More health workers may ‘flee’
• ‘Nigeria can only achieve sufficiency in 100 years’
• ‘58 doctors stopped last week have left the country
More Nigerian medical practitioners may leave the country as the
United Kingdom yesterday announced new ‘Health and Care Visa’ policy to
attract the best talents in Nigeria and other parts of the world.
The country, which has since the outbreak of COVID-19 stopped
issuance of visa, opened the migration window for care professionals,
social workers and their families, to bolster its National Health
Service (NHS).
The new visa policy aims to make it cheaper, quicker and easier for
healthcare professionals to come go to UK, beginning from August.
Findings show that UK is one of the leading destinations for
migrating Nigerian health workers. Estimates have it that there are over
4000 Nigerian doctors in UK, spread across 83 sub-specialties.
Just recently, the Nigeria Immigration Service (NIS) at the Murtala
Muhammed International Airport (MMIA) Lagos, intercepted 58 Nigerian
doctors, who attempted travelling to UK without visa.
The 58 medical doctors were refused departure in line with Section 31
subsection 2a and b, on powers conferred on the Comptroller General of
Nigeria Immigration Service by the Immigration Act 2015, to prohibit
departure of any person under the conditions stated in the Act.
The doctors were said to be travelling for a training programme.
The UK Home Secretary and Secretary of State for Health and Social
Care had on Tuesday announced that the new Health and Care Visa would be
launched this summer, creating a new fast-track visa route for eligible
health and care professionals and delivering on a key manifesto
commitment.
According to details of the statement, it has been designed to make
it easier and quicker for the best global health professionals to work
in the NHS, for NHS commissioned service providers, and in eligible
occupations in the social care sector.
It further said that the legislation needed to open this new route
would be laid in Parliament and health professionals would be able to
apply from August.
The UK government statement said that the new Health and Care Visa
would come with a reduced visa application fee compared to that paid by
other skilled workers, including exemption from the Immigration Health
Surcharge.
Health and care professionals applying on this route can also expect a
decision on whether they can work in the UK within just three weeks,
following biometric enrollment.
“Those working in health and social care, who do not qualify for the
Health and Care Visa, will still be able to claim a reimbursement from
the Immigration Health Surcharge, if they have paid this on or after
March 31,” the statement added.
UK Home Secretary Priti Patel said: “We are indebted to overseas
health and care professionals for their tremendous contributions, not
just in saving thousands of lives throughout this crisis, but for the
vital role they play year-round”.
She added that the Health and care professionals from all over the
world have played a vital role in hospitals and care homes across the
country fighting coronavirus.
“The introduction of the Health and Care Visa follows a number of
unprecedented measures to show the UK’s gratitude to health workers from
overseas,” she said.
Medical experts, in separate conversations with The Guardian, warned
that despite the turning back of some 58 UK-bound doctors at the airport
by the NIS, more of their colleagues and other health workers were set
to leave the country.
They blamed the situation on poor working conditions and environment,
lack of work opportunities, rising living cost, high taxes and
deductions from salary, low work satisfaction, poor salaries and
emoluments.
They said for some others, frustrations and despair about the
devastation of family life, crime, insecurity, personal health and
concerns about the education of children are enough reasons to pull up
stakes and leave the shores.
They said most healthcare facilities do not have functional equipment
thus, Nigerian doctors work blind. They noted that more Nigerian
doctors were going to leave for overseas owing to global
COVID-19-induced shortage of medical personnel and the fact that many
countries were attracting medics with mouth-watering packages.
It is believed that, for health workers, specific advantages come
with searching for greener pastures abroad. In 2018, a total sum of $25
billion was remitted to Nigeria from the Diaspora, constituting a
whopping six per cent of Nigeria’s Gross Domestic Product (GDP) and the
equivalent of 83 per cent of the country’s total national budget for
that year. The sum was more than Nigeria’s combined total earning from
oil and gas for the same year.
Experts, however, said the 58 doctors that were stopped last week at
the airport by NIS have left the country again. A Consultant Paediatric
Surgeon and Chief Medical Director (CMD) of Lagos University Teaching
Hospital (LUTH) Idi-Araba, Prof. Chris Bode, told The Guardian that
emigrating health workers were of special concern for four reasons: “We
do not have enough workers in this vital sector. We make huge
investments to produce them. Richer nations simply harvest these workers
free from our system. We seem powerless to stop the trend.”
Bode said popularly quoted figures indicate that about half of
Nigeria’s estimated 72,000 registered doctors practice abroad. He said
the trend seems to have escalated lately, with both fresh graduates and
those already in the residency-training programme fleeing in droves. The
surgeon said the country could not meet its sectoral goals in
healthcare if principal actors abandoned the theatre of operation for
greener pastures.
With doctor-to-patient ratio of 1:4000, as against the World Health
Organisation (WHO)-prescribed ratio of 1:600, it has been said that
“assuming no doctor leaves this country after being trained, going by
the number coming from our medical schools every year, it will take us
about 100 years to have the number of doctors we need.’’
Why do Nigeria’s medical health workers leave? Bode said skilled
manpower emigrates mainly because of economic instability and poor
labour conditions in their native country which seem to “push” them out,
unwanted, unappreciated, unrewarded, into the hands of advanced
economically prosperous nations, which “pull-in” such skilled labourers,
especially because the number of working-age people is already
shrinking in many such latter countries. He said in support of this is
the high fertility rate in the midst of developing nations’ poverty as
compared with the zero or negative population growth in the affluent,
advanced countries.
The surgeon said with the ongoing Brexit imbroglio and its
uncertainties, many healthcare workers from the European Union fled the
uncertainties in the UK. He said a British Medical Association (BMA)
survey of more than 15,000 General Practitioners (GPs) found that nine
per cent of GPs hope to leave the UK to work overseas in the next five
years.
Amongst GP trainees, this figure was even higher at 21 per cent. Bode
said these gaps have been an opportunity for Nigerian healthcare
workers to exploit and account for the bulk of doctors, nurses and other
healthcare workers presently heading for the UK. The surgeon said it is
projected that the shortage gap for nurses in the USA will rise from a
2015 figure of 20 per cent to 28.8 per cent by next year.
Medical Director of Medical Art Centre (MART) Maryland Ikeja, Lagos
and Joint Pioneer of In Vitro Fertilisation (IVF) in Nigeria, Prof.
Oladapo Ashiru, said as more doctors leave the shores of Nigeria, the
healthcare system is in a deficit which can negatively impact the
well-being of its populace.
Ashiru said the doctors would travel at any given opportunity. “There
is a craving for greener pastures abroad and the doctors are better
compensated for their services there. They also have the opportunity to
practice where they have the abundance of state of the art
technologies,” he said.
Ashiru said the exodus is not limited to the young doctors; consultants and very senior doctors are on the queue.
Medical Director and Consultant, Obstetrician and Gynaecologist
(O& G) at Optimal Specialist Hospitals Limited Surulere, Lagos
State, Dr. Ugochukwu Celestine Chukwunenye, said: “The true situation is
that most Nigerian youths have been brain washed into believing that
life is very difficult to live in Nigeria, and better in any other
country, especially overseas. This brain washing starts early, in many
homes and primary schools. It continues in the secondary schools, and
perfected in the polytechnics, colleges of education and
universities/medical schools. That is why there are many Nigerian youths
suffering in other African countries, and in overseas countries today.
The Nigerian medical doctors, and other health workers are a subset of
the Nigerian youths. As long as we continue to run government without
accurate census, and detailed plans for every citizen, the situation
will persist, and continue to deteriorate.”
Emeritus Professor of Physiology, College of Medicine, University of
Lagos, Prof. Soga Sofola, said: “Hundreds of young doctors have been
recruited in the UK in the past couple of years after passing the exams.
There is shortage of doctors in the UK and Nigerian doctors have been
found to be competent. It is mostly ‘brain drain’ as they have a better
life elsewhere compared to Nigeria with poor salary and poor conditions
of service etc.”
A virologist, vaccinologist and Chief Executive Officer (CEO) of
Innovative Biotech Limited, Keffi, Dr. Simon Agwale, said: “I am not
surprised with this arrangement because of shortage of medical personnel
due to COVID-19 globally and many countries are attracting medics to
their countries with very attractive packages. As you know, in a
globalized economy, the countries that pay the most and offer the
greatest chance for advancement tend to get the top talent. For an
example, the Council on Physician and Nurse Supply estimates that in 10
years, the United States could have a shortage of 200,000 doctors-these
positions must be filled and from where, of course the developing
countries.
“So, the best strategy to retain our medical professionals is to
first of all create an enabling environment for them to thrive and this
will enable them provide the best services to those that need them most.
I hope that this will be done quickly before it is too late.”
Public health physician and Director General and Chief Executive
Officer (CEO) of the Delta State Contributory Health Commission (DSCHC),
Dr. Ben Nkechika, said the situation portends danger to the Nigeria
healthcare system and that even the medical doctors remaining in the
country are seeking other sources of livelihood to meet up. He said this
further compromises quality of healthcare service in Nigeria.
To address the situation, Nkechika recommended a refocus on quality
of healthcare services in Nigeria, value of life of the Nigerian and
health insurance for all Nigerians to ensure a functional and
sustainable healthcare financing across the country. He said without the
NHS, healthcare in the UK would not have been very effective; the same
for other countries with viable National Health Insurance programmes
like Ghana, Rwanda, South Africa, Germany, France, Canada and the United
States.
Director General of the Nigerian Institute for Medical Research
(NIMR), Prof. Babatunde Salako, said: “Doctors moving outside the
country cannot be stopped even if you pay double what we are earning
now. Some may go for training, others just want to change environment
etc. But government can reduce the number of doctors leaving by
improving health worker’s conditions of service generally.”
A public health physician and Executive Secretary, Enugu State Agency
for the Control of AIDS (ENSACA), Dr. Chinedu Arthur Idoko, said the
implications was persistent brain drain. “We are losing our best brains
to foreign countries. These talents would probably have stayed back,
contributing to the growth of the health sector and nation in general if
the necessary enabling environment were in place. He said the solution
was “focused and sustained effort from all directions and in all spheres
by government, all and sundry to improving the health care situation.”
A professor of Virology and pioneer Vice-Chancellor of Redeemer’s
University, Oyewale Tomori, said: “…My sympathy for the fleeing doctors.
It was not meant to be like this. I suspect in their hearts they are
suffering, doubly pained by the impotence of helplessness created by an
uncaring nation.’’
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Saturday, July 18, 2020
TIME FOR NAIJA DOCTORS TO WAKA.......UK’s new migration visa lures Nigerian doctors
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