Nigerian lawmakers propose six-month jail term for doctors, nurses who delay emergency treatment

The Senate on Wednesday passed for second reading a bill seeking to amend Nigeria’s National Health Act to prescribe a six-month jail term or an option of a fine of up to ₦300,000 for hospitals and healthcare workers who delay emergency medical treatment.

Senate President Godswill Akpabio announced the passage during plenary after a majority of senators supported it by voice vote.

After its passage, the bill was referred to the Senate Committee on Tertiary and Primary Health for further legislative scrutiny and a public hearing.

The proposed legislation is titled “A Bill for an Act to Amend the National Health Act, 2014 to Provide for Emergency Medical Treatment Standards and Referral Protocols in Healthcare Facilities and for Related Matters”.

The bill, sponsored by Abdulaziz Yar’adua (APC, Katsina Central), seeks to establish mandatory standards for hospitals and healthcare providers attending to patients requiring emergency medical attention.

The proposed amendment prescribed that hospitals would be required to commence treatment within 15 minutes of a patient’s arrival.

It also seeks to mandate hospitals, doctors, nurses and other healthcare providers to begin basic stabilisation measures, including oxygen therapy, intravenous fluids, pain relief and preliminary diagnostic procedures, within 30 minutes of arrival.

Leading the debate on the bill, Mr Yar’adua said that, where a licensed medical doctor is unavailable, a trained and certified nurse could conduct the initial assessment of an emergency patient and immediately commence treatment.

He said the bill also provides for immediate life-saving interventions, including cardiopulmonary resuscitation, airway management and bleeding control, once a life-threatening condition is identified.

The proposed legislation would prohibit hospitals from rejecting emergency patients, regardless of the circumstances, and require them to provide appropriate medical attention.

Other critical provisions

For patients requiring admission, the bill stipulates that a hospital bed should be assigned within two hours of arrival, provided bed space is available.

Where a healthcare facility lacks the capacity to admit an emergency patient, it would be required to commence resuscitation and stabilisation immediately and initiate the referral process within two hours of arrival or as soon as the patient is clinically assessed and considered stable for transfer, whichever comes first.

The bill further proposes that the transfer process be completed within three hours of arrival, except where external circumstances, including transportation difficulties, insecurity or natural conditions, prevent compliance.

To minimise delays during referrals, hospitals would also be required to commence ambulance dispatch or secure alternative patient transportation within 30 minutes of communicating a decision to refer a patient.

The proposed amendment, however, protects healthcare practitioners who document their inability to meet the prescribed requirements because of inadequate resources.

Such practitioners would be required to comply with the referral protocol and report the circumstances to hospital management or the appropriate authority.

Patients who died after alleged delays in emergency treatment

Nigeria has recorded several cases of patients who died after allegedly being denied or delayed emergency medical treatment at hospitals. Some of the most prominent cases involved victims of armed robbery and road accidents who reportedly encountered administrative barriers while seeking urgent medical attention.

In September 2009, Bayo Ohu, a journalist with The Guardian, was shot by armed men who invaded his Lagos home. He was reportedly denied treatment at a hospital because his relatives did not have a police report. He died while being taken to another hospital.

In November 2019, Moradeun Balogun, a 29-year-old podcast host, was stabbed by armed robbers in Lagos. She was reportedly denied treatment at a hospital because she did not have a police report. She was subsequently taken to another facility, where she died.

In 2021, Ebenezer Ayeni, an Ibadan-based music producer, was shot by armed robbers shortly before his wedding. He was reportedly taken to the University College Hospital and J-Rapha Hospital, both of which allegedly demanded a police report before treating him. He died about four hours after the shooting.

In October 2023, Greatness Olorunfemi was reportedly pushed out of a moving commercial vehicle by suspected “one-chance” criminals in Abuja. She was taken to Maitama District Hospital. Although, a panel set up by the Minister of the Federal Capital Territory (FCT), Nyesome Wike, later revealed that the victim was brought to the Maitama Hospital dead

In another case, an unidentified boy who was among victims of a road accident along the Bauchi-Jos Highway reportedly died after being denied treatment at Abubakar Tafawa Balewa University Teaching Hospital in Bauchi because of a lack of bed space. The hospital subsequently set up a committee to investigate the incident.

These incidents and several others have raised concerns about the enforcement of existing laws requiring healthcare providers to prioritise emergency medical care and the need for stronger accountability for hospitals and medical personnel.

The proposed amendment seeks to address such concerns by establishing mandatory timelines for emergency treatment, stabilisation and referral, while providing sanctions for healthcare providers who fail to comply.