Early this April, the Nigerian National Assembly proposed a bill that sought to compel Nigerian-trained medical and dental practitioners to practice for a minimum of five years in the country before being granted a full licence. The bill is designed to address the issue of brain drain and the shortage of medical personnel in the country. The proposed legislation seeking to amend the Medical and Dental Practitioners Act 2004 will require medical students to enter into a bond with the government, which would require them to serve in Nigeria for at least five years after graduation.
The bill has already met with mixed reactions, with some individuals and groups supporting the idea of compelling medical doctors to remain in Nigeria, while others opposed it. Supporters of the bill argue that it would help to address the shortage of medical personnel in the country, as well as improve the quality of healthcare.
Granted, the issue of brain drain has long plagued Nigeria’s healthcare system, with many medical professionals choosing to migrate to other countries in search of better pay, working conditions, and opportunities. However, there have been suggestions that the government should take measures to prevent medical doctors from leaving the country, either through regulations or incentives. While the intentions behind these proposals may be admirable, they run counter to fundamental principles of individual freedom and are not supported by the law.
One of the most important principles underlying the argument against compelling medical doctors to stay in Nigeria is individual freedom. Every individual has the right to pursue their professional aspirations and opportunities, and it is not the government’s place to dictate where someone works or practices. This principle is enshrined in various international human rights instruments, such as the Universal Declaration of Human Rights and the International Covenant on Civil and Political Rights, which Nigeria has ratified.
As in any democratic society, protection and safeguarding the basic or fundamental rights of the citizens is of utmost importance. By its very nature a fundamental right is a right that stands out and above the ordinary laws of the land and which in fact is antecedent to any political society. It is so described because the rights are guaranteed by the Constitution itself and other laws having international flavor. Being provided for in the Constitution, fundamental rights are guaranteed to all persons and any person who alleges that the provision relating to fundamental right has been or is likely to be breached can approach the Court for redress. Section 46 (1) of the Constitution of the FRN 1999 (as amended) provides that: “Any person who alleges that any of the provisions of this chapter has been, is being or is likely to be contravened in any state in relation to him may apply to the High Court for redress.” The Constitution itself has given access to Court to any person who alleges that his right has been, is being or is likely to be breached by any individual, organization or government.
Thus, compelling medical professionals to remain in Nigeria would be a clear violation of their right to choose their profession and exercise their freedom of movement. It would be akin to forcing someone to work in a particular location against their will, which is a clear violation of basic human rights.
Another reason why the government cannot legally compel medical doctors to stay in Nigeria is that any attempts to do so would be ineffective and counterproductive. The reasons why medical professionals choose to migrate, such as low pay and poor working conditions, are often the result of systemic issues that require significant structural changes to address.
Moreover, medical professionals who feel forced to stay in Nigeria against their will may be less motivated and productive, potentially harming the quality of healthcare in the country. A more effective approach would be to address the underlying issues that lead medical professionals to migrate, such as improving working conditions, pay, and opportunities for professional growth and development.
Another limitation to the government’s ability to regulate the movement of medical professionals is that many healthcare workers who migrate do so legally. They obtain the necessary visas and permissions to work abroad, which means that the government would have little legal authority to prevent these individuals from leaving or to enforce regulations that require them to stay. In fact, some medical doctors have left the shores of this country while not identifying with their profession in their new country.
In addition, medical professionals who migrate may choose to do so because they are seeking opportunities that are not available in Nigeria. These opportunities may include access to advanced medical technologies, opportunities for research, and better compensation packages. Attempting to regulate the movement of medical professionals would therefore be futile, as it would not address the underlying issues that lead to brain drain in the first place.
As things stand now, any attempt to regulate medical professionals to stay in Nigeria could violate their constitutional rights. The Nigerian Constitution guarantees freedom of movement and the right to choose one’s profession. It would be unconstitutional to impose restrictions on these rights, even if the intention is to address a societal issue such as brain drain.
The government’s role should be to create an enabling environment that encourages medical professionals to remain in Nigeria voluntarily. This could be achieved by implementing policies that address the root causes of brain drain, such as improving working conditions and pay, investing in healthcare infrastructure, and creating opportunities for professional growth and development. By doing so, they can create an environment that encourages medical professionals to remain in Nigeria and contribute to the country’s healthcare system, while respecting their fundamental rights to individual freedom and professional aspirations.
Medical migration is a complex and multifaceted phenomenon that has significant implications for healthcare systems around the world. While there are challenges associated with medical migration, there are also potential benefits that should be considered in efforts to address the issue. Ultimately, the goal should be to create healthcare systems that provide quality care to all patients, regardless of where they are located, and that support the needs and aspirations of medical professionals.
Okeke writes from the Centre for Social Justice (CSJ) Nigeria
