A huge fight is brewing among health sector professionals, as the federal Government gets set to amend the nation’s key health laws through the Health Sector Executive Bills 2026. However, members of the Joint Health Sector Unions (JOHESU) and the Assembly of Healthcare Professional Associations (AHPA), and other health sector associations are up in arms, literarily; challenging some aspects of the reforms; particularly those that seek to streamline governance across health institutions. They fear that any restructuring that sidelines key professional groups risks creating friction, which could translate to inefficient health care delivery. CHINYERE OKOROAFOR reports.
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A major crisis is brewing in Nigeria’s health sector. At the centre of the crisis are the 24 Health Sector Executive Bills, 2026, proposed by the President Bola Ahmed Tinubu-led administration aimed at amending the nation’s key health laws and ushering a regime of improved efficiency and quality health care delivery to Nigerians.
But the Bills, which the President has transmitted to the National Assembly, have been met with a groundswell of opposition by some frontline health workers, who are arguing that certain aspects of the reforms could destabilise Nigeria’s already fragile health system.
In pushing the proposed amendments to the nation’s health laws, the administration argued that the reforms are necessary to streamline governance across federal health institutions, particularly by reducing what it described as “oversized” boards.
The goal, according to the presidency, is to improve efficiency, decision-making, and service delivery across major health institutions, regulatory bodies, and professional councils that form the backbone of the healthcare delivery system.
Among those affected are agencies such as the National Agency for Food, Drug Administration and Control, the Medical Laboratory Science Council of Nigeria, and the Nursing and Midwifery Council of Nigeria, as well as several tertiary and specialist hospitals.
The inclusion of new proposals like the Records Officers Registration and Digital Health Bill 2025 and the Federal College of Complementary and Alternative Medicine Bill 2025 further signals an attempt to modernise and expand the health sector’s regulatory space.
The Bills, according to government sources, followed a comprehensive legal and institutional review led by the Attorney-General of the Federation in collaboration with the Ministry of Health, and subsequently endorsed by the Federal Executive Council (FEC).
With these, President Tinubu expressed confidence that lawmakers will give the bills “careful and judicious consideration.” At the National Assembly, the Bills moved swiftly through the early stages. Senate President Godswill Akpabio referred the proposals to the Senate Committee on Rules and Business, while several of them have already passed first reading in the House of Representatives.
Events outside the chambers of the legislature, however, tell a not so smooth story. A stiff resistance mounted by health workers under the Joint Health Sector Unions (JOHESU) and the Assembly of Healthcare Professional Associations (AHPA) stand as indication that the Bills were not well received.
The health workers’ open rejection of the Bills even culminated in a protest at Abuja’s Unity Fountain on March 26. While the government framed the reforms as administrative, the aggrieved health workers fear that the restructuring could alter the power dynamics within the health sector.
According to them, the restructuring could weaken professional representation and ultimately affect how care is delivered. They argued, for instance, that healthcare delivery is not just about infrastructure or governance boards; that it is heavily dependent on coordination among professionals; hence any attempt to sideline key groups risks creating friction, which could translate into inefficiencies at the point of care.
The protest by health workers, according to some critical stakeholders in the health sector, is not just a reaction, it is a signal. It reflects a trust deficit between policymakers and practitioners, and raises a critical question: Can structural reforms succeed without the buy-in of those who operate the system daily?
Health workers’ grievances
At the heart of the growing resistance to the Health Sector Executive Bills lies a fundamental question: who should control and regulate Nigeria’s healthcare system? JOHESU and AHPA views the intention behind this legislative proposal as the inordinate ambition of the Nigeria Medical and Dental Council of Nigeria (MDCN) and medical practitioners in Nigeria in their alleged usual antics to impose an inglorious apartheid regime of regulatory control and practice in the Nigerian health sector.
While government officials insist the reforms are designed to improve coordination and efficiency, health workers across multiple professions, including laboratory scientists, nurses, pharmacists, and radiographers, see a different picture. To them, the proposals signal a gradual shift toward doctor-led dominance, potentially sidelining other critical players in the healthcare delivery chain.
This concern is strongly echoed by the National Chairman of JOHESU, Kabiru Ado Minjibir, who framed the dispute as one that goes beyond labour interests. “This protest is not just about our jobs,” he said, pointing out, “It is about the structure of Nigeria’s healthcare system.
“The bills could allow doctors to dominate, push other professionals aside, put patients at risk and affect welfare structures built over the years. So, the fight is to protect our independence and ensure balanced healthcare delivery.”
Central to these fears is a controversial provision that could place multiple health professions under the regulatory authority of the MDCN. Health workers argue that such an arrangement would effectively weaken existing regulatory institutions, many of which were established to ensure professional standards, accountability, and specialised oversight.
For professionals under bodies like the Association of Medical Laboratory Scientists of Nigeria, the implications are profound. They warn that collapsing diverse regulatory frameworks into a more centralised structure risks “eroding the independence” of councils governing laboratory science, nursing, pharmacy, and other allied health fields.
The President of the Association of Medical Laboratory Scientists of Nigeria (AMLSN), Dr. Casmir Ifeanyi, was emphatic in rejecting what he described as a flawed approach to professional regulation. Drawing parallels with other sectors, he questioned the logic of cross-professional control.
“Have you ever heard that a Professor of English is a member of the Council for Legal Education? Certainly no,” he said, adding, “Professional regulation globally is profession-led. You cannot regulate what you do not understand.”
He argued that the proposed structure deviates from international best practices, where regulatory bodies are largely driven by practitioners within the field, with limited external representation to safeguard public interest.
According to Dr. Ifeanyi, introducing a majority of non-professionals, or individuals outside a specific discipline, into regulatory boards undermines both competence and accountability.
“A situation where in a 14 to 16-man board, eight or nine are not medical laboratory scientists, what regulation are they coming to do?” he queried.
“Where did we import the term ‘community interest’? Globally, what is recognised is ‘public interest,’ and even that does not override professional expertise.” Beyond governance concerns, Ifeanyi warned that the reforms could have direct consequences for patient care.
He alleged that certain provisions of the bill appear to reassign specialised laboratory responsibilities to medical doctors, roles he insists they are neither trained nor licensed to perform.
“Doctors are not trained to perform testing. It is not their duty anywhere in the world. If you assign responsibilities to people who do not have the knowledge, skill, and competence, patients will pay the price,” Ifeanyi said.
He cautioned further: “The day you strip any healthcare system of independent regulation, you have primed that system for failure.” He cited Nigeria’s poor global health indices as evidence that the system requires strengthening, not further disruption.
While acknowledging that President Tinubu may have acted with good intentions, Ifeanyi suggested that the reform process may have been influenced by narrow professional interests.
“We know the President means well for Nigeria,” he said. “But what was presented as reform is, in reality, a restructuring that could populate regulatory boards with political interests and undermine professional balance.”
For many health workers, the stakes go beyond institutional control. They warn that if the bills are passed in their current form, the consequences could include increased medical errors, weakened accountability, and rising mortality rates. “We are crying for Nigerians,” Ifeanyi said, adding, “Lives will be lost if this bill becomes law.”
Radiographers share similar concerns. The President of the Association of Radiographers,
Dr. Musa Dembele called the bill a serious threat. “It is aimed at dismantling our profession and placing us under a council that lacks expertise in our field,” he said.
Nurses and pharmacists also fear loss of independence and possible changes to their welfare structures.
Legal tensions
Beyond protests and policy disagreements, health workers say the controversy surrounding the reform bills is also rooted in law, long-standing professional rivalry, and unresolved institutional conflicts within the system.
According to JOHESU and AHPA, Nigeria’s courts have consistently upheld the autonomy of healthcare professions, warning against the dominance of one group over others. They point in particular to a 2016 judgment of the National Industrial Court, which affirmed that no profession should encroach on the statutory functions of another.
For health workers, this legal precedent is central to their resistance. They argue that the current reform proposals risk contradicting established judicial decisions and could plunge the sector into fresh legal uncertainty.
At the core of their argument is the nature of healthcare itself. The sector, they insist, is inherently multi-professional and interdependent, relying on collaboration among doctors, laboratory scientists, nurses, pharmacists, and other specialists.
Each profession, they note, operates within clearly defined legal and regulatory frameworks designed to protect patients and ensure adherence to professional standards. Any attempt to weaken these boundaries, they warn, could destabilise the system.
But beyond theory, the unions allege that tensions between medical doctors and other health professionals are not new. They accuse some practitioners under the MDCN of historically undermining the regulatory authority of other professional bodies.
They claim that over the years, there have been repeated instances where inspection teams from agencies such as the MDCN and the Nursing and Midwifery Council of Nigeria were resisted or obstructed from carrying out statutory oversight functions in hospitals and clinics.
These disputes have frequently ended up in court, where, according to the unions, judgments have largely reaffirmed the independence and legal authority of each professional regulatory body.
One such case frequently cited is the 2016 ruling involving the Association of Medical Laboratory Scientists of Nigeria (AMLSN) and the Obafemi Awolowo University Teaching Hospitals Complex, where the court held that laboratory scientists “cannot be discriminated against in their areas of competence” and are entitled to lead and regulate their own profession.
Despite these rulings, JOHESU and AHPA allege that attempts to centralise control have persisted. They point to a 2018 suit filed by the Medical and Dental Consultants Association of Nigeria, which sought to establish the MDCN as the sole regulatory authority over clinical and allied health practices.
The case was eventually struck out for lack of evidence, yet, unions argue, the current bills appear to be pursuing similar objectives through legislative means. “They are seeking through legislation what they failed to achieve in court,” a JOHESU source said, warning that such an approach could undermine the rule of law.
There is also concern about legislative procedure. Health workers argue that some of the issues addressed in the proposed amendments are still subjects of ongoing litigation, raising questions about whether the National Assembly can validly legislate on matters pending before the courts.
For the unions, this is not just a technical issue but a constitutional one. They caution that proceeding with the Bills under such circumstances could violate parliamentary rules and weaken public confidence in the legislative process.
The Medical Laboratory Council Bill
A closer examination of the proposed amendment to the Medical Laboratory Science Council of Nigeria (section HB2701) reveals a reform that, while presented as administrative restructuring, carries far-reaching implications for power, professionalism, and patient care within Nigeria’s health system.
At first glance, the Bill seeks to “reduce the size of the governing board, restructure its membership and enhance professionalism.” But beneath this objective lies a fundamental shift in how authority is distributed within the laboratory science profession.
One of the most immediate changes is the reduction in the size of the Council’s governing board. In governance terms, smaller boards are often associated with efficiency, faster decision-making, less bureaucracy, and clearer lines of responsibility.
However, this efficiency may come at a cost. Fewer members can also mean reduced representation, particularly in a sector where diverse professional voices are critical to balanced decision-making.
The composition of the new board further deepens this concern. While it retains key professional stakeholders, such as representatives from the Ministry of Health, academia, and practising laboratory scientists, it also introduces six members representing “community interests,” a category that remains loosely defined. This ambiguity raises a critical question: who truly represents the profession in its highest decision-making body?
Perhaps more consequential is the provision that vests the power of appointment in the hands of the President, acting on the recommendation of the Minister of Health.
In practical terms, this centralises control over the Council’s leadership within the executive arm of government.
While this may enhance policy alignment, it also raises concerns about independence. A board whose members are politically appointed may, critics argue, feel a greater sense of loyalty to the appointing authority than to the profession it regulates. Over time, this could influence decisions, priorities, and even regulatory enforcement.
However, not all elements of the Bill are contentious. In fact, one of its most progressive aspects is the expanded definition of medical laboratory science. By formally recognising fields such as microbiology, molecular biology, virology, immunology, and forensic science, the Bill aligns the profession with modern scientific realities.
This update reflects the evolving nature of diagnostics in contemporary medicine and positions Nigerian laboratory science within a global context. In this respect, the amendment signals a forward-looking attempt to modernise the profession.
Yet, the most debated provision lies in the clear limitation placed on the role of laboratory scientists. The Bill explicitly states that medical laboratory scientists cannot make diagnoses or determine treatment. Their role is confined to conducting tests and producing results.
This effectively draws a rigid boundary between laboratory scientists and medical doctors, with diagnostic authority resting solely under the purview of bodies like the Medical and Dental Council of Nigeria. While this clarification may reduce role conflicts on paper, it also risks diminishing the professional autonomy of laboratory scientists, many of whom argue that their expertise extends beyond mere testing.
Taken together, the provisions of the Bill establish a new hierarchy within Nigeria’s health system, one in which the government exercises stronger control over regulatory leadership, while the Medical Laboratory Science Council of Nigeria retains oversight of laboratory practice.
Within this structure, laboratory scientists are largely confined to technical functions, conducting tests and producing results, while doctors, under bodies such as the Medical and Dental Council of Nigeria, maintain exclusive authority over diagnosis and treatment decisions.
Far from being a routine administrative adjustment, this restructuring fundamentally reshapes professional relationships and shifts decision-making power across the sector. Ultimately, the amendment presents a mixed picture. On one hand, it introduces structural efficiency and modernises the scope of laboratory science.
On the other, it raises legitimate concerns about reduced professional independence and increased political influence. The central issue, therefore, is not whether reform is necessary, but whether this particular reform strikes the right balance between efficiency, autonomy, and patient safety.
Reform supporters cite accountability
The proposed reforms have also received backing from the Nigerian Medical Association (NMA), highlighting a deep divide within the sector over what constitutes effective regulation.
Chairman of the NMA in Lagos, Dr. Saheed Babajide Kehinde, argued that strengthening the MDCN is essential to addressing persistent gaps in oversight, particularly in cases of medical negligence and professional discipline. “Without a fully functioning council, cases remain unresolved and patient safety is affected. This is about protecting lives,” he said.
From the perspective of medical doctors, the reforms are less about dominance and more about coordination. The NMA maintains that a stronger, more centralised regulatory framework could help streamline disciplinary processes, reduce unsafe practices, and improve overall standards of care.
They also point to existing delays in handling misconduct cases, which they attribute to structural weaknesses within the current system. For them, reform represents an opportunity to close these gaps and enhance accountability across the sector.
However, this position sharply contrasts with that of unions such as JOHESU and AHPA, which argue that centralisation does not necessarily translate to efficiency. Instead, they warn it could erode professional independence and weaken the checks and balances provided by multiple regulatory bodies.
Global standards vs Nigeria’s reality
Beyond the immediate protests, Nigeria’s unfolding health sector crisis also raises a broader question; how do modern healthcare systems manage professional roles, power, and regulation?
A comparative look at countries such as the United Kingdom, United States, Canada, and Australia reveals a consistent pattern: no single profession dominates the healthcare system.
Across these countries, healthcare delivery is built on clearly defined professional boundaries, where doctors, nurses, pharmacists, and laboratory scientists operate within legally protected scopes of practice. These roles are not determined by hierarchy or influence, but by training, competence, and regulatory approval.
Equally significant is the structure of regulation. Each profession is overseen by independent regulatory bodies, ensuring that no group exercises control over another.
In the UK, for instance, doctors are regulated by the General Medical Council, while nurses fall under the Nursing and Midwifery Council, and laboratory scientists are regulated by the Health and Care Professions Council. None of these bodies is subordinate to the other.
The same principle applies in the United States and Canada, where strong “scope of practice” laws clearly define what each professional can and cannot do. In Canada, for example, each province operates a system of “controlled autonomy,” where professional colleges regulate their members independently, with minimal political interference.
Even in Australia, where regulation is centralised under a national framework, each profession still maintains its own board and authority, reinforcing the idea that healthcare is collaborative, not hierarchical.
This global model also extends to labour rights. Health workers in these countries are allowed to protest or embark on industrial action, but within strict frameworks that protect patient care. Essential services are maintained; ensuring that while workers’ rights are respected, public safety is not compromised.
For analysts, these patterns offer critical context for understanding the current resistance in Nigeria. Health unions argue that if the proposed reforms are perceived to expand the authority of one profession over others, or blur established professional boundaries, then opposition is not only expected, it is consistent with global best practices.
“Modern health systems are not built on dominance,” a health policy analyst noted, pointing out that “They are built on autonomy, collaboration, and clearly defined roles. Once that balance is threatened, the entire system becomes unstable.”
This comparison places Nigeria’s debate in sharper focus. The concerns raised by health workers are not occurring in isolation; they reflect a broader global standard where professional independence is seen as essential to safe and effective healthcare delivery.
In that context, the ongoing protests can be viewed not merely as resistance to policy, but as a defence of a principle widely upheld across advanced health systems: that no single profession should control the entire chain of care.
A lecturer at the English and Literature Department at the Abia State University, Dr. Isaac Udo, said, “Healthcare should not be a battle. Every professional must be free to do their job well, so patients can get proper care.”
As the National Assembly considers the bills, stakeholders say any decision must protect patients, respect professional roles, and follow global standards.
In the end, the stakes are profound. It is more than a power struggle between doctors and other health professionals; it is a defining moment for the integrity, safety, and future of Nigeria’s healthcare system.
How the National Assembly acts today will shape not only the careers of thousands of health workers but the quality of care for every Nigerian who walks into a hospital tomorrow.
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