 Tonight, as we mark the World Health Day, we will be addressing concerns in the health sector in Nigeria, even as reps prescribe compulsory 5-year local practice for Nigeria-trained doctors. And African nations reiterate requests to join BRICS, a made ongoing global political world. This is Plus Politics. My name is Nyam Ghul, Aghaji. A bill to prevent Nigeria-trained medical or dental practitioners from being granted full licenses until they have worked for a minimum of five years in the country has passed second reading in the House of Representatives. With the Nigeria's health care system plagued by a massive brain drain with a mass exodus of medical doctors and others killed workers, the House of Representatives passed for the second reading the bill to stem the worrisome tide. Honourable Ganyu Johnson, who raised the motion expressed concern that it is only fair for medical practitioners who enjoy taxpayer subsidies on their training in local institutions give back to society by working for a minimum of five years in the country before exploring their skills abroad. Now, as we mark the World Health Day, the Minister of Health Osage Ihanere has said health systems can only function with healthy workers, improving health services, coverage and realising that the right to the enjoyment of highest attainable standard of health is dependent on their availability, accessibility, acceptability and quality. Well, joining us live to discuss these is Tunji Abdul Hamid, a public affairs analyst. Thank you for joining us on the program, Tunji. Thank you, Abhimiyad Aghaji. Good evening. Okay, we are hoping to be joined by a medical practitioner later on in the show and we do hope that when he comes we can just bring him to answer the questions that we have for him. But Tunji, let's look at what the House of Reps has proposed that if you are a locally trained medical practitioner, you should practice for up to five years before you're given a license so that even if you have to, like we say these days, jackpot, we know that you have put in five years. It's like, you know, going to school in Nigeria and you have to do a compulsory one year service to your nation. That's what they're proposing five years for, for the medical practitioners. Let us get to hear what you feel about this proposal by the House of Reps. I'll tell you that that will be unfair and it will be a bit of their fundamental right. That's in 1934 of the Constitutional Pre-Linguias Amendment. For me, I am not unaware of the intention of that bill, the intention is to ensure that we don't have a brain drain any longer. I think for me, that particular law, we are meant to discrimination, it's we are meant to breach of fundamental rights, and to be unfair on the part of those medical doctors for them to be put into what I call compulsory and possible because that to me, that means you are making me to work where I do not have the intention of working or where I have no choice that I have to stay put. For me, it is a breach of the fundamental right. Like I said earlier on again, I am aware that medical doctors are moving out of the country, not only them, even lawyers are moving, bankers, so many others of them. And the reason behind it, I don't know why the justification for saying medical doctors will say yes, apart from they want to cover a brain drain, I don't know because most of these doctors are not going to school for free, they may argue they will subsidise, subsidise. So if you subsidise, subsidise, it is not only them, all universities in Nigeria will be said to have been subsidised, it's not the one if you went to school and let them know, you went to school and let them attend, you let any other courses, you have benefited from the government, so you should be forced to work wherever the government feels you should be able to work or work in Nigeria. If I also talk about those who have been trained by governments, about those who went to private university, that they pay fee for that training, without any government contributing anything to it, in terms of what they call it, subsidy, also subsidising the fee they pay. So for me, it's unfair to be unfair on the medical doctor, it's unfair to bring a breach of the parliamentary. I expect the government to look at why do we have a brain drain, why are they running after the country, why are they going elsewhere. That's simple for me, the question is that there is no conducive environment in this country, there is no living environment, there is no equipment or facility for them to go to work with. There is no money, commercialised with what they are doing, people are not being paid, money they are being paid cannot take them home, talking about feeding their family or feeding them. So I will support the bee, if there will be a trust in that bee, they will say, within that five years, what they will be paid, will be commensurate to what they will take abroad, give their travel abroad to go and do their, to offer their services abroad. They are asking them to stay put for five years, before considering whatever they want to be, even if they have the opportunity abroad, before the good day, we will be unfair and we will be a bit of a constitutional right as far as I am concerned. They should also not only look at the same thing, but they should also look at why are you going back, and why are we traveling. And in that regard, if you have to say, what they have been paid here is what they are contained of, I expect the government to also make that payment commensurate with what is obtained abroad. Most of these people who are talking, the person there will be in a position to send their children abroad to go and practice, thereby they will afford the service of five years in the country. They can also put in that law, that look, any child or children of any body who has heard of this in this country, to not go abroad for any training, or after the training in Nigeria, or anywhere in the world, he must come back to Nigeria to work for five years before going out of the, before it cannot decide where to go to. That will make it fair for me. If the law applies to everyone, that is accounting, law, and other people, even if you are in Nigeria, you must come back home and come and do that five years compulsory, the medical practice. And then I will see it as a fair law in that regard. There are cities today, as far as I'm concerned, it's a bit of a mental right, it's a military, and it's unfair to the part of the medical doctor. We're being joined by another guest that we promised earlier, but before we bring him on, let me just ask, why is it really, really unfair? Because as far as I'm concerned, it's the same thing that is happening in the National Youth Service Corps. You finish your four years, or your five years, or your seven years as the case may be, and you are, permit the word, forced to serve the country for one year. And you cannot go out and use whatever you're using, because you have not served, if you have not served that one year. So is it because it is five years that it is so worrisome, or even the NYSC can be put into the same mold, and said to be draconian? It is unfair on the fact that one, it's made five years. If you're talking about NYSC, it applies to everybody, whether you read medicine, whether you are a lawyer, whether you are, you read accounting, whether you read this and that, you are bound to go for NYSC, once you are within the age bracket. And then when you say a month with five years, for medical doctor alone, then it's becoming a military, and therefore it's unfair. So as far as I'm concerned, making it compulsive for them to say, look, you must come and do this service in this Nigeria for five years, not thinking of how will they survive, what is important, what are the possibilities provided for them to be able to train. Some of them travel not because of the money, some of them travel because they want to acquire more experience, and they want to acquire more money, because what they needed to work in Nigeria are not available. So it's unfair on their part for them to say, look, only medical doctor must spend five years after service. Science is compulsive, and it's part of that curriculum. That's not the part of the curriculum for everybody, it's just only for them. So that makes it discriminatory, and that makes it unfair. So if it's not discriminatory, I would not say it's unfair. Because it's discriminatory, it's unfair, because it not only applies to medical doctor, not everybody. The NYSC applies to every courses in Nigeria, and like I said, I want them to also extend it to anybody who trains abroad if they want to go down. So say, look, even if you go abroad to train as a medical doctor, you must come back to Nigeria, once you are in Nigeria, you must do five years before you go anywhere. Because that is the sort of code they would be using. They had the ability to send their children abroad to go and train. They would not say they are sent there because they didn't train in Nigeria. So they would want to. So to me, I'm so concerned, that's my home. Even as much as I don't want to also have a brain drain, I think we should also not put people with other emergency pressure, post-labor. In other words, I don't want to work for you. You see, I must stay back and work. And anyway, it will not be fair on them, and some of them may even be killer. What I say killer here, I'm talking about somebody who's all willing to work, a medical doctor. It's impossible to work. He would not be doing whatever he likes. And then in the process, he may not even practice in Nigeria. He may not even practice in business the way he should be practiced. And then people may resort to so many other unconsequential negative effects in that regard. So to me, it's unfair because it does not apply to everybody. It applies only to a category of people. And it's not general. NYC is general. And then that cannot be compared to NYC. Because it only applies to what's called... Thank you. Thank you very much. We're being joined by Dr. Robinson Ebi, Chairman of the Nigerian Medical Association, River State. Thank you so much for joining us, Dr. Ebi. Dr. Ebi, can you hear me? Yes, I can hear you. Okay, very good. Thank you so much for joining us on the show today. Thank you very much for having me. Okay. We're hearing what is happening in the House of Representatives, where a bill is being read and debated and passed for second reading to make sure that every doctor that trains in Nigeria will have to put in five compulsory years before they can export their talents to anywhere else in the world. How is the enemy taking that? Thank you very much for having me. Okay, I'll be very straight to your question. You have called this law a bit of being draconial. I will say this is more than imprisonment and more than slavery. And the enemy is not taking it very lightly. We are taking it very seriously and we are vehemently against this law. We are vehemently going to oppose this law. We will take them to court if it needs to get to that extent. Well, this is not the second reading. There is going to be the committee stage and everybody will be invited to be on the table and we are going to discuss this matter. So that law is not acceptable by the Nigerian doctors who rejected the entire team with the concept to which they have been able to put this law together. And I think that this is quite unfair to the medical profession. In fact, it is what is going to be another killer machine for the medical profession. And no matter what they think, it's going to be counter and counterproductive right. And you're the barista in the explanations we are giving to this. This is against our fraternity. This is against our creed. This is against the health sector. We seem to be having a problem. Okay, go ahead please. All right. So for putting this law together, we say we are vehemently against this law and then we reject it. In fact, the ideology of NYC is quite different from this law that is trying to imprison medical professionals. The ideology of NYC is for national integration, is for nationalization and to bring the dignity of this country to self-accounting. But this is going to sell people that have been trained. They have the specialized skills not to sell people, not to move out, not to a small world. Even in this area of a global village, then they are trying to murder the medical profession. And the Nigerian doctors will stand against this law. You cannot, you cannot tell us not to travel for the after five years of that. However, I must say categorically that even the doctors that are living, and not even the only the nurses are living, senior registrars are, to not even only the young doctors, so they, I don't think that it is only the young doctors that are living in the country, it's apparently to fight brain-brain or whatever the process is. There are causes of brain-brain and we have not been able to sort out the factors causing brain-brain. And you're coming to imprison people. I wonder what kind of society will conform to such a thing. We know that our services are measured in terms of quantity. And then people are ready to buy our services more than what you are offering. If you want to be, if you want us to be in the country and serve you, then raise up your game. However, medical education in Nigeria is not free. It's paid for. There are people that are still on loans trying to train their children and was in medical school. There are people still trying to pay loans, parents, they're trying to pay loans, parents out of their seats. Dr. Ebi, just a moment. The argument, one of the arguments is that the medical doctors in Nigeria go to school with some kind of subsidy from the government. How far does this subsidy go if it does come to you as medical? I have not seen any subsidy in terms of medical training. That is the universally acceptable, acceptable fees that are being paid by every student. It is not peculiar to medical students or to medical education. Government infrastructures across board is being subsidized, both in education, in health care services, in transportation, everything owned by government is subsidized. Then, what about those that have gone to private universities that paid heavily for this medical education? We are there also subsidized. We are there fees also subsidized. We are there any form of control for the private universities on what they charge for medical students to pay as much as three, five, six million per session in private university. As much as three, four, five, six, seven million, depending on the university, what subsidy, parents pay, parents take loans and make sure that the children undergo this medical education. That ideology, that medical education is subsidized, is complete fallacy and is not acceptable to us. Okay, let me just ask you this. People go out of the country not just because of, well, maybe everything is related to greener pastures, but some people go because they want to further their education. Some people go because they need to go and join their loved ones. Some people go for various reasons, but some other people go because of the conditions, the working conditions of that existed in Nigeria. Now, the complaints have been that a lot of things have not been put in place to make the profession or to make the practice of medicine in Nigeria very comfortable. That's why some people are going out. If that is the case, what are some of those things that are lacking in Nigerian medical space, health space, that will make a doctor to leave Nigerian shores to another place to seek that which can be provided in Nigeria? Yes, it is very obvious that it may not necessarily be for greener pastures why people are living in the country, why medical professionals are living in the country. Like the colleagues, like Barisatunji have said, it's not only doctors that are living, pharmacists, med-life scientists, radiographers are all living. So this is not necessarily because of greener pastures or welfare related issues. However, it should be also noticed that the infrastructure development of the country, this is the working environment for these doctors, for healthcare providers, is also very, very reasonable. Now, what healthcare financing has been an issue? Most of the health sectors are underfunded and when they are underfunded, the management of those health facilities have not been able to put in place necessary infrastructure to enhance effective healthcare delivery. So I want to just enumerate that healthcare financing has been a very serious challenge. Power is a challenge. Security is a challenge. I can go on and on and on and on. So apart from welfare related issues and greener pastures, these are some of the other inferential circumstances that affect the human factor slide or that pushes medical and healthcare providers to live their country. So some of these things are not in place. Most of us public sectors are underfunded and for us, let us cast our mind back to the COVID era. Nigeria witnessed a reduction in the allocation of funds from the federal tragedy to health. They were doing a pandemic. It's not bad as that. It is not bad as that. The Nigerian healthcare funding has never grown above 15%. Our favor is the fact that it has always been 15%, 5% and 6% of our growth budget. Our budget allocation to healthcare has always gone below 10%. So how do you get universal health? So some of these things are the issues. Meanwhile, the environment is not comfortable. Meanwhile, other institutions and other things are made to be put in place. It's not in place for them to function. And then they need to really go out and also get all that specialized training for themselves. The training environment is not conducive. There's no adequate training. There's no adequate funds for research. But there is not what you do. You cannot separate medicine from research. It cannot separate medicine from research. So medical education is research-based. What are the research funds? What are the funds for research? These are the questions. So it is not only welfare. It's not only greener partial. We have issues with work funding. We have issues with specialized power training. We have issues with security. We have also issues with community participation and others and others and others can go on and go on. So these are the issues surrounding too early the brain drain we see today. Thank you. Okay. Thank you very much. Let me come back to you, Tunji. We have agreed that, okay, there is a problem. Brain drain, if we call it brain drain, it's not just people going from one place to the other to explore. But if we call it brain drain, then there is actually a problem. But we've also established the fact that it may not be the best solution to just compulsorily give five years to people to stay back and do whatever they need to do, even though some people may not even ever in their life travel out, even as medical doctors. But if you say five years' compulsory becomes like a prison to them, what recommendations, what alternatives should be explored by the National Assembly, by the government to seek to profile the solutions that will make the brain drain to stop instead of five years' compulsory service? You see, my staff for instance, I'm not a medical doctor or a mid-lawyer. For me to even travel out for two weeks, even though the environment is not conducive, it's difficult for me. If you bed me with a pizza, I mean, I would only turn it to you for two weeks, to anywhere to work, because I need to affect it. So if you made the environment conducive in terms of providing adequate facility, security, and then the money is there to make it to complement what they are doing, you know what, you see a medical doctor who's a confidant that's been pregnant for 25 years to pay school fees or school fees to analyze, it's a problem. To pay his family is a problem, and you expect that kind of person to take food and when it's, there's a lot of opportunities in the way. For example, now I'm going to talk about the younger ones. It's only the younger that's pregnant. The old ones are pregnant, 25 years in practice, 30 years in practice. And for me to even think of, for them to even think that when you are young, that's when you are supposed to be pregnant, it's wrong. That's five years you are using them enough. That's when you are supposed to benefit from your experience. That's when you are not supporting them outside, or you are allowing them to go. So for me, what they need to do, it's not about anything, it's not about forcing people to do compulsory labor or another slave trade, another slave trade work. What they need to do is to ensure that look, we have a conducive environment, a medical situation whereby those who are depressed in the ministry, the governor, whatever, can stay in Nigeria and attend those medical facilities. That is it. If it's that conducive enough that, for example, a governor built a world-class hospital, and he has just a minor headache, he's abroad. That means there's no confidence in that system in Nigeria. So they are also telling us that no, we don't have trust in this system. We don't have trust in these medical facilities here. So if they provide a non-medical facility, if they make a salary, commission it with what people are brought to pay, and make everything proper, they want to try to go and survive in some way, and then start leaving his family, some of them go as far as leaving their family in Nigeria, they will be there, the wife will be in Nigeria, he will be abroad. Do you think anybody like that? No. They have no choice. They have to move on and get more things to be done. Nigeria, if they are going to move, get more experience, because their facilities are not there for you to get that experience you are looking for. So if they don't want them to travel, it's not about composing law, it's not about making composing that you must stay somewhere. Make the environment conducive. Make the, that's the solution. Make the environment conducive in terms of providing the healthcare facilities, in terms of ensuring they have a good pay. That will be not, that will stay for as long as it takes. If you say that that would be the solution, asking them to stay back for five years, you are making them to stay against their wish. And for me, like I said, his first label, he's contrary to the profile of Nigeria, or the constitution of Nigeria, his symmetry is unfair. That is the way I see it, and it's going back to having a slave free, and that's what I think. So just make the environment conducive. That's just the solution. Once the environment is conducive, they get the medical facilities are there. There's nothing you want to get abroad. You don't have in Nigeria, they pay a merchant what they are doing, then they will stay back. So you don't have to force anybody to stay, not to stay in Nigeria, or to stay in Nigeria for five years or whatever. Like I said again, I want to repeat it again. That first five years is most crucial for them, because that is the year they get the experience more. So if you take them out within that five years, after the five years, we are supposed to be getting their worth of experiences. That is where you are now allowed to go out of the country and then go and give it to people outside the country. It doesn't make sense to me as far as I'm concerned. So what I think we should do, like I said, I want to repeat it, is just one solution. Make the environment conducive. Provide good welfare. Provide good renumeration. Then they will stay put. That's just my own way of doing it. Okay, Dr. Ebi, now from you, let's take a final word from you. If the government wants to do a revamp of the medical sector or the health sector, they may not be able to carry all the eggs at the same time and do everything at the same time. What are some of the most pressing things, maybe one, two, three, that they need to do urgently if they want to stop this brain drain and improve the medical or the health sector in Nigeria? Very few of those things that we need to, like they say, low-hanging fruits that must be done urgently before we look to doing the rest of the things that we need to do. Can you hear me? Yes, okay, we can hear you. Yes, please. Thank you very much. Sorry, the network has not been very friendly. That's all right. I want to say that first we have to take the issues of health very critical and thank God that today is World Health Day and the theme for today is health for all and that means equitable health for all. Health without race, health without status, health without gender, health without tribe, whoever, wherever you are, you should have access towards effective and efficient health care service. My dear, I will say the first thing I want to advocate is that there should be a law restricting every public officer, public officer, public office holder from leaving this country to seek health care from outside with taxpayer's money and every public officer must use the government or public health facility in this country just to that for us and let's see whether the health sector will not improve. We have forgotten the hurry that when COVID came. Let's wrap up. Let's wrap up, doctor. Yes, correct. When COVID came, everybody was stuck. I pray COVID never comes again, but if it does, it may be worse on us. Therefore, if that is done, then welfare will be secondary. Every doctor will stay. Everybody will be in this country and develop our health care system. Thank you very much. Thank you so much. Even though doctor sounded like do me or do you, but it's well put and we're hoping that people who are concerned are listening now. We'll take a quick break and when we return will be addressing global politics as world powers come together to create their new currencies thereby neglecting the dollar also known as the brick alliance. Just stay with us.