Reps propose licence revocation for hospitals denying emergency care

File: House of Representatives

The House of Representatives has begun moves to strengthen enforcement of patients’ right to emergency medical care, proposing tougher sanctions, including suspension or withdrawal of operating licences, for hospitals that refuse, delay or obstruct treatment.

This followed the second reading on Wednesday of a bill sponsored by the member representing Ikole/Oye Federal Constituency of Ekiti State, Mr Akin Rotimi which seeks to amend the National Health Act, 2014, by introducing mandatory emergency triage, stabilisation and referral procedures, with clearly defined timelines and enforceable obligations for healthcare facilities and professionals.

Under the proposed legislation, hospitals would be required to commence triage within 15 minutes of a patient’s arrival and basic stabilisation within 30 minutes, while life-saving interventions must begin immediately once a life-threatening condition is identified, irrespective of administrative procedures.

Leading the debate on the general principles of the bill, Rotimi said the proposed amendment was designed to address preventable deaths and complications arising from delays in accessing emergency medical care.

He lamented that despite existing legal provisions protecting patients’ right to emergency treatment, Nigerians continued to suffer avoidable consequences because of administrative bottlenecks, demands for payment before treatment, unavailable hospital beds and poorly coordinated referrals.

“Mr Speaker, in a medical emergency, time is the difference between life and death. Yet, Nigerians continue to lose their lives or suffer preventable complications because of delays arising from administrative bottlenecks, demands for payment before treatment, unavailable hospital beds and poorly coordinated referrals,” he said.

Rotimi noted that although Section 20 of the National Health Act, 2014, prohibits the refusal of emergency medical treatment, experience has demonstrated the need for clearer operational standards and stronger enforcement mechanisms.

“Although the National Health Act, 2014, prohibits the refusal of emergency medical treatment, experience demonstrates the need to reinforce this obligation with clear operational standards and enforceable accountability. The right to emergency treatment must translate into timely assessment, immediate life-saving intervention, stabilisation and effective referral where necessary,” he added.

The proposed amendment also seeks to address delays caused by shortages of medical personnel, allowing trained and certified nurses to conduct triage where a medical practitioner is unavailable.

On emergency admission and referral, healthcare facilities would be required to assign a bed to an emergency patient within two hours where one is available.

Where no bed is available, the facility must commence stabilisation and initiate referral within two hours of the patient’s arrival or immediately upon clinical stabilisation.

The bill further stipulates that transportation should be arranged within 30 minutes of a referral decision, while the transfer should be completed within three hours, except where circumstances beyond the facility’s control prevent compliance.

Beyond response timelines, the proposed legislation introduces stricter penalties for healthcare establishments and professionals that fail to discharge their emergency care responsibilities.

Hospitals that refuse, delay or obstruct emergency treatment could face financial penalties, suspension of their operating licences and, in cases of subsequent offences, possible closure or withdrawal of their licences.

Healthcare professionals who wilfully refuse or abandon emergency patients could also face criminal sanctions and professional disciplinary proceedings.

The proposal, however, recognises that healthcare facilities sometimes operate under genuine resource constraints. It provides protection for healthcare workers who act in good faith, properly document resource limitations and comply with established referral procedures.

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It also proposes that patients or their representatives could seek compensation through civil action against healthcare facilities where injury, disability or death results from a contravention of the emergency treatment provisions.

Explaining the rationale behind the proposed legislation, Rotimi said the objective was to protect lives while restoring public confidence in the country’s healthcare system.

“Mr Speaker, Honourable Colleagues, this bill is fundamentally about protecting human life and strengthening public confidence in our healthcare system.

“An emergency patient depends on the readiness, competence and responsiveness of the healthcare facility. Every unnecessary delay increases the risk of deterioration, disability or death. Our laws must therefore establish clear responsibilities and minimum standards for timely intervention,” he stressed.

The lawmaker said the proposed amendment also acknowledged the challenges confronting healthcare delivery in Nigeria by distinguishing genuine resource limitations from negligence and wilful abandonment of patients.

He argued that mandatory training, professional certification and standardised emergency care procedures would improve preparedness among healthcare workers, strengthen referral coordination and establish clearer lines of responsibility when emergency treatment is delayed.

The bill mandates the Medical and Dental Council of Nigeria and the Nursing and Midwifery Council of Nigeria to jointly develop and maintain a standardised national emergency care curriculum.

Healthcare workers involved in emergency care would be required to undergo mandatory training and certification at intervals not exceeding 18 months.

Rotimi maintained that the ability of healthcare institutions to respond effectively to emergencies was a critical measure of the strength of any health system.

“Mr Speaker, the true strength of a healthcare system is demonstrated not only by the quality of its routine services but also by its capacity to respond when lives are at immediate risk. Every Nigerian deserves timely and appropriate emergency medical attention, irrespective of circumstance or location,” he said.

Urging lawmakers to support the bill, he argued that no Nigerian should be compelled to negotiate for treatment at a time when immediate medical attention could determine whether a patient survives.

“No Nigerian should have to negotiate for survival at the point of a medical emergency. No family should lose a loved one because treatment was unnecessarily delayed, a referral was poorly coordinated or a healthcare facility failed to discharge its responsibility.

“This bill provides an important legislative step towards emergency medical care that is timely, competent, coordinated and accountable.

“It seeks to ensure that the right to emergency treatment is not merely declared in our laws but reflected in the actual delivery of healthcare. I therefore urge Honourable Members to support the general principles of this Bill and allow it to proceed to the Committee Stage in the interest of safeguarding the lives and wellbeing of Nigerians. I so move. Thank you,” he argued.

The proposed amendment comes amid longstanding concerns over access to emergency medical services in Nigeria, where patients and their families have faced difficulties securing urgent treatment because of financial barriers, inadequate facilities, shortages of medical personnel and poor referral arrangements.