Dr. Saleh N. Garba, a member of the board of Nursing and Midwifery Council of Nigeria, has given advice on what must be done to make the Nigerian healthcare delivery system great again.
Delivering the keynote address at the event of the 18th National Professional Conference and Scientific Update of the University Graduates of Nursing Science Association (UGONSA) at University College Hospital (UCH), Ibadan, the don identified quackery and poor remuneration of healthcare professionals as the bane of our healthcare system.
He said: “Bringing the hammer hard on quacks and quackery with every sense of seriousness and implementing a non-dicriminatory welfare and emolument package for healthcare professionals is necessary to put our health system on the path of greatness again.
“As a nurse and a member of the Nursing Council’s board, I have personally made a critical study of the establishment Act of the Nursing and Midwifery Council of Nigeria and found out that in the fight against quackery in Nursing and Midwifery practice, the established legal framework for Nursing education and practice is rather a critical enabler of quackery than a deterrent.
“The provisions of the Act regarding punishment for offences such as unauthorized practice without registration, employment of an unregistered person to practice as nurse or midwife and forgery of the council’s documents such as practicing license need to be thoroughly reviewed and strictly implemented.
“First the Act in its Section 20 stated that the Courts where cases of quackery should be tried are those lower than the High Court, which in my humble understanding can be magistrate or customary court.
“Secondly, the Act prescribed the penalty for those tried and convicted of quackery as a fine not exceeding N1000 (one thousand naira) for individuals or N2000 (two thousand naira) for corporate bodies or a prison term not exceeding 2 years.
“The term “not exceeding”, as far as I am concerned, is a caricature and mockery of the fight against quackery because it creates obvious loop holes that have been perennially exploited by offenders and trial judges. An amount not exceeding N2000 or N1000 as the case may be can be one naira or fifty kobo and a duration not exceeding 2 years can be 30 seconds or one hour, depending on the discretion of the trial judge. In my opinion, the act needs to be reviewed so that stiffer punishment will be introduced to meet the exigency of time. This will improve the quality of nursing services in the country since nurses are the single largest, most visible and most effective health personnel in all health care facilities.
“Unlike the developed world where cases of quackery are given wider publicity and tried in a higher court, here, quackery (a crime against humanity, whose punishment should be commensurate and hefty) is not considered grievous enough to deserve trial at our high courts despite that quacks, through malpractices and medical errors, kill and maim Nigerians every day.
“The slap-on-the-wrist punishments prescribed by the Act have emboldened defaulters to keep defaulting. Little wonder most Private Hospitals and Churches have continued to constitute themselves into quack breeding centres with unbridled impunity.
The don, who is also Head of the Department of Nursing Sciences of Ahmadu Bello University, Zaria, also harped on poor remuneration of healthcare professionals as another key factor that has contributed to keeping our health system below average.
“In developed health systems, which our political leaders patronize in their escalating medical tourism, private hospitals are the key drivers of care delivery. Yet you are unlikely to find any private hospital that enlists the services of a quack. However, here in Nigeria, most private hospitals, in trying to save cost and maximize profits, enlist the services of quacks, who are dubiously branded as ‘auxiliary Nurses’, to the detriment of qualitative care and client safety. Just as there is nothing like ‘auxiliary Doctor’, there is also nothing like ‘auxiliary Nurse’.
Every year our best brains and highly skilled healthcare professionals migrate to foreign countries in search of better emoluments and welfare packages. Funny enough, the millions we refused to spend on their remunerations here to develop our own health system in turn leaves our coffers as billions annually in medical tourism to the advantage of foreign countries that have their health systems in good order.
The don concluded by calling on the National Assembly to urgently review the establishment Act of the Nursing and Midwifery Council of Nigeria and make its bite on quackery harsh enough to serve as a potent deterrent. He also called on the Federal and State governments to take the issues of welfare and remunerations of healthcare professionals paramount to avert the sporadic industrial actions frequently witnessed in our healthcare system such as the one recently suspended by the National Association of Resident Doctors (NARD) and that currently embarked on by a coalition of healthcare professionals under the umbrella of Joint Health Sector Union (JOHESU).
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