Senate bill would fine hospitals ₦300,000 or jail them for refusing emergency patients

The Senate is considering a bill that would make hospitals and health workers liable to a fine of up to ₦300,000, six months in jail, or both, for refusing to treat emergency patients or breaking new emergency care rules.

The bill, sponsored by Senator Abdulaziz Yar'Adua, seeks to amend the National Health Act 2014. It was debated at Wednesday's plenary, where Yar'Adua said it would close gaps that cost patients their lives, regardless of their wealth, influence or where they live.

For an ordinary Nigerian, the proposal speaks to a familiar fear: arriving at a hospital in an emergency and being turned away over inability to pay or because there is no police report. PM News reported that the bill is aimed at curbing such rejections, which it said have led to avoidable deaths.

What the bill would require

Under the proposal, public and private hospitals licensed for emergency care must begin triage and initial assessment within 15 minutes of a patient's arrival. Where no doctor is available, a trained and certified nurse may carry out the triage.

Basic stabilisation, including oxygen, intravenous fluids, pain relief and preliminary tests, must start within 30 minutes. Once a life-threatening condition is found, life-saving steps such as CPR, airway management and bleeding control must begin immediately.

Patients who need admission should get a bed within two hours, subject to availability. If no bed is free, the hospital must stabilise the patient and start referral arrangements within two hours, or as soon as the patient is stable enough to move.

Referrals should be completed within three hours, except where transport problems, insecurity or natural conditions get in the way. An ambulance or other transport must be arranged within 30 minutes of the decision to refer.

The bill also requires the Medical and Dental Council of Nigeria and the Nursing and Midwifery Council of Nigeria to jointly develop a national emergency care curriculum. Health workers in emergency care would be retrained and certified at least once every 18 months.

According to Independent, the bill offers a safeguard: health workers who cannot meet the timelines because of resource constraints would not be penalised if they document the problems, follow referral rules and report the case to management or the relevant authority.

Supporting the bill, Senate Whip Senator Mohammed Monguno said it would prevent deaths from road accidents and maternal emergencies, and introduce criminal liability for violations.

What happens next

The bill has only been debated. It still needs to pass further legislative stages in the Senate and the House of Representatives, and be signed by the President, before it can become law. The timelines and penalties could still change before then.