The Nigerian Medical Association has opposed the proposed bill seeking a six-month jail term or a fine of up to N300,000 for hospitals and healthcare providers who declined treatment for emergency patients.
The NMA said the National Assembly should legislate to ensure funds are approved for emergency care as provided for in the National Health Act rather than introduce punitive measures for doctors over what it described as a systemic challenge.
PUNCH Healthwise reports that the Senate is currently considering a bill to jail doctors and healthcare facilities that violate proposed emergency treatment standards.
The bill also seeks to compel public and private hospitals to assess emergency patients within 15 minutes of arrival, commence initial stabilisation within 30 minutes, and complete referrals to other facilities within three hours where necessary.
Sponsored by Senator Abdulaziz Yar’Adua, the proposed legislation seeks to amend the National Health Act, 2014, to establish enforceable standards for emergency medical treatment, healthcare workers’ training and patient referral procedures.
Reacting to the proposed bill in a statement and letter addressed to NASS and made available to our correspondent on Friday, the NMA President, Prof. Afekhide Omoti, said the NMA was not opposed to legislation that protects patients or promotes accountability in healthcare delivery.
He, however, insisted that accountability must be equitable, evidence-based and accompanied by corresponding government responsibility.
“Nigerian doctors are not the enemy. We are the ones holding the system together. But sadly, we see patients we could have saved if we had equipment, buried. We lose colleagues to burnout, to japa, and sometimes to death on duty.
“Do not jail us for the failure of the system. Jail the failure. Fund the system. Implement Section 11 and Section 20 together of the NHA 2014 and Section 6 of the NHCPF guidelines.
“If you fund emergency care, we will deliver it. If you only punish us, more doctors will leave, and more Nigerians will die at the gate. We are ready to work with the National Assembly — at the public hearing, in the committee, and at the bedside,” Omoti said in a letter addressed to NASS.
Furthermore, he said in a statement that introducing stiffer penalties for doctors would worsen the issue around emergency care.
“We believe that the proposed legislative intervention, if pursued without first addressing the underlying challenges confronting our healthcare facilities, would amount to putting the cart before the horse,” Omoti said.
The NMA president maintained that while the NHA already provides a legal framework for the protection of emergency patients, provisions for its effective execution have not been implemented.
“Of particular importance is Section 6 of the National Health Act, which establishes the Basic Health Care Provision Fund and provides for the funding of emergency medical treatment. This provision recognises that emergency care requires financial support and that healthcare facilities must not be left to bear the cost of providing such services without appropriate reimbursement.
“Unfortunately, the implementation of this aspect of the BHCPF remains inadequate. Hospitals and healthcare facilities that have provided emergency treatment, often at considerable financial cost and sometimes at the expense of their already overstretched resources, are unable to access the expected refunds or reimbursement. This creates an unsustainable situation in which hospitals are expected to provide emergency care without the necessary financial support.
“It is fundamentally unfair to impose criminal liability on healthcare workers and hospitals for failing to deliver services when the government has not fulfilled its corresponding responsibility to provide the resources and enabling environment required for such services,” the NMA president said.
Beyond the funding challenges, he said Nigeria was confronted with myriad challenges affecting emergency care
“Our hospitals are consequently operating with dangerously inadequate manpower. In several facilities, the few available doctors are expected to manage overwhelming patient loads, sometimes under extremely difficult circumstances and without adequate support.
“Even more disturbing is the deplorable state of infrastructure and the persistent shortage of essential medical supplies in many of our hospitals. Basic emergency-care requirements, including oxygen, essential drugs, blood and blood products, resuscitation equipment, consumables, functional ambulances and other life-saving facilities, are not readily available in many healthcare institutions.
“How can we reasonably expect a doctor to provide emergency care when the hospital lacks the basic equipment, drugs and consumables required to save a life? How can we threaten health workers with imprisonment for circumstances that are substantially beyond their control?
“The NMA strongly believes that the priority of the National Assembly should be to address these fundamental systemic deficiencies rather than introduce punitive measures that may further demoralise an already distressed healthcare workforce,” Omoti said.
The NMA president, however, urged the National Assembly to prioritise effective implementation of the National Health Act and the BHCPF, improve healthcare infrastructure, address healthcare personnel shortages, and improve conditions of service.
Others include protection of healthcare workers, stakeholder engagement, and ensuring a clear distinction between professional misconduct and systemic failure.
Omoti said, “The proposed amendment, if implemented in isolation, risks criminalising the victims of a dysfunctional healthcare system rather than addressing those responsible for its dysfunction.
“It may further heighten frustration, erode professional morale and accelerate the already alarming emigration of doctors and nurses from Nigeria. This would ultimately worsen access to emergency medical services and expose more Nigerians to avoidable deaths.
“The Senate must understand that you cannot legislate your way out of a healthcare crisis by threatening the very professionals expected to manage it. Laws imposing obligations must be accompanied by the resources, infrastructure and institutional support necessary to fulfil those obligations.”
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