NHFRA Bill: Reform or a New Layer of Bureaucracy?
NHFRA Bill: Reform or a New Layer of Bureaucracy?
“Every legislative proposal deserves objective scrutiny not only of its provisions, but also of the public interest it seeks to advance. Sound laws are judged by both their purpose and their impact.”
The National Health Facility Regulatory Agency (NHFRA) Bill currently before the National Assembly has generated considerable debate among stakeholders in Nigeria’s health sector. While every effort to strengthen healthcare deserves commendation, legislation of this magnitude must be carefully examined to ensure it addresses genuine gaps rather than creating new institutional conflicts.
At first glance, the bill seeks to establish a central agency responsible for regulating health facilities across the country with the stated objectives of improving quality assurance, licensing, and compliance in healthcare delivery. These are noble goals that every Nigerian would support.
The real question, however, is whether establishing another federal agency is the most effective way to achieve them.
Nigeria already has several statutory regulatory bodies with clearly defined mandates. These include the Medical and Dental Council of Nigeria (MDCN), the Nursing and Midwifery Council of Nigeria (NMCN), the Pharmacy Council of Nigeria (PCN), the Medical Laboratory Science Council of Nigeria (MLSCN), the Radiographers Registration Board of Nigeria (RRBN), the Dental Therapists Registration Board of Nigeria (DTRBN), among others. Each of these institutions is empowered by law to regulate professional practice, maintain standards, and ensure compliance within its jurisdiction.
This naturally raises important policy questions. If these bodies already possess regulatory powers, why should another agency be established to perform functions that appear to overlap with their statutory responsibilities? Would this improve efficiency, or would it create duplication, jurisdictional disputes, and additional bureaucracy?
Rather than multiplying regulatory institutions, policymakers should focus on strengthening coordination among existing agencies. Effective collaboration is more likely to improve healthcare delivery than overlapping mandates that may generate administrative conflicts.
Another aspect of the bill that deserves attention is the proposed composition of its governing board.
While the bill provides representation for government ministries and several regulatory councils, the only professional association specifically represented is the Nigerian Medical Association (NMA). This raises legitimate concerns about equity and inclusiveness.
Nigeria’s healthcare system is multidisciplinary. It depends on the collective contributions of physicians, pharmacists, medical laboratory scientists, nurses, midwives, radiographers, physiotherapists, and many other professionals. If one professional association is considered deserving of representation, there is a compelling argument that other nationally recognized professional associations including the Pharmaceutical Society of Nigeria (PSN), the Association of Medical Laboratory Scientists of Nigeria (AMLSN), the National Association of Nigerian Nurses and Midwives (NANNM), and the Association of Radiographers of Nigeria (ARN) should receive similar consideration.
Balanced representation strengthens confidence in public institutions. Perceived exclusion, on the other hand, often fuels unnecessary professional rivalry.
There is also the issue of existing state regulatory frameworks.
Several states have already established agencies responsible for monitoring and accrediting healthcare facilities. Lagos State, for example, operates the Health Facility Monitoring and Accreditation Agency (HEFAMAA), while Edo State has the Edo State Health Regulation and Monitoring Agency (EDOHERMA).
Introducing another federal regulatory layer without clearly defining its relationship with existing state institutions may increase compliance costs for healthcare providers, create multiple licensing requirements, and ultimately transfer those financial burdens to patients through higher healthcare costs.
The experience of some state regulatory agencies also demonstrates the importance of ensuring that regulatory powers are exercised transparently, fairly, and without creating perceptions of intimidation or selective enforcement. Any new regulatory institution must therefore be designed with strong accountability mechanisms that promote service improvement rather than institutional dominance.
Healthcare regulation should not become a contest for authority. The ultimate objective should remain improving patient safety, service quality, and access to care.
As the National Assembly continues deliberations on the NHFRA Bill, legislators have an opportunity to conduct extensive stakeholder consultations and determine whether the proposed agency fills a genuine regulatory gap or merely duplicates existing functions. A thorough review will help ensure that any eventual legislation strengthens not fragments Nigeria’s healthcare regulatory architecture.
President Bola Tinubu, the Senate President, and the Speaker of the House of Representatives should ensure that any reform emerging from this process advances efficiency, accountability, and collaboration across the health sector. Sustainable reform is achieved not by creating overlapping institutions but by building coherent systems that allow existing agencies to work together effectively in the national interest.
The health sector deserves reforms that unite professionals around better patient care not reforms that risk creating avoidable institutional conflicts.