Emergency care: Doctors reject jail bill, threaten nationwide strike

The Nigerian Medical Association and the Nigerian Association of Resident Doctors have rejected a proposed amendment to the National Health Act seeking to impose up to six months’ imprisonment or a N300,000 fine on doctors and other healthcare workers for denying or delaying emergency medical treatment.

While the NMA warned that criminal sanctions could expose medical practitioners to unfair prosecution for circumstances beyond their control, NARD threatened nationwide industrial action if the National Assembly proceeded with the proposed punitive provisions.

The associations argued that punishing healthcare workers without addressing inadequate funding, poor hospital infrastructure, staff shortages and shortages of essential medical supplies would worsen the country’s healthcare crisis and potentially accelerate the migration of medical professionals.

Their positions followed the passage for second reading of the National Health Act (Amendment) Bill, 2026, sponsored by Senator Abdulaziz Yar’Adua, representing Katsina Central.

The bill seeks to establish mandatory standards for emergency medical treatment and referral procedures in public and private healthcare facilities.

It proposes that hospitals commence emergency assessment within 15 minutes of a patient’s arrival and provide basic stabilisation measures, including oxygen therapy, intravenous fluids and pain relief, within 30 minutes.

It also mandates immediate life-saving interventions in life-threatening situations and stipulates timelines for transferring patients requiring specialised medical attention.

However, healthcare professionals and facilities found to have violated the proposed provisions could face a fine of up to N300,000, imprisonment for six months or both.

The bill, which secured the support of a majority of senators through a voice vote on Wednesday, has been referred to the Senate Committee on Tertiary and Primary Health for further legislative scrutiny and a public hearing.

Commenting on the development in a statement signed by its National Publicity Secretary, Prof Olayinka Atilola, on Friday, the NMA commended the intention of the bill but urged lawmakers to consider the realities of healthcare delivery before introducing criminal sanctions.

It identified inadequate infrastructure, insufficient staffing, shortages of essential medicines, dysfunctional equipment, unreliable electricity and oxygen supplies, poor ambulance coverage and weak referral networks as major obstacles to emergency medical services.

The association questioned how hospitals with only one doctor attending to several critically ill patients, inadequate nursing personnel and no functional oxygen supply could meet the proposed 15-minute assessment and 30-minute stabilisation requirements.

It also cited situations where patients requiring emergency surgery might face delays because operating theatres were occupied, compatible blood was unavailable or specialists were absent.

Patients referred to tertiary hospitals could equally be stranded due to unavailable ambulances, a lack of beds at receiving facilities, insecurity and poor road infrastructure, the NMA added.

The association said these challenges reflected the everyday realities confronting healthcare facilities, particularly in rural and underserved communities.

“The NMA is particularly concerned about the possibility of imposing criminal liability without sufficiently distinguishing between wilful professional misconduct and failures arising from institutional or systemic limitations,” the statement read.

“There is an important difference between a healthcare worker who deliberately abandons a patient despite having the capacity and resources to provide emergency care, and one who is unable to provide a particular intervention because the necessary equipment, personnel, medicines or infrastructure are unavailable.”

The NMA argued that the inability to provide a specific intervention should not automatically amount to professional negligence, adding that criminal law should target culpable conduct rather than undesirable clinical outcomes.

It warned that rigid timelines, if implemented without consideration for clinical circumstances and available resources, could encourage defensive medical practice, inappropriate interventions and unnecessary referrals rather than improve patient outcomes.

Similarly, NARD described the proposed sanctions as unjust and punitive, arguing that doctors should not be held criminally responsible for failures caused by poor government funding, inadequate hospital facilities and staff shortages.

In a statement issued on Thursday, the association said it supported measures to ensure prompt emergency medical attention but would resist any legislation that held healthcare workers criminally responsible for systemic failures beyond their control.

“It is unacceptable to punish doctors for the consequences of a healthcare system that successive governments have failed to adequately fund, equip and staff,” the association said.

NARD noted that doctors were already battling difficult working conditions, including obsolete medical equipment, inadequate personnel, unreliable electricity, shortages of emergency supplies and deteriorating hospital infrastructure.

Questioning the urgency attached to the proposed penalties, the association challenged the National Assembly to demonstrate similar commitment to addressing the country’s persistent healthcare funding crisis.

It noted that Nigeria had continued to fall short of the 15 per cent health-sector budget allocation commitment under the Abuja Declaration.

The association urged lawmakers to prioritise adequate healthcare funding, functional emergency departments, modern diagnostic equipment, uninterrupted electricity, reliable ambulance services and sufficient medical personnel.

“You cannot legislate oxygen into an empty cylinder, electricity into a dark operating theatre, or life-saving equipment into an inadequately funded hospital,” it said.

NARD also challenged political officeholders to submit themselves to the same accountability standards they intended to impose on healthcare professionals.

It proposed that public officeholders should be required to seek medical treatment in Nigerian government hospitals, with appropriate sanctions for those who misuse public resources on avoidable overseas medical trips.

According to the association, the continued preference for foreign medical treatment by political leaders raised questions about their commitment to improving the country’s public healthcare system.

It further warned that imposing additional criminal sanctions on already overstretched medical personnel could accelerate the migration of skilled healthcare workers under the Japa syndrome.

NARD maintained that although the proposed amendment recognised resource limitations and circumstances beyond the control of healthcare practitioners, the safeguards were insufficient unless made explicit, comprehensive and enforceable.

It insisted that doctors should not face criminal prosecution for institutional failures, unavailable medical equipment, inadequate staffing or other circumstances beyond their reasonable control.

The association called on the National Assembly to withdraw and reconsider the punitive provisions, urging lawmakers to consult medical associations, hospital administrators, patient representatives and other relevant stakeholders before proceeding with the legislation.

It also called for legislation guaranteeing adequate healthcare funding, minimum emergency-care infrastructure standards, appropriate staffing levels, reliable electricity and functional referral systems.

NARD warned that it would convene its appropriate decision-making organs to consider all lawful options, including nationwide industrial action, if lawmakers proceeded with what it described as legislation that unjustly criminalised doctors for failures beyond their control.

It, however, assured that necessary arrangements would be made to protect emergency and critically ill patients in the event of any industrial action.