Some Acts of the National Assembly can be very long indeed, see the Companies and Allied Matters Act. Some other Acts can also be very short, comprising just one, two or three sections only. The federal Teaching Hospital Acts are among the short Acts, most of them comprising just three sections only.
The long title of an Act summarizes the purpose of the Act. The provisions of the Act proper, then expands this summary contained in the long title.
Teaching Hospitals are created for a purpose, and we shall soon see that purpose infra. However, the recent clamour by some groups of non-medically qualified persons to commence postgraduate hospital training, which they also called residency training, in our Teaching Hospitals, appear to be ill-advised as it is illegal. Things are not done that way in a society regulated by laws. Thus, if an institution is established for the training of accountants, for instance, it would be unthinkable to start pushing and demonstrating for the training of lawyers there, unless the law establishing that institution is first and foremost modified and altered to accommodate the new area of study.
I shall now lay down the characteristic three sections of the Teaching Hospital Acts (shortened as Hospital Act later) thus:
LAGOS UNIVERSITY TEACHING HOSPITAL ACT
An Act to provide for the establishment of a teaching hospital for the University of Lagos and of a management board for the hospital.
[1961 No. 70.] [28th December, 1961] [Commencement.]
1. Short title:This Act may be cited as the Lagos University Teaching Hospital Act.
2. Establishment of the Hospital and the Management Board
(1) There shall be established in Lagos a teaching hospital, to be known as the Lagos University Teaching Hospital, for the purpose of providing such facilities for the training of medical students as are usually provided by teaching hospitals of internationally high repute.
(2) There shall be established a board of management for the hospital, which shall be a body corporate by the name of the Lagos University Teaching Hospital Management Board.
3. Composition, functions, etc., of Board
The composition, functions and powers of the Board established under subsection (2) of section 2 shall be as provided for in the University Teaching Hospitals (Reconstruction of Boards, etc.) Act. [Cap. U15.]
These provisions are in pari material with the provisions of the numerous other Teaching Hospitals Acts. University of Nigeria Teaching Hospital Act was enacted in 1976.
Having highlighted the only training purpose of a Federal Teaching Hospital as enacted into law, which is for the training of medical students, it is now necessary to construct the meaning of medical students. It is also important to stress the point that the training of the medical students, as provided, has to be as are usually provided by teaching hospitals of internationally high repute.
The meaning of medical students is provided for in the Teaching Hospital Management Board Act (shortened as Board Act later), at the Interpretation Section of this Act, at section 19:
“Medical student” means a student whose course of instruction is—
(a) designed (either alone or in conjunction with other courses) to enable him to qualify as a medical practitioner;
(b) designed for the further training of medical practitioners.
The import is that the purpose of establishing the Teaching Hospitals is for the training of undergraduate medical students and postgraduate and resident doctors.
The Act establishing Teaching Hospitals does not permit the postgraduate training of any other professions. One then wonders what the hullabaloo is all about.
The Teaching Hospitals do not train only medical students. The Teaching Hospital Management Board Act created another categories of students that can be trained in the Teaching Hospitals. In fact, the Board Act defines students (which also subsumes medical students) at its section 19 thus :
“Students” means a person enrolled at an institution controlled by the Board for the purpose of pursuing a course of instruction at the institution.
It will appear from this provision that the Board Act has modified the Hospital Act by including other categories or professional trainings than medical training. This is provided for in the functions of the Hospital Management Board at section 7 of the Board Act, thus:
(1) It shall be the duty of the Board—
(a) to equip, maintain and operate the hospital so as to provide facilities for diagnosis, curative, promotion and rehabilitative service in medical treatment;
(b) to construct, equip, maintain and operate such training schools and similar institutions as the Board considers necessary for providing the hospital at all times with a proper staff of hospital technicians and nurses;
(c) to construct, equip, maintain and operate such clinics, out-patient departments, laboratories, research or experimental stations and other like institutions as the Board considers necessary for the efficient functioning of the hospital.
(2) The duty of operating the hospital imposed by the foregoing subsection shall include, without prejudice to the extent of that duty apart from this subsection, the duty of providing proper courses of instruction for the medical students of the associate University, and the Board may perform the last-mentioned duty by arranging with the approval of the Minister, for students of such associate University to attend courses at other institutions not controlled by the Board.
(3) The Board shall ensure that the standards of teaching provided at all establishments controlled by itself and the standards of treatment and care provided for patients at those establishments do not fall below those usually provided by similar establishments of international repute.
(4) Subject to this Act, the Board shall have power to do anything which, in its opinion, is calculated to facilitate the carrying out of its functions under this Act.
From the foregoing, it is obvious that the additional training duty of the Teaching Hospitals has nothing to do with postgraduate training of any other professionals.
Section 7(1)(b) , which provided for training schools for nurses and technicians, specified what the purpose of such training is all about. The training schools are within the Hospital and for nurses and technicians for the sole purpose of providing the hospital at all times with a proper staff of hospital technicians and nurses.
This purpose is quite different from the modalities and purpose of training medical students, who can come from Associate University which is not within the Hospitals. Thus:
(a) While the purpose of training medical students is for the provision of doctors and specialists for Nigeria as a whole, the operation of training schools for nurses and technicians is purely for the local hospital work force needs.
(b) While the training of medical students involves an associate University, the training of nurses and technicians is a local arrangement of the Hospital Management Board.
(c) While the training of the medical students is undergraduate and postgraduate training, the training of nurses and technicians, allowed by the Board Act, does not involve a university degree program. The tone and intendment of the Board Act portrays a purely local hospital certification, with or without involvement of the associate professional bodies.
(d) While medical trainees are admitted by another institution and are combinedly trained in the Teaching Hospitals, nurses and technicians in this Act are fully and completely admitted, trained and graduated by the Hospitals.
(e) Lastly, while the number of nurses and technicians to be trained at a time can be limited to hospital needs, the number of undergraduate medical students and resident doctors that can be trained at a time is not limited by hospital needs.
The power of expansion granted the Hospital Management Board in section 16 of the Board Act is limited to medical students :
Section 16. Powers of the Board in relation to expansion, staff, etc., of the hospital
(1) The Board shall be responsible for laying down general policies and guidelines relating to major expansion programmes of the hospital and the provision of facilities for the training of medical students of the associate university and it shall be the duty of the Board to execute such policies and to keep within such guidelines.
Funny enough, the group that is so much in the vanguard to commence postgraduate residency training in the Teaching Hospitals (outside medical practitioners) is not in contemplation of the relevant Acts. There definitely needs to be enacted another Act to accommodate their ambitions and desires. But while we await this impossible new Act, let peace reign in the medical world.
©Awkadigwe Fredrick Ikenna (MBBS, LLB, MWACOG, DSC). firstname.lastname@example.org