Meeting resident doctors’ demands

There are strong indications that the Nigerian Association of Resident Doctors (NARD) may suspend the nationwide August 10 strike following a meeting with the federal government. However, calling off the strike depends on how soon the government meets the demands of the doctors. Nevertheless, there is need to holistically address the challenges of the sector. The health sector has been pushed to the brink by years of neglect, broken promises, poor funding and policy inconsistency. Therefore, the government must ensure that it fulfills the demands of the doctors.

Doctors’ strikes have become an unfortunate feature of Nigeria’s healthcare landscape. Every few years, patients are left stranded, surgeries are postponed, emergency services are disrupted and thousands of vulnerable Nigerians bear the consequences of a conflict they neither created nor can influence. No responsible government should allow negotiations to deteriorate to the point where industrial action becomes the only option left.

Resident doctors have often complained about unpaid allowances, delayed salaries and poor working conditions. They have also lamented inadequate training support and unfulfilled agreements with government. Their grievances deserve prompt and sincere attention.

The health sector cannot function effectively when its workforce is frustrated, poorly remunerated and deeply distrustful of its employer. Unfortunately, that is the situation confronting the Federal Government today. Years of promises that are either partially implemented or abandoned altogether have created an atmosphere of scepticism. Every new agreement is greeted with doubt because previous commitments remain outstanding.

This is dangerous. Healthcare determines whether patients live or die. A distressed doctor cannot consistently deliver optimal care. The consequences are borne by ordinary Nigerians who depend almost entirely on public hospitals for affordable healthcare. The situation is compounded by the relentless exodus of healthcare professionals. Nigeria is steadily losing some of its brightest medical minds to countries offering better pay, safer working environments, superior equipment and greater professional respect.

According to the Nigerian Medical Association (NMA), more than 16,000 Nigerian doctors left the country within six years. The Association of Community Pharmacists of Nigeria also disclosed that about 9,850 pharmacists relocated to Canada, the United Kingdom (UK), Australia and the United States (US) over the past five years. Every departure widens the gap between the country’s healthcare needs and its capacity to meet them. This brain drain has become a national emergency.

The tragedy is that Nigeria spends enormous public resources training these professionals, only to watch wealthier countries reap the benefits of that investment. Hospitals increasingly struggle with acute manpower shortages. Doctors who remain are forced to work exhausting shifts, enduring burnout. Unsurprisingly, more of them eventually join the migration train.

Meanwhile, the political elite and affluent Nigerians continue to patronise foreign hospitals. Medical tourism has become a convenient escape route for those who make decisions about Nigeria’s healthcare system. This creates a troubling disconnect. Those with the power to reform the system rarely depend on it themselves. Consequently, the urgency required to transform public healthcare is often absent.

Funding remains one of the greatest obstacles. Nigeria’s health allocation has hovered around four to five per cent of the national budget in recent years, far below the 15 per cent target adopted by African leaders under the 2001 Abuja Declaration. Chronic underinvestment has translated into dilapidated facilities, obsolete equipment, inadequate diagnostic capacity, frequent shortages of essential medicines and poor staff welfare.

Germany spends about 12 per cent of its Gross Domestic Product (GDP) on healthcare, while the UK devotes roughly 10 per cent and France about 11 per cent. These nations also maintain far higher doctor-to-population ratios than Nigeria. They invest heavily in training and retention, and ensure adequate funding for public hospitals. Their health workers still negotiate for better conditions from time to time, but industrial disputes rarely threaten the collapse of the entire healthcare system.

The economic implications of Nigeria’s failing health sector are dire. An unhealthy population cannot sustain a productive economy. Poor health reduces labour productivity. Businesses suffer when workers are frequently ill. National productivity declines. Gross Domestic Product inevitably suffers when human capital deteriorates. Adequate investment in healthcare yields returns through increased productivity, longer life expectancy, healthier children and stronger economic growth.

Let the government address all the grievances of the doctors. Outstanding salaries and allowances should be settled without delay. Existing agreements should be faithfully implemented. Residency training should receive appropriate funding. Hospitals should be equipped with modern facilities, while healthcare workers across all professional cadres should receive competitive remuneration that reflects the value of their service.

Nigeria requires a comprehensive health sector reform agenda that prioritises workforce retention, infrastructure renewal, expanded health insurance coverage, transparent financing and accountability. Above all, government must restore confidence by demonstrating that its promises are binding commitments rather than temporary tools for ending strikes.