Senate Bill Proposes Six-month Jail Term, N300k Fine for Hospitals Who Delay Emergency Treatment

The senate has passed for second reading a bill seeking to amend the National Health Act, 2014, to establish mandatory emergency medical treatment standards and referral protocols for public and private healthcare facilities across Nigeria.

Similarly, a bill seeking to amend the National Health Act, 2014, to empower authorities to suspend or withdraw the operating licences of healthcare facilities that refuse or obstruct emergency medical treatment passed a second reading in the house of representatives.

The proposed legislation in the red chamber, sponsored by Abdulaziz Yar’Adua, senator representing Katsina central, seeks to prescribe specific timelines for the assessment, treatment, stabilisation and referral of patients requiring emergency medical attention.

The bill, which scaled second reading during Wednesday’s plenary, proposes a fine of up to N300,000 or imprisonment for a term not exceeding six months, or both, for healthcare providers and facilities that violate its provisions.

It also seeks to prohibit hospitals, healthcare workers, and other providers from refusing emergency medical treatment to anyone, regardless of the circumstances.

“A health care provider, health worker, or health establishment shall not refuse any person emergency medical treatment for any reason whatsoever,” the proposed amendment states.

“All healthcare workers involved in the provision of emergency medical care shall be required to undergo training and obtain certification in emergency care competencies as a condition for participating in the delivery of emergency medical services.

“The Medical and Dental Council of Nigeria and the Nursing and Midwifery Council of Nigeria shall jointly develop and maintain a standardized national emergency care curriculum, and all healthcare workers involved in the provision of emergency medical care shall be required to undergo such training and certification at intervals not exceeding eighteen (18) months.”

Leading the debate on the bill, Yar’Adua said the legislation would establish clear obligations for healthcare facilities and personnel attending to patients in critical conditions.

Under the proposed amendment, all public and private healthcare facilities licensed to provide emergency medical services would be required to commence triage and initial assessment within 15 minutes of a patient’s arrival at the emergency department.

Where a licensed medical doctor is unavailable, a trained and certified nurse may conduct the initial assessment.

The bill also requires healthcare facilities to initiate basic stabilisation measures, including oxygen therapy, intravenous fluids, pain relief and preliminary diagnostic procedures, within 30 minutes of a patient’s arrival.

It further provides that life-saving interventions, including cardiopulmonary resuscitation, airway management and bleeding control, must commence immediately after a life-threatening condition is identified.

ADMISSION AND REFERRAL TIMELINES

On hospital admission, the proposed amendment stipulates that where a licensed medical officer determines that a patient requires admission, a hospital bed should be assigned within two hours of arrival, provided bed space is available.

Where a facility has no available bed space, it would be required to commence basic resuscitation and stabilisation immediately while initiating arrangements to transfer the patient to another healthcare facility.

The referral process must commence within two hours of arrival or as soon as the patient has been clinically assessed and deemed stable for transfer, whichever comes first.

The bill further proposes that the transfer process be completed within three hours of the patient’s arrival, except where external circumstances, including transportation difficulties, insecurity or natural conditions, make compliance impossible.

To reduce delays during referrals, healthcare facilities would also be required to commence ambulance dispatch or secure alternative transportation within 30 minutes of communicating the decision to refer a patient.

The proposed amendment provides protection for healthcare practitioners who are unable to meet the prescribed requirements because of resource constraints, provided they document the circumstances, comply with the referral protocols and report the incident to hospital management or the appropriate authority.

The bill was referred to the relevant senate committee for further legislative work and is expected to be considered within four weeks.

BACK STORY

Nigeria’s existing legal framework already prohibits hospitals and healthcare workers from refusing emergency medical treatment.

Section 20 of the National Health Act, 2014, provides that a healthcare provider, health worker or health establishment shall not refuse a person emergency medical treatment for any reason. The law prescribes a fine of N100,000 or imprisonment for up to six months, or both, for offenders.

The proposed amendment seeks to strengthen the existing provision by introducing specific timelines for emergency assessment, stabilisation, admission and referral, increasing the maximum fine to N300,000 and requiring periodic emergency-care training and certification for healthcare workers.