The Nigerian Medical Association and the Nigerian Association of Resident Doctors have opposed proposed amendments to the National Health Act that seek to criminalise the denial or delay of emergency medical treatment, warning that the provisions could expose healthcare professionals to unjust prosecution.
The proposed legislation recommends a fine of up to N300,000, a maximum of six months’ imprisonment, or both, for healthcare workers and facilities found guilty of violating its provisions.
While the NMA cautioned that criminal penalties could unfairly hold medical practitioners responsible for circumstances outside their control, NARD threatened to consider nationwide industrial action if the National Assembly proceeded with the contentious provisions.
Both organisations maintained that introducing punitive measures without addressing the structural problems undermining healthcare delivery would further destabilise the sector. They identified inadequate funding, deteriorating hospital infrastructure, insufficient medical personnel and shortages of essential supplies as some of the challenges requiring urgent government intervention.
The controversy followed the passage of the National Health Act (Amendment) Bill, 2026, sponsored by Senator Abdulaziz Yar’Adua, representing Katsina Central, for second reading in the Senate.
The bill received majority support through a voice vote on Wednesday and was subsequently referred to the Senate Committee on Tertiary and Primary Health for further legislative consideration and a public hearing.
Reacting to the development on Friday, the NMA, in a statement signed by its National Publicity Secretary, Prof. Olayinka Atilola, acknowledged the importance of improving emergency medical services but urged lawmakers to consider the prevailing conditions in Nigerian hospitals before introducing criminal liability.
The association argued that several healthcare institutions lacked the basic resources required to deliver timely emergency interventions.
Among the challenges highlighted were inadequate hospital facilities, shortages of doctors and nurses, insufficient essential medicines, malfunctioning medical equipment, unstable electricity, unreliable oxygen supplies, inadequate ambulance services and ineffective referral arrangements.
According to the NMA, these limitations could make compliance with the proposed emergency response timelines difficult, regardless of the commitment of individual healthcare workers.
It questioned how a hospital with a single doctor attending to multiple critically ill patients, inadequate nursing staff and no functional oxygen supply could reasonably satisfy the proposed requirement to assess patients within 15 minutes and stabilise them within 30 minutes.
The association also explained that emergency procedures could be delayed by circumstances such as occupied operating theatres, unavailable compatible blood and the absence of specialist doctors.
Similarly, patients requiring urgent referral to tertiary healthcare institutions could experience delays because of inadequate ambulance services, limited bed spaces at receiving hospitals, insecurity and poor road networks.
It stressed that such difficulties were particularly common in rural areas and communities with limited access to functional healthcare facilities.
Expressing concern over the implications of the proposed legislation, the association said criminal prosecution must distinguish between deliberate professional misconduct and situations resulting from institutional shortcomings.
“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 maintained that the inability of a medical practitioner to perform a particular intervention should not automatically be interpreted as professional negligence.
It argued that criminal legislation should address demonstrably culpable behaviour rather than clinical outcomes influenced by factors beyond the control of healthcare providers.
The association further warned that enforcing strict response timelines without considering available resources and individual clinical circumstances could encourage defensive medical practices.
Such an approach, it said, might lead to unnecessary referrals and inappropriate medical interventions instead of improving emergency patient care.
NARD Threatens Industrial Action
In a separate reaction issued on Thursday, NARD described the proposed sanctions as punitive and unjust, insisting that medical practitioners should not be criminally prosecuted for failures arising from inadequate government investment in the healthcare sector.
The association said it supported efforts to guarantee timely emergency treatment but would oppose legislation that transferred responsibility for systemic healthcare deficiencies to individual doctors.
“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 observed that medical professionals were already working under difficult conditions characterised by outdated equipment, insufficient manpower, unreliable electricity, shortages of emergency medical supplies and poorly maintained hospital facilities.
It questioned why lawmakers were prioritising criminal penalties when fundamental problems affecting the country’s healthcare system remained largely unresolved.
The association also drew attention to Nigeria’s continued failure to meet the healthcare funding commitment contained in the Abuja Declaration, which recommends allocating at least 15 per cent of national budgets to the health sector.
It urged the National Assembly to focus on increasing healthcare expenditure, strengthening emergency departments, providing modern diagnostic equipment, ensuring uninterrupted electricity and improving ambulance and referral services.
The association further called for adequate recruitment and deployment of healthcare professionals to reduce pressure on existing medical personnel.
Emphasising the contradiction between the proposed penalties and the condition of public hospitals, NARD said: “You cannot legislate oxygen into an empty cylinder, electricity into a dark operating theatre, or life-saving equipment into an inadequately funded hospital.”
Beyond demanding improved healthcare infrastructure, the resident doctors challenged political officeholders to demonstrate confidence in Nigeria’s public hospitals by seeking medical treatment within the country.
It proposed that public officials should be subjected to similar accountability standards, including appropriate sanctions for the misuse of public resources on avoidable overseas medical treatment.
According to NARD, the continued preference for foreign medical facilities among political leaders raised concerns about their commitment to strengthening Nigeria’s healthcare institutions.
The association also warned that introducing additional criminal penalties against already overburdened medical professionals could worsen the ongoing exodus of skilled healthcare workers under the Japa syndrome.
Although NARD acknowledged that the proposed amendment recognised resource constraints and circumstances beyond the control of healthcare practitioners, it argued that the safeguards contained in the bill were inadequate.
It insisted that such protections must be clearly defined, comprehensive and enforceable to prevent doctors from facing prosecution over unavailable equipment, inadequate staffing and other institutional deficiencies.
The association consequently urged the National Assembly to withdraw and reconsider the punitive provisions while consulting medical associations, hospital administrators, patient representatives and other relevant stakeholders.
It also advocated legislation that would guarantee sustainable healthcare financing, minimum standards for emergency medical facilities, adequate staffing, reliable electricity and functional referral networks.
NARD warned that it would convene its appropriate decision-making organs to consider all lawful options, including nationwide industrial action, should lawmakers proceed with what it described as legislation that unjustly criminalised doctors for failures beyond their control.
However, the association assured Nigerians that arrangements would be made to ensure emergency services and care for critically ill patients were protected if industrial action became necessary.
