Nigeria is set to introduce new regulations governing the employment and working conditions of temporary healthcare personnel, including locum doctors, under a proposed national policy.
The policy recommends that initial locum contracts should not exceed six months, with only one additional six-month renewal permitted. It also proposes a maximum 48-hour working week for healthcare workers.
The National Association of Resident Doctors (NARD) announced the proposed National Policy on the Engagement of Locum, saying it was designed to regulate the recruitment, remuneration, working conditions and welfare of temporary healthcare personnel.
The policy was developed following the work of a committee established by the Federal Ministry of Health and Social Welfare to address the regulation and casualisation of doctors.
According to NARD, the policy followed extensive consultations and aims to ensure that temporary healthcare workers are engaged under fair, transparent and non-exploitative conditions.
Six-month contract limit
Under the proposed framework, hospitals would only be permitted to employ locum personnel where there is a recognised staffing shortage and approval has been obtained from the relevant authorities.
An initial locum appointment would be limited to six months, with only one further six-month renewal allowed.
However, healthcare workers who remain continuously engaged for 12 months would become eligible for consideration for permanent employment.
The policy also prohibits hospitals from using locum appointments as a replacement for permanent recruitment or as a means of exploiting temporary healthcare workers.
48-hour weekly work limit
The proposed policy seeks to address concerns over excessive working hours in Nigeria’s healthcare sector.
Healthcare personnel would be restricted to a maximum of 48 hours of work per week, including weekends.
Any additional hours would have to be properly documented and either financially compensated or offset with structured time off.
The proposed rules would also prohibit healthcare workers from working for more than 24 consecutive hours, including call duties.
Workers would be entitled to at least 12 hours between shifts, as well as a 24-hour post-call rest period following weekday and weekend calls.
A one-hour break would also be required after six hours of continuous work.
Limits on call duties
The policy proposes that healthcare workers should undertake no more than two calls per week and one weekend call per month.
Hospitals would also be required to distribute call duties fairly among their staff.
Pay and welfare provisions
The proposed framework includes provisions for standardised remuneration in line with the government’s Scheme of Service.
Locum workers would be entitled to receive their salaries monthly and without delay, alongside monthly payslips.
They would also be entitled to government-approved leave, public holidays and occupational insurance coverage.
Healthcare institutions would be expected to provide safe working environments, suitable call rooms and refreshments during prolonged shifts and call duties.
The policy further calls for measures to reduce burnout among healthcare workers.
It also requires all locum personnel to undergo orientation and integration into their respective clinical or administrative teams.
Termination and dispute resolution
Under the proposed rules, either the healthcare institution or the worker could terminate a locum contract by giving one month’s notice or payment in lieu.
All outstanding entitlements would be required to be settled within 14 days of termination.
Cases of professional misconduct would be handled under the relevant regulatory council guidelines, while disputes would first be addressed through institutional procedures.
Unresolved disputes could subsequently be referred to the Federal Ministry of Health and Social Welfare and the Federal Ministry of Labour and Employment.
The Health Ministry would also be responsible for monitoring compliance and ensuring that healthcare institutions do not violate labour laws through exploitative staffing practices.
When will the policy take effect?
NARD said the proposed policy will become legally binding once it receives approval from the Federal Ministry of Health and Social Welfare.
The framework is expected to undergo a comprehensive review within two years of its implementation.
NARD described the proposed policy as an important step towards improving the welfare, dignity and working conditions of doctors and other healthcare professionals in Nigeria.
The association thanked the Coordinating Minister of Health and Social Welfare, Prof. Muhammad Ali Pate, for approving the initiative and commended the Minister of State for Health and Social Welfare, Dr. Iziaq Adekunle Salako, for his guidance.
NARD also expressed hope that the National Council on Health would approve the policy, paving the way for its implementation across Nigeria’s healthcare system.
