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The UK’s National Health Service and its reliance on Nigerian doctors

Jeremy Hunt, the UK’s Health Secretary pledged today at the Conservative Party conference in Birmingham to end the NHS’s reliance on foreign doctors.

Data from the UK’s General Medical Council (GMC) shows that 30,472 doctors come from the EU and other countries in the European Economic Area, while 71,139 were trained in other parts of the world. These include 4,153 trained in Nigeria.

Hunt asked: “Is it right to import doctors from poorer countries that need them?” Nigeria certainly needs all the doctors that it trains. The brain drain of Nigerian doctors to richer countries like the UK was a trickle in the 1980s that became a flood from the 1990s. Those 4,153 Nigerian doctors in the UK were most likely educated at significant public expense, while the UK is now benefiting from Nigeria’s investment.

The effect of the loss of these medics to Nigerian healthcare is devastating. It is no wonder that most rich Nigerians, including the ruling elite, hop on a plane abroad for treatment for even minor ailments. President Muhammadu Buhari was treated in London for an ear infection in June this year, and admitted, without a hint of shame, that he has been seeing doctors in the UK since 1978.

Bola Tinubu, the former Lagos State governor, visits President Buhari as he recuperates in London after treatment for an ear infection
Bola Tinubu, the former Lagos State governor, visits President Buhari as he recuperates in London after treatment for an ear infection

As the ruling elite usually seeks treatment abroad, there is little incentive for them to address severe doctor shortages in Nigeria and the reasons why the country is losing so many medics. Last year Ibifuro Green, Rivers State Chairman of the Nigerian Medical Association raised concerns about the shortage of doctors in the country: “The World Health Organisation has recommended that one doctor should attend to not more than 600 patients but the ratio in Nigeria is one doctor to about 4,000 patients”. Green warned that many more doctors were looking to migrate.

Naijiant.com spoke to a London-based Nigerian doctor, who specialised in forensic psychiatry and also practices general medicine and left Nigeria in the 1990s. Contrasting his experience in Nigeria with the UK, he said: “Working conditions here [the UK] were obviously better. Professionally, the main challenge was the new technology [which they were not exposed to in Nigeria]. Clinically, we were more than competent and in many respects ahead of our British peers, especially in fields like gynaecology and even surgery because in Nigeria you ‘get your hands dirty’ early”.

He added: “However, the main drawback [in the UK] was almost always the subtle ‘institutional’ racism. We all have stories as you know”.

Despite the “institutional racism” in the UK, he is unlikely to return and practice full time in Nigeria “at the stage of my career I am at now”. But he is open to voluntary or charity work in Nigeria.

If the UK’s NHS ends it reliance on foreign-trained doctors, the significant numbers of Nigerian doctors seeking to migrate may just strike the UK off their list of options and go elsewhere rather than remain in Nigeria. Nigeria needs a coordinated national healthcare programme that would address the conditions that make so many medics leave the country, especially around the obsolete equipment they have to endure and issues around pay and conditions of service.

Addressing such issues increases the likelihood of some of the 4,513 Nigeria-trained doctors in the UK returning home to improve healthcare provision in the country. This should reduce the health tourism of the Nigerian ruling elite and other rich Nigerians, and may have an added benefit of easing the foreign currency shortages that have dragged the economy into recession.

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