Emergency rooms are places where medical decisions cannot always wait. A patient’s condition may deteriorate within minutes, requiring doctors to assess, diagnose and initiate treatment with little room for hesitation. Yet, the ability to respond to such emergencies depends not only on the competence of the medical personnel, but also on the resources available to them.
A man battling a long-standing bleeding ulcer was rushed to the Accident and Emergency Unit of the Federal Teaching Hospital, Lokoja, in May 2024, after he began vomiting blood. His condition required urgent medical attention, but the hospital reportedly lacked some of the essential supplies needed to stabilize him. According to an investigation by PUNCH Healthwise, the facility had no intravenous omeprazole, a medication used in managing the condition, and no blood available in its blood bank.
Despite efforts by the medical team to attend to him, the patient’s condition reportedly deteriorated. A doctor involved in his treatment, identified only as Rasheed, told the newspaper that the team attempted to stabilize him but was constrained by the unavailability of critical medical supplies. The patient eventually died, leaving behind a troubling account of the difficulties that can arise when medical emergencies meet hospitals struggling with basic resources.
His experience reflects a broader concern about emergency healthcare delivery in Nigeria, where patients and their relatives often arrive at hospitals expecting immediate attention, only to encounter challenges involving inadequate equipment, shortages of essential drugs, insufficient personnel and other limitations.
Nigerian doctors working in underfunded public hospitals encounter this challenge which is particularly significant. Inadequate equipment, shortages of essential supplies, insufficient staffing and unreliable electricity are among the difficulties that can complicate emergency treatment. The responsibility to save lives rests heavily on medical professionals, but their ability to respond effectively is also dependent on the capacity of the hospitals where they work.
It is against this backdrop that a proposed amendment to the National Health Act has generated controversy within Nigeria’s medical community. The bill, which has passed second reading in the Senate, seeks to require hospitals to assess emergency patients within 15 minutes and commence stabilization within 30 minutes, with violations attracting a six-month jail term or a ₦300,000 fine.
However, the Nigerian Association of Resident Doctors (NARD) has rejected the proposed penalties, arguing that doctors are being held responsible for systemic failures arising from inadequate funding, obsolete equipment, staff shortages, unreliable electricity and shortages of basic medical supplies. The association maintains that imposing criminal sanctions without addressing these challenges risks placing an additional burden on healthcare professionals already working under difficult conditions.
Nigeria’s obligation to provide emergency medical treatment is not new. The National Health Act, 2014, already prohibits healthcare providers, workers and establishments from refusing emergency treatment. Under Section 20, violators face a fine of ₦100,000, imprisonment for up to six months, or both.
The proposed amendment seeks to strengthen this provision by setting clearer timelines for emergency care, including patient assessment within 15 minutes and stabilisation within 30 minutes. It also proposes increasing the maximum fine to ₦300,000 and introducing periodic emergency-care training and certification for healthcare workers.
These stricter requirements, particularly the prospect of criminal sanctions, have drawn opposition from NARD. While the association supports timely emergency care, it argues that doctors should not face imprisonment for delays beyond their control, especially in hospitals lacking adequate personnel, equipment and essential medicines
At the centre of the debate is the need to protect patients from avoidable delays while recognising the challenges healthcare workers face within an under-resourced system. Yet, for patients arriving at hospitals in critical conditions, the immediate concern is not where the failure lies, but whether they receive the care they urgently need. Every delay can have serious consequences, making access to timely emergency treatment a matter of life and death.
NARD’s reported threat of a nationwide strike is equally troubling. Although doctors have legitimate reasons to demand better working conditions, withdrawing their services could further limit access to care for patients already struggling with shortages and delays.
The effectiveness of the proposed amendment will depend not only on enforcing professional accountability but also on addressing the conditions within which emergency care is delivered. Adequate staffing, equipment, essential medicines and institutional support remain critical to meeting the proposed timelines. Without these provisions, enforcing stricter penalties may do little to resolve the systemic challenges affecting emergency care.
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