Dr Paul John, firstname.lastname@example.org,08083658038
Dear Minister of Health,
Do not arrogate to yourself, the powers you do not have. Neither the Federal Executive Council nor the Federal Ministry of Health,represented by the Honourable Minister of Health, has such power as to ban private practice by doctors in public service .Such power is vested in the National Assembly according to S4(1) of the Constitution of the Federal Republic Of Nigeria (CFRN) as amended, and there is an existing law regulating private practice by medical doctors in public service . Why is it that our leaders always take actions that will be subject of litigation and the end of such litigation will ridicule their offices? Why can’t our leaders learn from the past? One of the reasons Governor Wike won his opponent(s) at the Supreme court was that his opponents based their arguments on the Electoral guideline( which is a mere executive pronouncement) whereas Governor Wike and his lawyers based their arguments on the Electoral law ( which is an Act of the parliament). The Executive has no right to either ban or modify an existing law without passing through the Legislative arm of the government as earlier cited .
In law, the issue of jurisdiction or power/authority takes preeminence over other matters because the decision or judgement that emanates from a court/panel/tribunal/group/person et cetera ,that does not have the jurisdictional power/authority over the matter is null,void and of no effect. Neither the Minister of Health nor the Federal Executive Council can usurp the statutory functions of the legislation.Does the Minister of Health have the constitutional right or power to alter any law enacted by the parliament? Meanwhile, S4(5) of the CFRN goes further to state the Supremacy of the laws made by the National Assembly over laws made by the State House of Assembly(another legislative arm ) ,not to talk of a mere pronouncement of a minister.
Dear Minister,let me start by drawing your attention to the fact that Nigerian medical doctors have fundamental rights and as we shall see later in this discourse,and there is an already existing rule by MDCN, regulating the private practice by doctors in full time government employment.Medical and Dental Council of Nigeria( MDCN ) was established by an Act of the National Assembly,which has the statutory power to make laws for the federation. Meanwhile, S.2 of the Medical & Dental Practitioners Act( MDPA) empowers MDCN to as follows:
The Council shall have responsibility for :-
(a) determining the standards of knowledge and skill to be attained by persons
seeking to become members of the medical or dental profession and reviewing
those standards from time to time as circumstances may permit;
(b) Securing in accordance with the provisions of this Act, the establishment and
maintenance of registers of persons entitled to practice as members of the
medical or dental profession and the publication from time to time of lists of
(c) Reviewing and preparing from time to time, a statement as to the code of
conduct which the Council considers desirable for the practice of the professions
(d) supervising and controlling the practice of homeopathy and other forms of
(e) making regulations for the operation of clinical laboratory practical in the field
of Pathology which includes Histoopathology, Forensic Pathology, Autopsy and
Cytology, Clinical Cytogenetics, Haematology, Medical Micro-biology and
Medical Parasitology, Chemical Pathology, Clinical Chemistry, Immunology and
Medical Virology, and
(f) performing the other functions conferred on the Council by this Act.
In view of this ,MDCN has established set of rules,called the Codes of Medical Ethics, for the practice of Medicine and Dentistry in Nigeria.It may interest you to know that Rule 49 of the Code of Medical Ethics in Nigeria 2008 edition states that:
49(1): Medical and Dental practitioners who are in full time employment in the public service in Nigeria are free to employ their spare time and unofficial hours to engage in medical or dental practice for remuneration as follows:
a. A registered practitioner in full time employment in the public service shall not engage himself in extra-mural private practice during official duty time under any circumstances.
b. A registered practitioner who holds the appointment of Consultant status or a medical or dental officer of more than Ten years
post-registration experience may run one private consulting clinic which will open for business only during periods when he is not on
c. A Consultant or registered practitioner of similar status in (b) above shall offer in-hospital care to his private patients only within the
public hospital he is in full employment. It is unethical for a registered practitioner in full employment in the public service to give in-hospital care, that is investigatory, admission and institutional care to patients outside the hospital in which he is in full time employment.
d. A registered practitioner of more than ten years post-registration who is in full time employment in the public service but is not engaged in clinical responsibilities in the public hospital may engage, outside the official duty hours, in clinical practice in an institution owned and run by full time private practitioners or hold consultations only in his own consulting clinic.
e. It is unethical for a registered practitioner engaged in a public health institution to demand and/or receive money from hospital patients under any guise whatsoever, either before or in the course of attending such patients.”
In view of this ,it is clear, dear Honourable Minister, that neither you nor the Federal Executive Council has the right to dictate to medical doctors in public service what they will do with their spare/unofficial time as they are citizens with inalienable rights to Dignity; Personal Liberty;Private and Family life;Freedom of Conscience ;and Freedom of Movement as contained in sections 34,35 ,37,38 and 41 of the CFRN respectively . I am aware that each Federal Ministry has a legal unit that is only consulted when there is a pending litigation and you leaders cannot consult your legal units before making ambiguous statements like this current ban on private practice by doctors in public service.
The National Assembly is the statutory body that can enact new laws or amend existing ones
Also, for the non-consultants fully employed by the government, I will refer you to Rule 49(2) of the same Code of Medical Ethics in Nigeria.
49(2): Private Practice by Non-Consultant Registered Practitioners who are in Full Time Employment in the Public Service :
A medical or dental practitioner who does not have the status of a Consultant may engage in private practice outside his official hours in an institution owned and managed by a full time private practitioner. It is unethical for a registered practitioner who is not a consultant or less than ten years post-registration and who is in the public service to own and run any private medical or dental facility.
The Medical and Dental Council of Nigeria hereby directs registered practitioners who are Chief Medical Directors, Medical Directors or Medical Superintendent in charge of public health institutions to provide facilities, programmes and systems in hospitals they administer, to enable practitioners engage in intra-mural private practice.
It is hoped that this measure will significantly curb the penchant for extra-mural private practice by practitioners during official hours.
Dear Minister, let us assume that the figment of your imagination or that of the Federal Executive Council to control what medical doctors in public service do with their unofficial/spare time is real, why did you not convince the Federal Executive Council to ban pharmacists, Medical laboratory scientists, physiotherapists, nurses and other members of JOHESU in public service from private practice? Are they sacred cows and untouchable? When National Association of Resident Doctors (NARD) went on nationwide strike, we all witnessed the roles your ministry played but when JOHESU went on a similar strike, almost all,if not all, their demands were approved. Are you aware that many consultants do not have private offices in our hospitals? Are you also aware there are no rooms for many consultants in our hospitals to rest while at work ,and that negates the caveat attached to Rule 49 of the Codes of Medical Ethics cited supra ,which states that: The Medical and Dental Council of Nigeria hereby directs registered practitioners who are Chief Medical Directors, Medical Directors or Medical Superintendent in charge of public health institutions to provide facilities, programmes and systems in hospitals they administer, to enable practitioners engage in intra-mural private practice.?
Are you aware that many so-called tertiary hospitals cannot boast of 8 hours power supply in a day? It may interest you to know that many of these doctors are still being paid peanuts as salaries and to worsen the whole situation, many of them are owed for several months? I hope your ministry will convince the Federal Executive Council to ban governors and hospitals that owe medical doctors their monthly salaries and arrears? Do I need to reiterate the poor and dilapidated states of our facilities in the so-called public health institutions? I thank God that wife of the president has started that by telling us that that there is no single syringe in Aso Rock clinic and that the X-ray machine there is not functioning ,if such could happen to a hospital closest to,and on the doorstep of Mr President, with such mind-boggling annual budget, then one can only imagine the states of our public hospitals very far from Mr president .
The Minister of Health,Prof Isaac F. Adewole
I hope your ministry is aware of the false health information being disseminated to Nigerian public by the herbal practitioners? Is there any ban that is imminent for such practice? Which directorate in your ministry supervises the information herbal practitioners disseminate to unsuspecting members of the Nigerian public? These herbal practitioners are there to tell Nigerians that every ailment is caused by Staph (Staphylococcus) and when staph stays longer in the body it turns to virus. This is where your ban is needed,dear Minister, at least to save Nigerians from noise pollution and false health information and not issuing a ban that contravenes an existing law.
Minister of state for Health,Dr Osagie
I want to state in an unequivocal term that neither your Federal Ministry of Health nor the Federal Executive Council has the statutory right to dictate to medical practitioners in public service what they will do with their spare/unofficial hours and any attempt to undermine the existing law will lead to litigation.
I am not oblivious of the fact that the minister has some control over MDCN as contained in S.4 of the MDPA which states as thus :
(1) The Minister may give to the Council directions of a general character or
relating generally to particular matters (but not to any individual persons or
case) with regard to the exercise by the Council of its functions under this Act
and it shall be the duty of the Council to comply with the directions.
(2) Before giving a direction under subsection (1) of this section, the Minister
shall serve a copy of the proposed direction on the Council and shall afford the
Council an opportunity of making representations to him with respect to the
(3) The Minister may, after considering any representations made to him in
pursuance of subsection (2) of this section, give the direction either without
modifications or with such modifications as appear to him to be appropriate having regard to the representations.
I am also aware of the president’s power to annul any rule(s) made by the Council as S.19 of the MDPA states that :
1) Any power to make Regulations, Rules or Orders conferred by this Act shall
include the power to—
(a) make provision for such incidental and supplementary matters as the authority
making the instrument considers expedient for the purposes of the instrument;
(b) make different provisions for different circumstances.
(2) The Minister shall submit a copy of all regulations make by the Council before
the President as soon as may be after the regulations are made, and if the
President decides that the regulations be annulled, they shall, without prejudice
to anything previously done in pursuance of the regulations, cease to have effect
on the day next following the date of the decision.
I may not end this piece without alluding to the fact that Executive powers of the federation are vested in the President of the Federal Republic of Nigeria and these Executive powers may be exercised by him either directly or through the vice-president and the ministers of the government of the federation or officers in the public service of the federation as contained in S.5(1a) of the CFRN .
However,as earlier stated,Nigerian doctors are also Nigerian citizens with fundamental Human Rights , the minister cannot dictate to them what they will do during their unofficial hours and any attempt to undermine the existing law or to infringe on the Fundamental Human Rights of medical doctors in the Public service will end in the law-courts.