Hospitals hire 564 contract doctors amid worsening shortage

Hospitals across Nigeria are relying on 564 locum doctors to temporarily fill staffing gaps and sustain healthcare delivery amid a worsening shortage of medical personnel, The PUNCH reports.

The number of temporary medical practitioners appointed on a contract basis was obtained exclusively from the Nigerian Association of Resident Doctors.

The figure illustrates the increasing reliance on casual employment within Nigeria’s strained healthcare sector.

Hospitals have increasingly turned to locum doctors as a stopgap response to a chronic shortage of medical personnel, a crisis fuelled by the mass emigration of healthcare workers.

However, the casualisation of these doctors comes with unsteady employment, without job security, pension, or benefits.

Health associations warned that this pattern deepens the crisis.

In 2024, NARD demanded an end to the casualisation of doctors, labelling it a severe threat to service delivery and doctors’ welfare.

The association said it was particularly worrisome that the practice was gaining ground amid massive manpower shortages in government hospitals across the country.

The continued use of temporary appointments persists despite the Federal Government’s introduction of reforms aimed at stabilising the health workforce.

Among the reforms is the One-for-One Replacement Policy, designed to allow hospitals to immediately replace any healthcare worker who exits the health system with a new hire, without going through prolonged bureaucratic approvals.

Also introduced was the National Policy on Health Workforce Migration, intended to strengthen recruitment, retention, and equitable distribution of healthcare professionals across the country.

However, both policies are yet to be fully implemented, leaving health institutions to rely heavily on short-term contracts and locum appointments.

Analysis by the Coordinating Minister of Health and Social Welfare, Prof Muhammad Pate, revealed that Nigeria has 55,000 doctors, which is below the recommended minimum of the World Health Organisation.

Yet, over 16,000 Nigerian doctors have left the country in the last five to seven years to seek greener pastures abroad.

According to Pate, the doctor-to-population ratio now stands at around 3.9 per 10,000, far below the suggested global minimum.

Speaking with our correspondent, the President of NARD, Dr Tope Osundara, called for systemic reform that would lead to permanent employment, better funding, and stronger retention.

He said, “Some of the implications of employing doctors on a contract basis are that it will reduce the enthusiasm to continue to work with the government, and that will increase the urgency to move out to greener pastures.

“So, you have invariably increased the rate of Japa, because somebody who is on a locum appointment is not going to get the full complement of the salary structure as other colleagues within the same facility.

“However, the initial essence of this locum appointment is to fill in a temporary gap in staffing, due to a shortage of manpower, so that there won’t be too much disparity or too much of a manpower gap within the facility.

“Unfortunately, what we’ve seen or observed is that some of these locum appointments have been left for too long in that same kind of appointment, which is not good.”

Osundara said the condition of working for the locum doctors was not favourable, adding that they were subjected to the whims of whoever was the leader of the facility or whoever was employing them.

The hospital heads can appoint them for a period of three or six months on a contract basis and decide not to continue with that appointment, nobody can hold him responsible for that because it is a contract,” he said.

The NARD president decried that locum doctors faced significant job insecurity.

“Since locum appointment is not achieving its desired purpose, it should be scrapped, because it makes the doctors prone to discrimination.

“It brings a lot of liability to the doctor. The appointment of a locum staff is easy to terminate at any time for any reason.

“You have to comply with the terms contained in that contract and the terms can be sometimes redundant. The government should find a way to scrap it once and for all,” Osundara insisted.