The bill to establish, a National Council of Radiology and Radiation Medicine (NCR), which is intended to provide for the control and practice of the profession of Radiology, Radiation Medicine, Nuclear Medicine, Radiotherapy, Radiography, Medical Physics and Technology and for related matter (2017), reportedly sponsored by Hon. Patrick Asaba is drawing the irk of other professionals particularly Radiographers. The protesters consider the bill as an attempt by radiologists, who are specialist doctors, to disingenuously haul other related professionals, who are not doctors, into a council that they will control.
While the introductory part of the bill confirms the incorporation of radiotherapists, radiographers, medical physicists and technologists who either have their own regulatory bodies or should have theirs, into a new proposed body, a rundown of membership of the proposed council shows why the bill, if passed, could ignite crisis in medical sector. The bill reserves the chairmanship of the council, permanently for a radiologist, while the other listed professionals shall be retained as ordinary members.
The import is that doctors, who specialise in radiology, will be substantially in charge of regulating radiographers, radiotherapists and other related professionals. The bill if passed will gift those to be regulated two professional regulatory bodies, with all the implications for them, and this may include payment of double dues for the same service, double jeopardy with respect to disciplinary act, where there is allegation of unprofessional conduct, and even conflict of interest where there is an internal dispute between the various professionals that the bill will regulate.
Again, there could disputes over standards and acceptable training programmes, from the two bodies that will subsequently regulate the professions. For instance, medical doctors are presently regulated by Medical and Dental Council of Nigeria (MDCN), while Radiographers are regulated by Radiographers Registration Board of Nigeria (RRBN), both statutory bodies, with responsibilities to regulate the different professions. Their responsibility include determining standards, admitting new qualifiers, punishing misconduct among other responsibilities.
Should the proposed bill become law, a doctor or radiographer will subsequently be compelled to belong to two professional bodies. Indeed, if the proposed bill in the public domain, represents the one before the National Assembly, then it is no more than a poor imitation of the Act establishing the RRBN. According to Frank Offor, a radiographer, who had canvased seriously against the proposed bill, claiming that such a bill if passed would disrupt the health sector, the proponents of the bill merely took the RRBN Act and changed RRBN for NCR and Radiographers for the potpourri of professionals.
He warned that such an act will add to the subsisting crisis in the health, much of which derive from the disputes over ego and wages between the different professionals in the sector. For instance, each time the federal government, after protracted industrial crisis increases the wages of doctors, complementary personnel like nurses, rise up in arms, asking for a commensurate increase in their own wages, in comparison with the doctors.
Within the medical professions, there is also contention over spheres of influence. While the medical doctors and pharmacists are always slugging it out over dominance, there is also usually the dispute about which of the two, is straying into each other’s area of core competence. There is also the dispute between medical laboratory practitioners and doctors with accusations and counter-accusations of over-stepping professional spheres of competence. It is noticeable that whether in the laboratory, pharmacy or clinic, there are no strict adherence to arrears of training, and Mr Offor argues that the proposed bill could trigger crisis in radiology practice.
The NCR bill in one of the section hopes to gift the council, the power to determine the standards of knowledge to be attained by persons seeking to be either Radiologists, Radiographers etc. Conversely in section 10(1) of the Radiographers (Registration, ETC) Act, the requirement for obtaining registration as a radiographer was listed, and it includes attending a course of training approved by the RRBN, whether at home or abroad. Should the proposed NRC bill becomes law, a radiographer will be registered based on registration with the RRBN.
Furthermore, in the section 1(k) of NCR bill, the council is to be empowered to discipline radiologists, radiotherapists, radiographers and medical physicists, in conjunction with their various boards or council for breaking the provisions of NCR bill. Again, in the RRBN Act, dealing with Penalties for Unprofessional Conduct, a radiographer who contravenes any of the rules listed therein will be dealt with by the Disciplinary Committee constituted under the Act, and having powers to punish. Should the NCR bill become law, a radiographer, like others will face two professional disciplinary committees, apart from a possible civil or criminal trial?
Another intra-discipline challenge the NCR will have is what becomes of the responsibilities of the radiologists, whose members are also beholden to MDCN. Would they repudiate members of that council, which is for all medical doctors, regardless of their subsequent specialization? Where a doctor has specialized in radiology, and has disciplinary issues, will he face both the NCR and MDCN disciplinary committees? Will he also pay membership dues to both bodies, and where there is a dispute between doctors and the other professions, what happens?
While the professions sought to be united in the NCR are inter-related, the training programme is wide apart. While to train as a radiology is a postgraduate training, radiology, radiotherapist and others are first degree courses. Moreover only medical doctors can subsequently train as radiologists. The import is that within the council, there will be rivalries and disputes, with the air of superiority that the radiologists are bound to have. Even the provision in the bill that in appointing the chairman of NCR, only the professional association of radiologists will be consulted, portends crisis ahead.
Perhaps what the radiology family needs is a voluntary association, more concerned with promoting excellence and research in radiology, radiation medicine, nuclear medicine, radiotherapy, radiography, medical physics and technology and other related disciplines. Such a body should promote medical journals, engage in research, attract research grants and advise governments and regulatory bodies across the radiology disciplines. Membership of such body can be geared towards enhancing radiology practice and its related discipline, instead of the mere appropriation of power and resources, which is the main interest of many professional bodies in Nigeria.
Instead of wasting energy to create another regulatory body, the leading lights in radiology, radiation medicine, nuclear medicine, radiotherapy, radiography, medical physics and technology and related discipline should be more concerned as to how to add value to the existing body of knowledge in radiology and its allied disciplines. So, I substantially agree with the letter by Frank Offor, published by this newspaper recently, that efforts should be made by relevant authorities to avoid any action that could precipitate avoidable crisis in the health sector. A critical review of the NCR bill is therefore appropriate.