The recent brain drain bill sponsored by Hon. Ganiyu Abiodun Johnson, proposing a mandatory five years of work in Nigeria by Nigerian-trained medical practitioners before being given a full practising licence, is, at best, a farce and at worst, a counterproductive misadventure.
According to the sponsor of the bill, which has curiously passed the second reading in the House of Representatives, its purpose is to curb the alarming exodus of health practitioners from Nigeria to other countries in search of better working conditions and facilities.
The proponent particularly hinges his argument on the claim that the training fees paid by medical students are “highly subsided” by the government and therefore the beneficiaries must be compelled to give back to the same society that helped to subsidise their education.
There is no denying that the recent wave of brain drain, especially in the country’s health sector, is a major source of concern that requires urgent attention. Indeed stakeholders in the sector have continued to bemoan the situation.
For instance, the Pharmacy Council of Nigeria (PCN), at a recent conference organised by the Association of Community Pharmacists of Nigeria (ACPN), Lagos State Chapter, noted that a total of 1,255 letters of good standing were issued to pharmacists who travelled out of the country in just 2021 and 2022, adding that the figure did not include those who had travelled but were yet to apply for letters of good standing.
However, what the so-called “anti-brain-drain” bill proposes is a knee-jerk reaction that reeks of ostrichism. Even the most passive observer of the country’s health system would readily aver that the solution to the brain drain problem goes deeper and requires a more thoughtful and systemic approach than mere threats and forced retention.
It is thus not surprising that the bill has continued to attract opprobrium across the country, especially as it violates the “freedom of movement” and “the right to freedom from discrimination” as enshrined in the country’s Constitution.
The Nigerian Association of Resident Doctors (NARD), in its reaction, expressed “shock and disappointment at the infuriating attempts by Ganiyu Abiodun Johnson and the House of Representatives to enslave Nigerian-trained medical doctors.”
Similarly, Nigerian foreign-based medical practitioners, operating under the aegis of Diaspora Medical Association, sent a letter to the Nigerian Senate, stating that the bill “will be counterproductive and will not achieve its intended goal.”
President of the World Medical Association (WMA) Dr Osahon Enabulele, also observed that the bill was ill-advised, badly researched, outlandish, and totally retrogressive. This is especially so, as the bill says nothing of doctors who were not trained in public universites, and thus not beneficiaries of the exaggerated “education subsidy”.
We agree with these and other well-meaning stakeholders that the cause of brain drain in the country’s health sector – as with other sectors of the economy – is not unwillingness of the professionals to serve their country but the fact that the environment of work is not only unconducive but also incapacitating. This, as has been consistently noted, is due to a poorly funded health system that stifles professionalism, growth, innovation and work satisfaction.
With health workers constantly grappling with inadequate facilities and equipment, paltry welfare packages, high level of insecurity, limited opportunities for employment, as well as other socio-political, economic and professional challenges, it is only natural and fundamental for them to seek a better life and better work environment.
Forcing them to stay and work in a state of dissatisfaction and demotivation will neither produce satisfactory outcomes for the patients they are meant to care for, nor for the health system they are being compelled to sustain.
What the lawmakers and, indeed, government at all levels, should be doing is to holistically address the drivers of brain drain, by ensuring improved welfare and security for health professionals, as well as an improved work environment, where they can thrive professionally, without feeling stunted or frustrated.
The fact that the bill focuses only on medical professionals is, as has been noted, not only discriminatory but also shows the gross ignorance of supposed policy makers about how the health system works. All members of the healthcare team – doctors, pharmacists, nurses, lab scientists and the rest – are critical to successful healthcare delivery and building a vibrant healthcare system. Therefore, restricting medical practitioners, while overlooking other members of the healthcare team, is an exercise in absurdity.
We insist that if the government is sincere about retaining healthcare professionals in the country, the solution is not coercion but a conscious and consistent commitment towards making the health system functional, conducive, progressive and generally attractive.