Press Release by the Association of Radiographers of Nigerian (Anambra Chapter) on the Proposed National Council of Radiology and Radiation Medicine Bill

On 13/Jun/2017 / In Press Publications

Good afternoon my honourable members of the fourth estate of the realm, fellow radiographers/imaging scientists and other Nigerian citizens. On  behalf of members of the Anambra State chapter of ARN, and by extension the entire community of medical imaging scientists and radiographers of Nigeria, resident in Nigeria and in the diaspora, I welcome you all to this maiden press conference, organized by the state chapter of our noble association. Before I go further with intimating us on the main reason why this press briefing was organized, I wish to throw more light on the constituent members of this association viz-a-viz our role and duties in the health sector. 
Association of Radiographers of Nigeria is the mother association of all Nigerian radiographers with Medical lmaging Society of Nigeria (MISON) as her 'trade' union arm. They are  people trained and licensed by the Radiographers Registration Board of Nigeria (RRBN) in the use of 'ionizing' and 'non-ionizing' radiation for the diagnosis and/or treatment of diseases.
Why we are gathered here today is to bring to public notice the existence of a private bill before the National Assembly, sponsored by an honourable member of the House of Representatives, a medical doctor by profession. A bill which unfortunately has  passed its second reading. This bill which sets to establish the National Council of Radiology and Radiation Medicine  (NCR) seeks to regulate the practices of the radiologists, the radiographers, the medical physicists, the radiology technicians, the biomedical engineers amongst others is nothing but a complete duplication of existing statutory functions as contained in several sections of the Radiographers Acts of this country, without any trace whatsoever of improvement in the intended outcome.
Possible Genesis of the NCR Bill:
During the last quarter of the year 2016, the RRBN, the statutory regulatory agency of the Nigerian government, saddled with the responsibility of licensing radiographers and regulating the radiography practices in Nigeria did embark upon her monitoring exercise, a function backed by law, with provisions therein the RRBN Act. Several diagnostic centres in Imo State, Lagos State, Osun State etc which did not meet the standard requirements for continuous provisions of radiography services were closed down. Chiefly amongst these requirements was the unavailability and use of a trained, qualified and licensed Radiographer for the dispensing of ionizing radiation to the unsuspecting public in these centres. Rather in its place, untrained, unqualified and unlicensed individuals simply referred to as quacks were freely allowed by these defaulting institutions, an action that prompted their lawful close down by the RRBN to save the Nigerian public from the hazards of developing cancer from the wrong use of radiation. However to the chagrin of every sane individual that understood the actions of the RRBN to sanitize the practices of Radiography in our country Nigeria, this monitoring action of the RRBN was vehemently opposed by the Nigerian radiologists and medical doctors, some of who were owners of some of the affected centres. On 17th November, 2016, the NMA President, Dr. Mike Ogirima issued a press release seeking to stop the former RRBN Registrar, Dr. Michael Okpaleke from carrying out his statutory functions as enshrined in the Radiographers Registration Act. Court cases were reportedly  instituted and lost by some Nigerian doctors. At this point it is important the public understands who a radiographer and a radiologist are.
The Radiographer/ the Radiologist and their Regulators in Nigeria:
The radiographer is a trained health professional with a basic 5 year B.Sc (Rad) qualification who is licensed by RRBN to dispense ionizing radiation amongst other functions, for the purposes of diagnosing and treating diseases. Radiography is a distinct profession in the health sector which over sees the use and application of conventional x-ray, ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), mammography, fluoroscopy, nuclear medicine, radiotherapy, etc in the diagnosis and treatment of pathologies. The radiography profession is regulated under the Radiographers Act, Decree 42 of 1987, promulgated on 17th December, 1987, now CAP R1 LFN 2004 by the RRBN. The radiologist is a trained medical doctor with a basic 6 year MBBS qualification, and who has successfully undergone residency training in the subspecialty Radiology, an arm.of the medical profession. This group of persons is solely responsible for interpreting radiological images acquired by the radiographers for the purposes of making diagnosis and treatment of patients. They also carry out interventional procedures,  a duty that is incumbent on the level of skill and advancements of individual radiologists. They, together with their sister specialists such as Urologists, Neurologists, Cardiologists, O & Gs, Pathologists, Surgeons, etc are regulated by the Medical and Dental Council of Nigeria (MDCN), which was set up by the Medical and Dental Act of 1988.
Having read and understood the persons of a Radiographer and a Radiologist, one may objectively ask how then does a subspecialty in Medicine & Surgery seek to surreptitiously regulate the practices of an INDEPENDENT  and distinct profession, Radiography;  as clearly stated in the Dr. Ogrima November 17th 2016 NMA press release.
X-raying the  NCR Bill further and why it must be done away with:
The ARN Anambra State chapter tries to identify and bring to the frontburner the NCR Bill to the Nigerian public as it seeks to create a “council of councils”, an omnibus council  for the Nigerian radiologists, whose main motive is to further subjugate the Nigerian Radiographers irrespective of the negative effects on the patient helpless population.  We also highlight the reasons why this bill is nothing but an unnecessary distraction:
The NCR bill is merely a duplication of already existing acts, the RRBN Act inclusive, with the aim of performing the statutory functions of the RRBN, which  have been judiciously performed by the RRBN for almost three (3) decades now. In line with legislative procedure worldwide, bills are not made by outright copying or duplication of already existing act. The proposed NCR bill is nothing but an exercise in legal tautology and creating a council to “regulate regulatory agencies” is befuddling, at its best.
Considering the cost implication of running another regulatory body whose functions is a mere duplication of the functions of other regulatory agencies in existence before now should be good enough reason to make our honourable members of the National Assembly to step down the Bill considering the harsh economic condition of the country and at this time when she is struggling to get out of recession and the crises it would create in the fragile health institutions. If we must remind the honourble members and members of the Nigerian public, it costs the Nigerian government a little above N2billion to run all the regulatory boards and councils in the health sector yearly.
The NCR bill, if passed, is capable of multiplying the cancer risk and other medical radiation work related hazards as the Nigerian Radiologists who know little or nothing about radiation doses and dispensing of ionizing radiation now seeks to head a council of medical radiation practitioners. They will no doubt allow further infiltration of quacks whom they will freely make use of to the detriment of the health of the Nigerian public. Let us not forget that this is actually the genesis of their grouse with the trained Nigerian radiographers and RRBN.
The NCR bill has an infinite capacity to cause conflict and continuous disharmony in the health sector. A law that completely mimics an existing law can be described as an accident waiting to happen and an invitation to anarchy.
In line with international best practices, there is no place in the world were radiologists regulates the practices of the radiographers. Nigeria cannot afford to ridicule herself in the eyes of the international community.
An attempt to pass the NCR bill requires the herculean task of amending the MDCN Act, the RRBN Act, the Nigerian Nuclear Regulatory Agency (NNRA) Act, and the Council for the Regulation of Engineering in Nigeria (COREN) Act, all of which contain provisions that will be conflicting with the NCR bill.
The NCR bill will no doubt open the way for an avalanche of other similar bills, as the pathologists, cardiologists, neurologists, surgeons, dentists, etc will all besiege the national assembly armed with their proposed bills for independent council for passage into law as the NCR Bill sets the precedence.  Denial of attention would lead to cascading of industrial disputes in the Health sector until a reversal to the status quo.
Way forward:
We are aware of the myriad of challenges of poor service delivery, misdiagnosis, quackery, suboptimal practices, etc, in the field of medical imaging and radiation sciences. Indeed we share the dismay of concerned law makers over this development. It is important therefore to do a proper diagnosis of the cause of these problems before attempting treatment. 
We would be delighted if the National Assembly could carry out a nationwide audit of government owned and private diagnostic centres with the view to ascertaining  the actual number of trained, qualified and RRBN licensed radiographers in these centres. This will help uncover the true identity of these quacks who parade themselves as radiographers with the support of the Nigerian radiologist thus perpetrating above listed havocs in the field of diagnostic radiation medicine.
The Nigerian government, law makers and public are expected to give the RRBN the necessary support , strengthen the regulatory powers of the RRBN, amend the penalties for infringement to reflect the dangers posed by quackery, increase funding to RRBN and tertiary institutions running the  undergraduate and post graduate medical imaging and radiation sciences programmes, support the establishment of the west African college of medical imaging and radiation sciences and encourage the training of radiographers in clinical post graduate courses/fellowships in our hospitals.
All diagnostic imaging facilities should be mandated by law, to display the registration and practicing license of all their staff, with their pictures. Government hospitals should provide the data base of all their trained and licensed staff, radiographers inclusive in order to fight the menace of quackery and professional impersonation
The Orientation Agencies should be specifically mandated to take up an enlightenment campaign on the dangers of engaging quacks in the field of medical imaging and radiation sciences. The public should also be enlightened on how to confirm if a practitioner is qualified and licensed.
Furthermore, it is regrettably disappointing to note that a bill deemed obnoxious by the key radiation custodians scaled through the first and second readings in the national assembly.  This would not have been if unbiased and well researched medical lmaging and  radiation scientists were privately consulted globally. The highest degree in learning is PhD.  Among all the medical radiation personnel in this country, a greater percentage of the PhD holders are the radiographers /medical imaging scientists and hence should be accorded the honour as advanced practitioners or consultants in considerations made by the government. 
Finally, we want to re-emphasize our stance as it concerns the NCR Bill  thus: we reject this obnoxious bill in its entirety and request  the honourble members of the house of representatives and well meaning Nigerians to support the campaign to abort this ill bill as its passage will  create more confusion in the health sector to the detriment of the citizens of this country and beyond, especially those who cannot afford medical tourism.
DR. A.C. Ugwu (KSM,  PhD, FMISON)
Chairman ARN, Anambra State Chapter.
Senior Lecturer, NAU.

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