Health sector dips as more Nigerian doctors move abroad
More reasons have emerged on why no fewer than 5,405 Nigerian-trained doctors and nurses are currently working with the British National Health Service (NHS) in the United Kingdom (U.K.) and why many more will join the league.
The figure, released by the British government, means Nigerian medics constitute 3.9 per cent of the 137,000 foreign staff of 202 nationalities working alongside British doctors and nurses.
The Guardian investigation revealed that many more Nigerian doctors would join their colleagues soon because the U.K. has need for medics from Commonwealth countries, since some doctors in the European Union (E.U.) are already leaving because of Brexit.
It was also gathered that most of the Nigerian doctors and nurses are leaving for the U.K. because of better conditions of service. The migration has further worsened the physician-patient ratio in Nigeria from 1:4,000 to 1:5,000, contrary to the World Health Organisation’s (WHO) recommended 1:600. The physician-patient ratio in the U.K. is 1:300.
According to the WHO, countries with low physician-patient ratio have worse disease outcomes and life expectancy.
Figures from the Nigerian Medical Association (NMA) showed that about 45,000 doctors are currently practicing in Nigeria. This means that 12 per cent of 45,000 Nigerian doctors, that is 5,405, are practising in the U.K. and the country is now left with less than 40,000, excluding those practising in the U.S., South Africa, Saudi Arabia and others.
NMA President, Dr. Mike Ogirima, described the exodus of doctors as worrisome. He blamed the situation on poor remuneration for medical doctors, poor working environment and inadequate medical equipment and infrastructure.
He said the trend has worsened the doctor-patient ratio of 1:4,000, caused longer waiting time at hospitals, rise in fatal disease outcomes, and more frequent medical errors by over worked doctors.
Ogirima said: “Nigeria is using her resources to train doctors and professionals that will leave to work in foreign countries. What are those things attracting these professionals outside? Can we duplicate them here?”
“Government should provide adequate remuneration. We are not saying we should pay so much, but pay them for the job they are doing as and when due.”
Consultant Public Health Physician, Prof. Akin Osibogun, however, said the situation could be reversed if the Federal Government makes the National Insurance Scheme (NHIS) compulsory for all citizens. According to him, this would provide enough funds to improve the conditions of service and working environment for health professionals.
He said: “The few ones we have are leaving because of poor conditions of service, working environment and after service package. It means the physician-patient ratio has worsened, maybe from 1:3,000 to 1:5,000. When you compare, those countries that have better physician-patient ratio have better treatment outcomes.”
Osibogun, a former Chief Medical Director (CMD) of the Lagos University Teaching Hospital (LUTH), said Nigeria currently produces about 3,000 medical doctors every year and needs to increase the ratio by producing more, and developing plans on how to retain them.
He explained: “We need to make working conditions attractive. If they know they will have a house after 20 years of training, the lure to leave would be reduced. What are the benefits attached to the job? What are the provisions for the doctor’s family? What are the long-term prospects for the staff?
“We need to improve the work environment in terms of financing. Make it work-friendly, not crowding 10 persons in one office. Talk about electricity supply; you come to work and you are scheduled to do a surgery but there is no electricity.
“We need to be more drastic; re-organising the way we fund health service. There should be compulsory NHIS that will bring a pool of funds. We have to adopt a more holistic approach.”
But a consultant paediatric surgeon and current CMD of LUTH, Prof. Chris Bode, said the situation is not hopeless. He said the high migration of Nigerian doctors to the U.K. is because some doctors in E.U. countries are leaving because of Brexit and the NHS has opened its gates to doctors from Commonwealth countries.
Bode, however, said Nigeria needs proper planning to harness the opportunity the situation brings.
He said: “A medical degree is an international passport. Because of global competition, many doctors are moving to the U.S. and U.K. We lose because we trained them but we also learn from them by getting exposed to cutting-edge technologies. One day, if we harness them, they will come back to impact positively on the practice here.
“That is the method Japan, India and China used in adapting what they learnt in the U.S. and U.K. It is not a total loss. We are seeing a lot of movement of medical doctors abroad. It is not as if Nigerian medicine is dead. I had to spend a lot, $14,000, some years back on going to Israel to learn new skills. That has distinguished me and Nigerians are benefitting.
“Nigerian doctors are going to the U.K. because they have opened their gates. By the time the medical doctors come back, we will be better for it. It is not a hopeless situation. There is a lot we can do to harness the opportunity. We need proper planning.”