A. THE MEDICAL AND DENTAL COUNCIL OF NIGERIA (REPEAL AND RE-ENACTMENT) BILL SB.480: MATTERS ARISING
It has come to the knowledge of the Nigerian Medical Association that a group of misguided individuals, acting under an amorphous unregistered body (‘JOHESU’) unknown to law, are hell bent on blackmailing the Senate of the Federal Republic of Nigeria and particularly the Chairman of the Senate Committee on Health over matters they could not logically advance during the transparently managed Senate Public hearing on 5 health related Bills, held on Monday, February 1, 2021.
It is shameful that this group of individuals who were given all the opportunities to make their views known at the Senate Public hearing (but chose to express their vacuousness) have decided to take to the media and public streets to unfairly malign the medical profession that gave birth to them in the first place. More ridiculous is their laughable threat to go on strike over purely professional and parliamentary matters for which they clearly lack understanding and knowledge.
B. THE TRUE SITUATION ON THE MDCN REPEAL AND RE-ENACTMENT BILL
- On Monday 1st February 2021, the Senate of the National Assembly of the Federal Republic of Nigeria held a Public Hearing on the Medical and Dental Council of Nigeria (Repeal and Re-enactment) Bill SB. 480 and four other Bills. SB. 480 seeks to repeal and re-enact the Medical and Dental Practitioners Act Cap M8. LFN 2004, which was enacted by Decree 23 of 1988 and amended by Decree 78 of 1992.
The effort of the Senate is timely, appropriate, and necessary to bring the regulation of Medicine and Dentistry in Nigeria up to date with respect to advancements and developments in healthcare nationally and internationally. The Nigerian Medical Association wholeheartedly welcomes the Bill.
Nigerian Medical Association is happy that the Bill seeks to reinforce the perpetuity of the Medical and Dental Council by making it immune to frequent and unnecessary disruptions through dissolution each time there is a change of government. The Bill also makes it easier for the Medical and Dental Practitioners’ Disciplinary Tribunal to try cases of professional misconduct against doctors in a timelier manner. It also provide more realistic sanctions against doctors who are found guilty by the Disciplinary Tribunal. The current state of affairs is such that cases linger for years due to the frequent dissolution of the Council and the Disciplinary Tribunal. And when the Tribunal finds a doctor guilty of professional misconduct, the extant law does not permit it to suspend such a doctor for more than six months. The next most severe sanction is erasure from the Medical Register.
We support the clear delineation of the function of the Council proposed in the Bill. The Passage of the Bill and assent will settle the unnecessary confusion, inter-professional acrimony and friction in the health sector.
- JOHESU’S PENCHANT FOR BLACKMAILING NIGERIAN DOCTORS AND GOVERNMENT AT ANY SLIGHTEST PERCEIVED OPPORTUNITY
Following the well organised and well conducted Public Hearing on the five (5) unprecedented health-related bills, it was surprising to note the outburst and of apprehension over the provisions of the Bill by members of professions allied to Medicine and Dentistry in Nigeria under aegis of and amorphous body called JOHESU.
We believe that these feelings are misguided and emanate from a misunderstanding and ignorance of the purpose of the Bill among these professionals, and mischief by a few of their leaders who exploit the misunderstanding and ignorance among their members. A dispassionate and ponderous reading of the provisions of the Bill would make it clear to all reasonable persons who only seek to advance themselves without causing unnecessary acrimony and rancour in the health sector and health system, that the Bill is well intended and in tandem with contemporary Medical and Dental practice.
3.The Long title of the Bill states clearly that it is “A Bill to Repeal the Medical and Dental Practitioners Act 1988 and Enact the Medical and Dental Practitioners’ Bill to Establish the Medical and Dental Council of Nigeria for the Regulation and Control of the MEDICAL and DENTAL PROFESSIONS! For further clarity section 2 of the Bill states that: “The provisions of this Bill shall apply to the professions of medicine and dentistry and all persons who are authorized to practice as medical practitioners or dental surgeons under this Bill “. It is surprising that anyone would claim that the Bill seeks to regulate any other healthcare professions. The provision of S.4(9) being bandied around by some people as an attempt to regulate other professions is noticeably clear in its provisions that it is about medical practitioners and dental surgeons. It states that one of the proposed functions of the Council would be: “making regulations for the operation and management of clinical diagnostic centres for the practice of Pathology or Radiology and any other branch of medicine and dentistry determined by Council, provided that the regulations shall provide for fully registered practitioners to manage the diagnostic centres.” Please note the proviso there! The Council’s regulations would only apply if it is related to registered medical practitioners and dental surgeons i.e., doctors and dentists. It did not say Council shall make rules for any other professions.
- Doctors practice Medicine and do not seek to practice Pharmacy, Medical Laboratory Science, Radiography or any other professions and occupations of persons who are not qualified to be registered as medical practitioners or dental surgeons.
While we may agree that the title “apothecary” is not a title generally used by doctors, we find it amusing that someone would propose that doctors in Nigeria should cease using the title “doctor”. “Doctor” is universally known as the title of practitioners of Medicine. The claim that the provisions of S.42 (1) of the Bill excludes other persons like holders of PhDs and Doctor of Veterinary Medicine etc from legitimately using the title “Doctor” is misconstrued. While paragraph (b) of that subsection states no person other than a Registered medical practitioner shall “take or use the title of physician, surgeon, doctor or licentiate of medicine, medical practitioner, or apothecary”, paragraph (c) of that subsection, makes an exception for those other than medical practitioners who have legitimate and reasonable reason to use the title “Doctor”. In any case, the provisions of S.42 of the Bill is the same as those of the extant laws of the Federation of Nigeria as contained in S.17(1) of the Medical and Dental Practitioners’ Act Cap M8 LFN, which is also similar to the provisions of the expended Medical and Dental Practitioners Act of 1963. We are not aware of any holders of PhDs, DVM, DD or any other similar degrees which give them reasonable and legitimate grounds to use the title “Doctor”, who have been prevented from using it. The law only seeks to protect members of the public from quacks, crooks and charlatans who deceive members of the public into thinking that they are medical doctors. Unfortunately, due to the failure of the law enforcement and prosecutorial authorities in our country, quacks and charlatans are brazenly and openly referring to themselves as doctors despite the existence of a law against it.
5.The complaint that S.45 (3) (e) seeks to enable doctors and nurses to usurp the duties of pharmacists is misconstrued especially when viewed on the background of the preceding S.45 (3) (d). The two paragraphs read: “(d). Only a registered pharmacist shall dispense medicines prescribed by a registered medical practitioner or dental surgeon. (e). “Nothing in the foregoing shall preclude a registered medical practitioner or dental surgeon, or a registered nurse under the supervision of a doctor or dentist, from providing medicines in the absence of a registered pharmacist” It is clear that the Bill while upholding the right of the registered pharmacist, only seeks to enable doctors and nurses use medication on patients in the course of their duties where it is very reasonable and conscionable not to have a pharmacist around. For example, the use of anaesthetic agents during an operation, emergency drugs in the Intensive Care Unit, an emergency room or in the ward.
The Nigerian Medical Association believes that the Medical and Dental Council of Nigeria (Repeal and Re-enactment) Bill is intended to further strengthen the Medical and Dental Council of Nigeria in regulating the medical and dental professions to protect the public by ensuring that registered medical practitioners and dental surgeons are competent persons who practice safe, ethical, and responsible medicine.
We fully support the Bill and call upon members of the Professions Allied to Medicine and Dentistry and members of the public in general to support the Bill for the advancement of quality healthcare delivery in Nigeria.
- Senator Ibrahim Oloriegbe and members of his committee performed excellently well, as they exhibited maximum degree of decency, decorum and exemplary leadership, even in the face of unruly behaviour of some JOHESU members in the hall. JOHESU’s desire was more to instigate a crisis by the issuance of unguarded threats to the nation’s health and public servants who carried out their lawful duty. Members of NMA salute the patience, understanding, maturity and wisdom of the Chairman and his very well organized team for the courage and wisdom in managing the public hearing involving five Bills within one day.
- We appeal to the general public and the NASS to ignore the dying voice of the paranoiac JOHESU who have sustained their attacks on Nigerian Doctors purely out of jealousy and envy, to get through the backdoor what they could not achieve while in school.
- NMA wishes to invite JOHESU members to join forces with the Medical and Dental Practitioners to improve the health circumstances of our people rather than threatening to go on strike for the wrong treasons at any slightest flimsy excuses
- Finally, I wish to appeal to governments and good spirited individuals to advise members of JOHESU and their cohort to go to medical school to read medicine Medical Doctors or for ever, leave Doctors and the Medical Profession alone. They should stop expressing their frustration towards a very intelligent group and members of the noble profession of Human Medicine.
Professor Innocent AO Ujah, FNMA, FNAmed, mni
Dr Philips Uche Ekpe
Secretary General, NMA