By Lemmy Ughegbe, Ph.D
Few things indict a health system more than a critically ill patient turned away from hospital. Not because medicine has run out of options, but because paperwork, payment or indifference has been placed above a human life.
In that moment between survival and death, the worth of government and the meaning of citizenship face their harshest test.
The National Assembly’s latest attempt to strengthen Nigeria’s emergency treatment laws is therefore both welcome and troubling. Welcome, because it treats avoidable deaths from delayed care as unacceptable. Troubling, because more than a decade after Nigeria outlawed the refusal of emergency treatment, lawmakers are still struggling to enforce a right that should never have been negotiable.
Section 20 of the National Health Act 2014 forbids healthcare providers, health workers and health establishments from refusing emergency medical treatment. Offenders face up to six months’ imprisonment, a ₦100,000 fine or both. Yet complaints of patients being denied care persist. A legal prohibition has not guaranteed enforcement.
On 4 November 2026, the Senate and House of Representatives advanced amendments to address this failure. The Senate bill, sponsored by Senator Abdulaziz Yar’Adua, sets mandatory timelines for assessing, stabilising and referring emergency patients. Hospitals would begin initial assessment within 15 minutes and basic stabilisation within 30, with immediate intervention for life-threatening conditions. Specified violations would attract up to ₦300,000 or six months’ imprisonment.
A related House bill, sponsored by Akin Rotimi, contemplates further sanctions, including suspension or withdrawal of operating licences and compensation where unlawful refusal or delay causes injury or death.
These proposals are not yet law. They have nonetheless opened an important debate about the duties of health professionals and the obligations of government.
The Nigerian Association of Resident Doctors has rejected what it sees as an excessively punitive approach. It warns that doctors should not be criminalised for failures caused by inadequate staffing, obsolete equipment, unreliable electricity and chronic underfunding.
That objection deserves a hearing. Doctors should not be immune from accountability, but responsibility must follow the real causes of failure.
A doctor cannot administer oxygen that is unavailable. A nurse cannot create an intensive care bed that does not exist. A surgeon cannot operate without equipment, staff and power. Punishing health workers for such conditions would confuse government neglect with professional misconduct.
But that argument must not become a cover for indifference.
A hospital genuinely unable to provide specialised care is different from one that refuses even to assess or stabilise a dying patient until payment is made. A necessary referral is different from abandonment. The law must recognise these distinctions and punish in proportion to the wrong.
Consider an accident victim brought in unconscious. He cannot negotiate payment, produce identification or explain his injuries. Every minute lost to administrative demands may reduce his chances of survival. A system that puts bureaucracy before clinical assessment has inverted the purpose of a hospital.
Yet the answer cannot lie in threats of imprisonment alone. Emergency care requires infrastructure, financing, competence and coordinated response systems. An ambulance that does not exist cannot carry a patient. A referral hospital without capacity cannot deliver what the law promises.
The proposed timelines are useful benchmarks, but they need practical arrangements that make compliance possible. Otherwise, the National Assembly risks producing another impressive law that collapses under institutional incapacity.
Government must also answer for its own priorities. Why should citizens endure inadequate hospitals while public officials enjoy medical care beyond the reach of ordinary Nigerians? Why should the political class demand international standards without providing the resources to meet them?
These questions grow more urgent as doctors and nurses leave Nigeria for better conditions abroad. The country cannot afford legislation that accelerates that exodus. Equally, professional associations must accept that public confidence depends on a visible commitment to patient welfare and accountability.
The right response is to strengthen the amendments, not abandon them.
Deliberate refusal, abandonment and reckless disregard for emergency patients should carry meaningful consequences. Health workers acting responsibly within documented resource limits should be protected.
Hospitals should maintain clear emergency protocols, document referrals and report serious incidents. Regulators should investigate complaints promptly and publish enforcement data. Government should set minimum standards for emergency facilities, backed by funding, inspection and independent oversight.
Financing matters too. If hospitals must stabilise patients without advance payment, a working reimbursement scheme must ensure that compliance does not bankrupt emergency departments. Government cannot pass the burden of preserving life entirely to individual hospitals while retreating from its own obligations.
Emergency care is not simply a matter of professional discipline. It is a test of governance. No citizen arriving at a hospital in distress should have to wonder whether it has the capacity, compassion or will to respond.
A country that can legislate penalties for delayed treatment must also show the political will to remove the conditions that make delay inevitable.
The right to emergency care already exists in Nigerian law. What remains uncertain is whether it can be exercised when life hangs in the balance.
This reform will not be measured by how many doctors government threatens to imprison. It will be measured by how many Nigerians are saved because hospitals are equipped, professionals are accountable and emergency treatment is finally treated as a duty, not a favour.
Dr Lemmy Ughegbe, FIMC, CMC
Email: lemmyughegbeofficial@gmail.com
WhatsApp ONLY: +2348069716645
