Wednesday, 8 April 2026

Nurses Expose Critical Loopholes in the 2026 Healthcare Regulatory Bill and Push for Revision

 Nurses under the auspices of the University Graduates of Nursing Science Association (UGONSA) have identified critical loopholes in the proposed 2026 Healthcare Regulatory Bill and have formally engaged the leadership of the National Assembly to demand urgent legislative review. This engagement was conveyed through a comprehensive memorandum, Ref No. UG/NAT/26/NIG/NASS/01 dated April 08, 2026,
addressed to the President of the Nigerian Senate and the Speaker of the House of Representatives, with copies forwarded to the Chairmen of the Senate and House Committees on Health.   Below is the details of the memo:

 

The Senate President/Speaker, House of Representatives

National Assembly Complex
Three Arms Zone
P.M.B. 141
Abuja, Federal Capital Territory

Your Excellency, Sir,

Re: Legislative Review and Proposed Amendments – 2026 Healthcare Regulatory Bills

We respectfully submit this memorandum highlighting critical provisions in the 2026 Healthcare Regulatory Bills that may undermine professional autonomy, encourage quackery, and disrupt interdisciplinary healthcare governance in the Nigerian health system. While these Bills aim to modernize healthcare regulation, certain provisions, especially within the  Nursing and Midwifery Council of Nigeria (NMCN) and the Medical and Dental Council of Nigeria (MDCN)  frameworks, pose significant risks to professional autonomy, equity, and interdisciplinary collaboration in Nigeria’s healthcare system. A detailed review of the Bill confirms that, unlike the Pharmacy Council of Nigeria (PCN) Bill, the NMCN Bill fails to explicitly require that the Chairman be a registered Nurse or Midwife. This omission creates a legal loophole that could allow non-nursing professionals or external appointees to lead the NMCN, a highly specialized professional regulatory body. Again, unlike the Medical and Dental Practitioners Bill , 2026 (MDCN), the NMCN Bill does not contain any explicit provisions addressing quackery, unlawful practice, impersonation, or institutional liability. This omission significantly weakens the regulatory authority of the NMCN and exposes the nursing and midwifery profession, and by extension, public safety, to grave risks. The Nursing and Midwifery Council of Nigeria Bill also prioritizes reducing Council size without safeguarding proportional and sectoral representation. Unlike the Pharmacy Council of Nigeria Bill and Medical and Dental Practitioners Bill, it risks excluding critical voices from clinical, academic, and regulatory sectors. This weakens policy quality, reduces professional influence, and exposes governance to dominance by narrow or external interests.

Section 4(1) of the National Hospital for Women and Obstetric Fistula (Establishment) Bill, 2026, which sets out the composition of the Management Board of the Hospitals, equally raises a serious concern regarding equity in professional representation. As presently framed, the Board includes a part-time Chairman, the Medical Directors of the hospitals (who are all Medical Doctors), the Federal Chief Nursing Officer, one representative of the medical profession, one representative of other health professions, and two persons representing community interests. This arrangement creates a clear structural imbalance by allocating multiple seats to the medical profession, while all other health professions are compressed into a single shared seat. Such a composition is neither equitable nor reflective of the multidisciplinary nature of fistula prevention, treatment, rehabilitation, and long-term care. Effective management of women’s health and obstetric fistula requires meaningful input from nursing, pharmacy, physiotherapy, laboratory science, counselling, social work, and other allied professions. Concentrating representation in favour of one profession undermines inclusive governance, weakens interdisciplinary collaboration, and risks marginalizing key contributors to patient care. Because Board decisions are determined by majority, this imbalance could translate into institutional dominance by one profession, to the detriment of balanced policy development and holistic service delivery. The Bill should therefore be amended to ensure separate and adequate representation for major healthcare professions, including explicit inclusion of Heads of Nursing Services of the Hospitals in the Boards. This will promote fairness, strengthen governance, and improve patient outcomes through broader professional participation in decision-making.

The Bill as currently drafted also appears to confer expansive and exclusive regulatory powers on the MDCN over areas that are legally and professionally governed by other statutory bodies. Some provisions, particularly those assigning authority “to the exclusion of any other person or body”, risk creating institutional monopoly, suppressing interdisciplinary collaboration, and undermining existing regulatory frameworks. Healthcare delivery is inherently multidisciplinary. No single profession should dominate or regulate others. Doing so not only violates principles of professional autonomy and fairness but weakens the entire health system. Nigeria already operates a well-established structure of professional regulation, including, the Nursing and Midwifery Council of Nigeria (NMCN), Pharmacy Council of Nigeria (PCN), Medical Laboratory Science Council of Nigeria (MLSCN), among others. Allowing one profession to assume control over others would create legal conflicts between Acts of Parliament, undermine professional development, reduce morale among healthcare workers and negatively impact patient outcomes. We are therefore calling for the removal of monopoly clauses, protection of jurisdiction of existing regulatory councils, establishment of interprofessional regulatory frameworks and inclusion of all core healthcare professions in governance structures. Nigeria’s healthcare system can only grow to world-class standard when it is driven by collaboration, mutual respect, and shared responsibility rather than subjugation and professional domination.

Issue Overview

 The Nursing and Midwifery Council Bill (NMCN), 2026 does not specify that the Chairman must be a Nurse or Midwife, unlike the Pharmacy Council Bill which clearly restricts leadership to pharmacists. The Nursing and Midwifery Council of Nigeria Bill lacks a Vice Chairman, risking leadership gaps, instability, and external interference unlike the Medical and Dental Practitioners Bill. The NMCN Bill also reduces Council size without ensuring sectoral representation, risking weak governance, poor policy decisions, and dominance by narrow or external interests. Furthermore, the NMCN Bill lacks provisions criminalizing quackery, protecting professional titles, and holding institutions accountable—unlike the Medical and Dental Practitioners (2026) (MDCN) Bill. This gap enables unqualified practice, increases public risks, increases maternal and neonatal risks, weakens enforcement, and erodes public trust. A new provision should prohibit unregistered practice, protect titles (Nurse/Midwife), criminalize impersonation and fraudulent registration, and impose penalties on individuals and institutions employing unqualified personnel, with strong enforcement powers for the NMCN. In addition, the Medical and Dental Practitioners Bill, 2026 introduces provisions that expand MDCN’s authority into multidisciplinary domains and establishes exclusive regulatory control over areas already governed by other statutory councils. This raises concerns regarding regulatory overreach and structural imbalance within the healthcare system. Section 4(1) of the National Hospital for Women and Obstetric Fistula Bill creates a governance imbalance by allocating multiple seats to the medical profession while all other health professions share a single representative. This undermines equity and fails to reflect the multidisciplinary nature of fistula care. Since Board decisions are by majority, it risks dominance by one profession and marginalization of others.

Why This Matters

The absence of leadership qualification safeguards and lack of succession plan for the chairman for the NMCN bill creates a legal loophole that may allow non-nurses to regulate the nursing profession. The NMCN Bill cuts Council size without guaranteed representation, risking professional marginalization, poor decisions, and external control over the largest healthcare workforce. Excluding quackery provisions from the Nursing and Midwifery Council of Nigeria Bill endangers patients, weakens regulation, and enables unsafe practice. Strong criminalization is essential to protect lives, ensure accountability, and uphold standards. Moreover, healthcare delivery depends on teamwork, specialized expertise, mutual professional respect and autonomy. Any attempt to centralize authority on the MDCN or skew board membership in favour of the medical profession weakens collaboration, creates institutional conflict, and reduces system efficiency.

Key Concerns

Mandatory Requirement for a Nurse/Midwife as Chairman of the Council

The absence of professional qualification requirement for Chairman in the NMCN Bill forms a critical governance gap. This omission constitutes a serious governance, legal, and professional risk that must be urgently addressed in the interest of fairness, patient safety, and regulatory integrity. A professional regulatory Council must be led by members of the profession it regulates. This principle is consistent with global best practices in professional governance and is essential for maintaining credibility, accountability, and informed decision-making. Nursing and midwifery regulation requires deep experiential knowledge of clinical care, education, ethics, and workforce realities in the profession—competencies that can only be meaningfully provided by qualified and experienced practitioners within the profession. The failure to enshrine this requirement in law undermines the autonomy and independence of nursing and midwifery practice. It exposes the profession to potential external influence, weakens internal governance structures, and risks policy decisions that may not align with the realities of patient care. Ultimately, such a gap may compromise regulatory effectiveness and adversely affect patient outcomes. Moreover, this omission raises significant constitutional concerns regarding equity, fairness, and non-discrimination. Allowing other professional councils to be led exclusively by members of their own profession while denying nursing and midwifery the same standard creates an unequal and unjust regulatory framework.

Recommended Amendment: To safeguard professional integrity and ensure effective regulation, the Bill should be amended to include that the NMCN Borad Chairman MUST be a Registered Nurse or a Registered Midwife.

Suggested legislative wording: “The Chairman of the Council shall be a registered nurse or midwife with not less than fifteen (15) years post-registration experience and demonstrable leadership within the profession. No person who is not duly registered under this Act shall be eligible for appointment as Chairman of the Council.”

 Weak Governance and Succession Structure in the NMCN Bill

Unlike the Medical and Dental Practitioners (2026) (MDCN) Bill, which expressly provides for the office of a Vice Chairman and thereby creates a clear line of internal succession, the Nursing and Midwifery Council of Nigeria (NMCN) Bill appears to lack a similarly defined governance and succession framework. This omission creates a structural weakness in the administration of the Council. Without a clearly designated officer to act in the absence, incapacity, removal, or vacancy of the Chairman, the Council may be exposed to leadership uncertainty, administrative disruption, and avoidable external interference in its internal affairs. Such a gap is particularly concerning in a professional regulatory body that is expected to maintain continuity, institutional stability, and professional independence. A bill establishing a major professional council should not leave questions of succession to discretion or improvisation. Where succession is not expressly provided for, there is a greater risk that external authorities may influence interim leadership arrangements in ways that could undermine professional autonomy.

Recommended Amendment: The NMCN Bill should be amended to expressly provide for the office of a Vice Chairman, drawn from registered senior members of the nursing and midwifery profession, who shall act whenever the Chairman is absent or when the office becomes vacant pending the appointment or election of a substantive replacement.

Suggested legislative wording:  “There shall be a Vice Chairman of the Council who shall be a registered nurse or midwife of not less than 15 years post-qualification experience, and who shall perform the functions of the Chairman whenever the Chairman is absent, unable to act, or where the office of the Chairman becomes vacant pending the appointment of a new Chairman.”

Reduction of Nursing Representation in the NMCN Bill

The proposed amendment to the Nursing and Midwifery Council of Nigeria (NMCN) Bill emphasizes a reduction in the size of the Council without establishing safeguards for proportional and sectoral representation within the nursing profession. This approach contrasts with the Pharmacy Council of Nigeria (PCN) bill, which maintains strong professional dominance, and the Medical and Dental Practitioners (2026) (MDCN) bill, which retains broad representation from multiple professional associations. By focusing primarily on numerical reduction rather than balanced representation, the NMCN Bill risks creating a governance structure that does not adequately reflect the diversity of the nursing profession, especially across clinical practice, academia, administration, and regulatory leadership. Reduced representation diminishes the ability of nurses and midwives to effectively shape policies affecting their profession. Failure to ensure representation from clinical, academic, and regulatory sectors undermines comprehensive decision-making. Furthermore, a smaller, non-representative Council may become susceptible to dominance by a narrow group or external interests.

Recommended Amendment: To ensure equity, inclusiveness, and professional integrity, the Bill should incorporate minimum representation thresholds for members of the Nursing and Midwifery professions.

Suggested Legislative Provision: “Not less than seventy percent (70%) of the members of the Council shall be registered nurses and midwives, drawn from diverse areas of practice including clinical services, academia, administration, and professional associations, with due consideration for experience and professional standing.”

Proposed Insertion of a quackery section in the NMCN Bill

Insertion of new section — Offences relating to quackery and unlawful practice

(1)  No person other than a person duly registered and licensed under this Act shall—
(a) for, or in expectation of reward, practise or hold himself or herself out to practise as a nurse, midwife, nurse practitioner, or in any other nursing or midwifery capacity recognised under this Act;
(b) take or use the title “Registered Nurse”, “Nurse”, “Midwife”, “Registered Midwife”, “Nurse Practitioner”, or any abbreviation, initials, addition, description, uniform, badge, insignia, seal, or device implying that he or she is authorised by law to practise nursing or midwifery in Nigeria; or
(c) without reasonable excuse, use any name, title, description, document, stamp, prescription form, professional identification, or representation implying that he or she is qualified, registered, licensed, or authorised to practise nursing or midwifery under this Act.

(2) A person who contravenes subsection (1) of this section commits an offence and is liable on conviction—
(a) in the case of a first offence, to a fine of not less than ₦1,000,000 or to imprisonment for a term of not less than one year, or to both; and
(b) in the case of a second or subsequent offence, to a fine of not less than ₦2,500,000 or to imprisonment for a term of not less than two years, or to both.

(3) Any person who, for the purpose of procuring registration, enrolment, licensing, renewal of licence, or entry of any qualification or other matter under this Act—
(a) makes a statement which is false in any material particular;
(b) submits a forged, altered, fraudulently obtained, or misleading certificate, licence, transcript, testimonial, or other document; or
(c) impersonates a registered nurse or midwife, commits an offence and is liable on conviction to a fine of not less than ₦1,000,000 or imprisonment for a term of not less than two years, or to both.

(4) Any person employed by the Council or by any institution who knowingly makes or permits any falsification in any register, roll, licence, record, or official document relating to registration or practice under this Act commits an offence and is liable on conviction to a fine of not less than ₦1,500,000 or imprisonment for a term of not less than two years, or to both.

(5) Where an offence under this section is committed by a body corporate, hospital, clinic, maternity home, school, agency, or other institution, and it is proved that the offence was committed with the consent or connivance of, or is attributable to any neglect on the part of, any chairman, chief executive, chief medical director, medical director, director of nursing services, manager, matron, secretary, proprietor, or other principal officer of that body, such officer and the body corporate shall be deemed to be jointly and severally guilty of that offence and shall be liable to be prosecuted and punished accordingly.

(6) Any person who knowingly employs, engages, presents, deploys, or retains an unregistered or unlicensed person to practise, perform, or offer nursing or midwifery services commits an offence and is liable on conviction—
(a) to a fine of not less than ₦2,000,000;
(b) to imprisonment for a term of not less than one year; or
(c) to both such fine and imprisonment.

(7) For the purposes of subsection (6), a person shall be deemed to have knowingly employed or engaged an unregistered or unlicensed person where that person failed to carry out reasonable verification of the individual’s registration and current practising licence status with the Council.

(8) In addition to any criminal liability under this section, the court may order—
(a) closure or suspension of the hospital, school, unit, facility, or establishment in which the offence occurred, pending compliance with this Act;
(b) forfeiture to the Council of any forged licence, identification, stamp, seal, badge, or document used in committing the offence; and
(c) publication of the conviction in such manner as the court or the Council may determine.

(9) The Council may collaborate with law-enforcement agencies and other relevant regulatory authorities for the investigation, prosecution, and suppression of quackery in nursing and midwifery practice.

Proposed Amendment to the Composition of the Management Board – National Hospital for Women and Obstetric Fistula Bill, 2026

The Bill grants multiple seats to Medical Directors (one per hospital), all of whom are medical doctors; Provides only one seat for all other healthcare professions combined, including nursing, pharmacy, physiotherapy, and laboratory science. This results in disproportionate dominance by one professional group; marginalization of other critical healthcare stakeholders; and a governance structure that does not reflect the multidisciplinary nature of fistula care. Board decisions are made by majority vote, and quorum is relatively small. A professionally skewed board can systematically pass decisions without meaningful input from other healthcare disciplines. This undermines fairness, inclusiveness, and technical robustness in policy decisions.

Proposed Replacement of Section 4(1): Delete Section 4(1)(e): “a representative of other health professions”.

Substitute With the Following Provision:  “(e) one representative each from the following healthcare professions: (i) Nursing and Midwifery; (ii) Pharmacy; (iii) Medical Laboratory Science; (iv) Medical Rehabilitation/Physiotherapy; (f) the Heads of Nursing Services of the respective Hospitals.

The full proposed Revised Board Composition in Section 4(1) should read:

The Board shall consist of:

(a) a part-time Chairman;

(b) the Medical Directors of the Hospitals;

(c) a representative of the Federal Ministry of Health not below the rank of Assistant Director;

(d) one representative of the medical profession;

(e) one representative each of: Nursing and Midwifery, Pharmacy, Medical Laboratory Science, Medical Rehabilitation/Physiotherapy

(f) the Heads of Nursing Services of the respective Hospitals

(g) two persons nominated by the Minister of Health to represent community and patient interests, including women’s health advocacy.

Regulatory Overreach in the Medical and Dental Practitioners (2026) (MDCN) Bill

The Bill grants MDCN authority over Laboratory Sciences, Genetic Testing, Aesthetic Practice, Alternative Medicine Practice, and Assisted Reproductive Technologies. These areas are multidisciplinary fields and areas already regulated by other councils.

Monopoly Clause in the MDCN Bill

The phrase “to the exclusion of any other person or body” creates regulatory monopoly, suppression of other professions and risk of abuse of power.

Risk of Constitutional Breach in the MDCN Bill

The Bill, in its current form, raises significant constitutional concerns under the Constitution of the Federal Republic of Nigeria 1999, particularly in the area of equality and non-discrimination . This is because the Bill appears to create a disproportionate regulatory advantage for one healthcare professional group over other duly recognized healthcare professions. This portends a serious concern under Section 42 of the Constitution, which guarantees freedom from discrimination on the basis of status, association, or profession. By subjecting multiple independent healthcare professions to the oversight or control of a single profession, the Bill risks institutionalizing professional inequality, undermining the legal standing of other healthcare regulatory bodies and creating a biased hierarchy not supported by constitutional principles. If not amended, such provisions may constitute an official endorsement of discrimination, as they fail to uphold equal recognition and autonomy of all healthcare professions within Nigeria’s legal framework.

Policy Position

We strongly affirm that each healthcare profession must be regulated by its own independent statutory body, constituted and governed by members of that profession, in accordance with global best practices and the equity and fairness principles enshrined in the Constitution of the Federal Republic of Nigeria 1999. Professional self-regulation is fundamental to preserving professional autonomy and identity, ensuring context-specific standards of practice and ethics, promoting accountability through peer-based oversight, and safeguarding the quality and safety of patient care.

 

 

 

Problematic Sections in the Medical and Dental Practitioners (2026) (MDCN) Bill That Need Amendment

SECTION 8(1) – “Exclusion Clause”

Current Issue: “to the exclusion of any other person or body…”  This creates absolute monopoly control.

Amendment Type Demanded: DELETE & REPLACE

Proposed Amendment: Delete “to the exclusion of any other person or body” and replace with “in collaboration with relevant statutory professional regulatory bodies”

SECTION 8(1)(f) – Alternative Medicine Control

Current Issue: Medical and Dental Council of Nigeria (MDCN) assumes control over alternative medicine, which is outside its core mandate.

Amendment Type Demanded: MODIFY

Proposed Revision: “Collaborate with relevant regulatory bodies responsible for complementary and alternative medicine in Nigeria to ensure standards of practice.”

SECTION 8(1)(g) – Clinical Laboratory/Pathology Control

 Current Issue: MDCN regulating “clinical laboratory practice… haematology, microbiology, clinical chemistry…” This directly infringes on MLSCN authority.

 Amendment Type Demanded: DELETE & REPLACE

Proposed Revision: DELETE entire paragraph (g) and REPLACE WITH “Medical practitioners involved in pathology shall operate within the clinical scope of medicine; however, all laboratory diagnostic services shall be regulated by the Medical Laboratory Science Council of Nigeria.”

SECTION 8(1)(h) – Assisted Reproductive Technology (ART)

Current Issue: Exclusive control over Assisted Reproductive Technologies (ART) (a multidisciplinary field)

Amendment Type Demanded: MODIFY

Proposed Revision: “Supervise and regulate assisted reproductive technology in collaboration with relevant professional bodies, including nursing, pharmacy, medical laboratory science, and other allied professions involved in reproductive health services.”

 

SECTION 8(1)(j) – Genetic Testing & Personalized Medicine

Current Issue: Unilateral control over a scientific, multidisciplinary field

Amendment Type Demanded: MODIFY

Proposed Revision: “Regulate medical aspects of genetic testing and personalised medicine in collaboration with relevant scientific and healthcare regulatory bodies.”

SECTION 8(1)(k) – Aesthetic Practice Regulation

Current Issue: Excludes nurses, pharmacy, medical laboratory science, and allied professionals from aesthetic practice

Amendment Type Demanded: MODIFY

Proposed Revision: “Develop guidelines for aesthetic medical practices in collaboration with relevant professional regulatory bodies whose members are involved in such practices.”

SECTION 8(2)(c) – Repetition of Laboratory Control

Current Issue: Reinforces MDCN dominance over Medical Laboratory Sciences

Amendment Type Demanded: DELETE

 Proposed Revision: DELETE Entire subsection 8(2)(c)

SECTION 8(2)(a) – Policy Control

Current Issue: “provide general policy… relating to the practice of medicine and dentistry”. This is acceptable only if limited to its scope, but risky if interpreted broadly.

Amendment Type Demanded: MODIFY

Proposed Revision: “Provide general policy and guidelines relating strictly to the practice of medicine and dentistry, without prejudice to the statutory roles of other healthcare regulatory bodies.”

SECTION 21 – Approval of Courses & Institutions

Current Issue: MDCN given broad power to approve training institutions—potential spillover into other professions

Amendment Type Demanded: MODIFY

Proposed Addition: “Provided that this authority shall not extend to training programmes or institutions regulated by other statutory healthcare professional councils.”

NEW CRITICAL SECTION TO BE INSERTED

Amendment Type Demanded: INSERT NEW SECTION

Title: Professional Autonomy Clause and Interprofessional Collaboration Framework

Proposed Text: “Notwithstanding any provision of this Act, no healthcare profession shall be placed under the regulatory authority of another profession. Each profession shall be independently regulated by its statutory council established by law. Where any aspect of healthcare practice involves multiple professions, regulatory oversight shall be exercised through a collaborative framework involving all relevant professional councils.”

LEGAL BASIS FOR AMENDMENTS

This proposal is supported by existing Nigerian laws, which recognize and uphold the principle of independent and autonomous professional regulation across the healthcare sector, including: Medical Laboratory Science Council of Nigeria Act (Cap M25 LFN 2004); Nursing and Midwifery (Registration, etc.) Act (Cap N143 LFN 2004); Pharmacy Council of Nigeria Act (Amended 2022) and National Health Act (2014). These laws establish independent regulatory authority for each profession, which must not be overridden.

Conclusion

The 2026 Healthcare Regulatory Bills contain critical structural and legal flaws that threaten professional autonomy, patient safety, and effective healthcare delivery in Nigeria. The Nursing and Midwifery Council of Nigeria (NMCN) Bill weakens its own profession by failing to mandate that leadership (Chairman)  be drawn from nursing, lacking a clear succession structure, omitting anti-quackery provisions, and reducing council size without ensuring fair representation. These gaps expose the profession to external control, unsafe practices, and poor governance. Conversely, the Medical and Dental Practitioners Bill (MDCN) expands its authority beyond its core mandate, introducing monopoly-like provisions that encroach on other healthcare professions. This risks institutional dominance, suppresses interdisciplinary collaboration, and conflicts with existing regulatory laws. Additionally, governance structures such as the Board composition in the National Hospital for Women and Obstetric Fistula Bill create professional imbalance by favoring the dominance of medical profession while marginalizing other key healthcare disciplines. Collectively, these issues undermine equity, violate principles of fairness and non-discrimination, and weaken Nigeria’s multidisciplinary healthcare system. The National Assembly must urgently amend the Bills to remove monopoly clauses, protect the autonomy of all professional councils, strengthen the NMCN with proper governance and anti-quackery provisions, and ensure equitable representation across professions. Ultimately, Nigeria’s healthcare system can only achieve global standards through collaboration, mutual respect, and balanced governance and not by professional dominance or subjugation.



Signed

  Nurse Opeyemi Ojo                                                            Nurse Philip Eteng

UGONSA National President                                        UGONSA National Secretary

 

CC:

Chairman, Senate Committee on Health

Chairman, House of Reps Committee on Health

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