospitals with neither necessary equipment nor medical professionals to work there.

The situation is exacerbated by the estimated 2,000 doctors graduating from the country’s medical schools annually; half of them leave to practise overseas at the earliest opportunity.

Rather than solve the problems, government officials embark on overseas medical trips for the slightest aliment, leaving other Nigerians at the mercy of the crumbling health care system.

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Stakeholders are conversant with the factors responsible for the brain drain. The NMA rightly blames the migration on poor remuneration of health professionals; and absence of equipment to work with. Others cite insecurity and rising inflation.

Regularly, medical professionals embark on strikes over conditions of service. At the height of the COVID-19 pandemic in 2020, doctors called a strike over remuneration, including their meagre hazard allowance of N5,000. State governments owe practitioners salaries. In Abia State, the doctors’ union has issued a December 8 ultimatum to the government to pay 25 months of arrears or risk a total shutdown. Therefore, it is certain that the brain drain will continue apace as medical practitioners are highly sought after across the world.

Undoubtedly, the government is not bothered. Two ministers personify this remiss. In 2019, the Minister of Labour and Employment, Chris Ngige – a medical doctor-turned-politician –declared, “No, I am not worried (about doctors leaving the country). We have surplus. If you have surplus, you export. It happened some years ago here.”

His colleague, Osagie Ehanire, the Minister of Health, demonstrated similar indifference, arguing that medical practitioners are highly mobile professionals. “They are even leaving the UK for Canada and the US,” he said. Both statements were reckless and exhibited unconcern for the populace.

To stem the ugly tide, Nigeria must return to the basics. In the past, the defunct regions invested massively in the training of medical practitioners. Today’s 36 states should return to that ideal.

Doctors are fleeing because of poor pay. Therefore, the remuneration of medical practitioners should be given utmost attention at the federal and state levels. For some months during the COVID-19 pandemic, Ghana temporarily offered doctors tax-free salaries. Nigerian governments can do better by offering guaranteed accommodation support, sponsored specialist training and scholarships.

MDCAN says Nigeria needs to produce 12,000 doctors annually for the next 25 years to meet the personnel shortfall in the system. In the medium and long terms, both tiers of government should deliberately expand the carrying capacity of the medical schools in Nigeria. In this, quality should not be compromised; incentives should be good enough to retain consultants and recruit foreign ones.

The various governments should also give grants to public and private universities’ medical schools, and students at home and abroad. Scholarships with bonds requiring beneficiaries on graduation to work at home for a certain number of years should be reintroduced and upgraded.

The federal, state, and local governments should increase their health budgets. Government officials should stop the reckless habit of medical tourism, which costs the country billions of naira annually; improve the local health care delivery system and provide effective security nationwide. ,

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