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The association described the proposed sanctions as punitive, arguing that doctors should not be held criminally responsible for failures arising from inadequate funding, poor hospital infrastructure and shortages of medical personnel
The Nigerian Association of Resident Doctors (NARD) has rejected a proposed amendment to the National Health Act that would impose a six-month jail term or a fine of up to N300,000 on healthcare professionals and facilities for delays in emergency medical treatment.
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The association described the proposed sanctions as punitive, arguing that doctors should not be held criminally responsible for failures arising from inadequate funding, poor hospital infrastructure and shortages of medical personnel.
In a statement issued on Thursday, NARD said it supported efforts to ensure prompt emergency care but opposed legislation that failed to address the conditions under which healthcare professionals work.
The association’s reaction followed the Senate’s passage of a bill seeking to amend the National Health Act, 2014, to establish mandatory standards for emergency medical treatment and referral procedures in public and private healthcare facilities.
The bill, sponsored by Abdulaziz Yar’Adua, senator representing Katsina Central, passed second reading on Wednesday after receiving support from a majority of senators through a voice vote.
It proposes that hospitals begin emergency assessment within 15 minutes of a patient’s arrival and start basic stabilisation measures, including oxygen therapy, intravenous fluids, and pain relief, within 30 minutes.
It also requires immediate life-saving interventions in life-threatening situations and provides for the transfer of patients requiring specialised care within specified timelines.
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Under the proposed amendment, healthcare providers and facilities found guilty of violating its provisions could face a fine of up to N300,000, imprisonment for up to six months, or both.
The bill was subsequently referred to the Senate Committee on Tertiary and Primary Health for further legislative scrutiny and a public hearing.
Poor hospital conditions
Reacting to the proposal, NARD said doctors across the country work under difficult conditions, often struggling to provide emergency care in hospitals with obsolete equipment, inadequate staffing, unreliable electricity, insufficient emergency supplies and deteriorating infrastructure.
“It is unacceptable to punish doctors for the consequences of a healthcare system that successive governments have failed to adequately fund, equip and staff,” the association said.
It questioned the priority given to punitive legislation while Nigeria continues to fall short of the 15 per cent health-sector budget allocation commitment under the Abuja Declaration.
The association challenged the National Assembly to demonstrate similar urgency in ensuring adequate healthcare funding, functional emergency departments, modern diagnostic equipment, uninterrupted electricity, reliable ambulance services and sufficient healthcare personnel.
“You cannot legislate oxygen into an empty cylinder, electricity into a dark operating theatre, or life-saving equipment into an inadequately funded hospital,” they said.
NARD also called on lawmakers to subject themselves to the same accountability standards they seek to impose on healthcare professionals.
It suggested that public officeholders should be required to seek medical treatment in Nigerian government hospitals, with appropriate sanctions for misusing public resources on avoidable overseas medical trips.
According to the association, the continued preference for overseas medical treatment among political officeholders raises questions about their commitment to strengthening public healthcare institutions.
Fears of worsening brain drain
NARD further warned that introducing additional criminal penalties against already overstretched healthcare professionals could worsen the migration of skilled medical personnel from Nigeria.
It said creating an increasingly hostile and punitive working environment could accelerate the country’s brain drain, popularly known as the Japa syndrome, at a time when the health sector is struggling to retain its workforce.
Although the association acknowledged that the proposed amendment contains provisions recognising resource limitations and circumstances beyond the control of healthcare practitioners, it said such safeguards must be explicit, comprehensive and enforceable.
It insisted that doctors should not be criminally punished for institutional failures, unavailable equipment, inadequate staffing or circumstances beyond their reasonable control.
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NARD called for the withdrawal and reconsideration of the proposed punitive provisions, urging the National Assembly to consult healthcare professional associations, hospital administrators, patient representatives and other relevant stakeholders.
It also urged lawmakers to prioritise legislation that guarantees adequate health-sector funding, minimum emergency-care infrastructure standards, appropriate staffing, reliable electricity, and functional referral systems.
The association warned that it would convene its appropriate decision-making organs to consider all lawful options, including nationwide industrial action, if the National Assembly proceeded with legislation that unjustly criminalised doctors for failures beyond their control.
It said it would, however, make necessary arrangements to safeguard emergency and critically ill patients in the event of industrial action.