The Nigerian Senate has advanced a landmark bill seeking to establish mandatory, legally enforceable response times for emergency medical treatment in hospitals and other healthcare facilities across the country, in a bold and decisive move aimed at curbing the rising, alarming and unacceptable cases of preventable deaths in emergency situations.
The proposed amendment to the National Health Act, which scaled second reading on the floor of the Red Chamber on Thursday after a robust and emotionally charged debate, requires all healthcare facilities, both public and private, irrespective of ownership, size or location, to assess patients within 15 minutes of arrival and commence stabilisation procedures within 30 minutes without any form of delay or discrimination.
The bill also seeks to strengthen patient referral procedures across the entire healthcare value chain in the country and introduce stricter, more stringent and more punitive penalties for healthcare providers, hospitals, clinics and medical personnel who violate the proposed standards or who refuse to attend to emergency cases promptly under any guise or excuse.
Leading the debate on the general principles of the bill, the sponsor of the legislation, Senator Abdulaziz Yari, representing Zamfara West Senatorial District and former Governor of Zamfara State, said the bill was born out of urgent necessity, compassion and the need to save the lives of ordinary Nigerians who die daily due to systemic failures.
Senator Yari lamented that avoidable delays in emergency medical attention continue to result in preventable, avoidable and untimely deaths, particularly among victims of road traffic accidents, pregnant women in labour, patients with cardiac arrest, stroke victims, asthmatic patients and other patients with life-threatening and time-sensitive conditions.
He noted that it has become a common, disturbing, heartbreaking and almost normalised practice in many hospitals across Nigeria for patients in critical, life-threatening conditions to be left unattended for hours, either because of demand for police report in accident cases, payment of deposit or sheer negligence and nonchalance on the part of medical personnel.
The former Zamfara governor cited several harrowing instances and verifiable cases where victims of road traffic accidents bled to death on stretchers, pregnant women lost their lives or their babies during childbirth, and asthma and hypertension patients died simply because they were not attended to within the golden hour that could have saved their lives and prevented tragedy.
He explained that the bill seeks to amend the National Health Act to specifically provide, in clear and unambiguous terms, that no hospital, whether government-owned or privately-owned, shall delay, refuse, reject or deny any person emergency medical treatment for any reason whatsoever, and that every health facility must have a functional emergency unit manned by qualified personnel at all times.
According to him, the proposed amendment provides that upon arrival at any hospital, a patient in an emergency situation must be triaged, examined and assessed within 15 minutes by a qualified medical professional, such as a doctor or nurse, to determine the severity of the condition, the urgency of intervention and the level of care required to stabilise the patient.
The bill further provides that stabilisation treatment, including but not limited to resuscitation, pain management, bleeding control, oxygen administration, intravenous fluid replacement and other critical life-saving interventions, must commence within 30 minutes of arrival, irrespective of the patient’s ability to pay, ethnic background, religion, gender or social status.
Senator Yari added that the bill also makes elaborate provision for a seamless, well-coordinated, professionally handled and properly documented referral system, where a hospital that does not have the capacity, equipment or manpower to handle a particular emergency must first stabilise the patient before referring the patient to a better-equipped and more specialised facility.
He stressed that the referral must be done with proper communication between the referring and receiving hospitals, with a functional ambulance and trained medical escort where necessary, and with full documentation, to ensure that the patient does not die in transit, get lost in the system or get rejected by the receiving hospital, which has been the case in many tragic instances across the country.
The lawmaker also disclosed that the bill proposes stiffer, more deterrent penalties, including heavy fines running into millions of naira, temporary or permanent suspension of operational licences, withdrawal of practising licences and possible jail terms, for any hospital, clinic or medical practitioner found guilty of violating the mandatory response time or rejecting emergency patients under any guise.
He argued that the existing provisions in the National Health Act are not explicit, detailed and punitive enough on timelines and sanctions, thereby creating room for abuse, negligence, arbitrariness and impunity among some healthcare providers, which the new amendment seeks to cure and address frontally for the benefit of all Nigerians and residents in the country.
Contributing to the debate, other distinguished lawmakers who spoke passionately in support of the bill stressed the need for a more effective, efficient, responsive and humane emergency response system in the country, emphasizing the sacred, ethical and professional responsibility of healthcare providers to ensure that patients receive prompt medical attention at all times.
Senator Asuquo Ekpenyong from Cross River South said the bill is timely, life-saving, people-oriented and long overdue, noting that many Nigerians have lost loved ones, breadwinners and family members due to the poor attitude, commercialisation and lack of empathy displayed by some health workers who insist on payment before treatment, even in clear emergency situations where every second counts and counts for life.
On his part, Senator Ipalibo Harry Banigo from Rivers West, who is a respected medical doctor and former Deputy Governor of Rivers State, said the 15-minute assessment and 30-minute stabilisation timeline being proposed is in line with global best practices, World Health Organisation guidelines and international emergency medicine protocols, and is achievable if hospitals are properly equipped, adequately staffed and committed to their professional oath.
Senator Banigo however cautioned that for the bill to achieve its intended purpose and not just remain a fine piece of legislation on paper, government at all levels must also address the fundamental challenges bedevilling the health sector, including inadequate funding, shortage of medical personnel, poor remuneration, lack of modern equipment, decaying infrastructure and the mass exodus of doctors and nurses out of the country in search of greener pastures abroad.
Other senators who contributed to the debate, including Senator Tony Nwoye and Senator Diket Plang, agreed that no Nigerian citizen or resident should die simply because a hospital refused to treat them on time, and called for strong monitoring mechanisms, public enlightenment, citizen awareness and collaboration between federal, state and local governments to ensure effective implementation and enforcement when passed into law.
After extensive deliberations, exhaustive contributions and robust debate that showed the unanimous support of the Senate for the proposal, the President of the Senate, Senator Godswill Akpabio, put the bill to a voice vote, and it was overwhelmingly and resoundingly supported by majority of the senators present on the floor, thereby passing second reading and scaling another legislative hurdle.
The bill has now been referred to the Senate Committee on Health and Secondary Health Care, chaired by Senator Ipalibo Banigo, for further legislative consideration, public hearing, stakeholder engagement and more detailed scrutiny, where critical stakeholders, including the Nigerian Medical Association, NMA, Association of Private Medical Practitioners, hospital administrators, NGOs and civil society groups, are expected to make inputs.
The committee is expected to report back to the Senate within four weeks for third reading, clause-by-clause consideration and possible passage, after which it will be transmitted to the House of Representatives for concurrence and thereafter to President Bola Ahmed Tinubu for assent, if all legislative processes are completed successfully and without any political or bureaucratic bottlenecks.
