Beyond the Clinic Walls: Why Private Doctors Say NHFRA Will Burden Patients, Not Heal the System
The proposed National Health Facility Regulatory Agency promises better oversight. But HACPAN says it will only duplicate existing regulators, add more fees, and leave ordinary Nigerians to pay the price. Mary Nnah writes
On a Thursday morning in Ikeja, the air was thick with more than just Lagos humidity. Inside a conference room, hospital owners, laboratory scientists, pharmacists, and maternity home operators sat shoulder to shoulder.
They were not politicians. They were not bureaucrats. They were the people Nigerians call at 2 a.m. when a child has a fever, when labour starts early, and when an accident happens down the street.
They came under one umbrella: the Healthcare Providers’ Association of Nigeria (HACPAN). And the reason they gathered was simple. A bill in Abuja could decide whether their doors stay open, or whether the next patient will have to travel farther, pay more, and wait longer.
The bill is called the National Health Facility Regulatory Agency of Nigeria Bill (NHFRA). On paper, it promises “quality assurance” and “patient safety.” But for the men and women who run Nigeria’s private clinics, it feels like another weight on an already tired back.
We Are Not Against Regulation
Speaking during a press briefing in Ikeja, Lagos, recently, the HACPAN National President, Dr. Austine Aipoh, leaned into the microphone not with anger, but with the weariness of someone who has carried patients, staff salaries, and generator fuel for 20 years.
“We support better healthcare quality; improved patient safety is key to our minds, stronger accountability, uniform national standards, and effective regulation and enforcement,” Dr. Aipoh told journalists.
“We can’t shy away from regulation because if you don’t regulate a human being, it will not do what it is supposed to do; it will cut corners. We are not afraid of regulation. Sometimes regulation starts from within.”
He paused, then added the line that stayed with everyone in the room: “But we believe in regulation, not the way the bill is trying to capture it.”
Multiple Fees, Same Patient
HACPAN was founded in 2004. Today, it represents licensed private hospitals, clinics, diagnostic centres, laboratories, pharmacies, maternity homes, dental centres, and optometry centres across Nigeria. For over two decades, these facilities have filled gaps where public hospitals could not. They are the small clinic in Port Harcourt that delivers babies at midnight, the laboratory in Benin that runs tests before the big hospital can, and the pharmacy in Kano that gives drugs on credit when salaries are delayed.
“For over two decades, HACPAN has partnered with governments at all levels to improve healthcare quality, patient safety, and access to healthcare services for millions of Nigerians,” Dr. Aipoh said.
“That tells the world that we are not partial to a better outcome of our healthcare system.”
Yet now, they say, a new layer is being proposed that could undo that work.
Dr. Aipoh walked the room through the bill. The NHFRA, if passed, would have powers to inspect, accredit, certify, monitor, investigate, sanction, and even suspend facilities. It could also appoint “franchisees” to conduct inspections.
To a policymaker in Abuja, that may sound like efficiency. To a clinic owner in Ikeja, it sounds like déjà vu.
“Nigeria already has an extensive health regulatory framework,” Dr. Aipoh explained, adding, “The Federal Ministry of Health, State Ministries of Health, NHIA, MDCN, PCN, NMCN, and several other statutory bodies are already empowered to regulate different aspects of healthcare delivery.”
His worry is not theory. It is arithmetic.
“If enacted, healthcare providers may be subjected to multiple inspections, multiple accreditation processes, multiple certifications, multiple regulatory fees, and overlapping enforcement actions… Rather than simplifying healthcare regulation, the Bill risks creating an additional layer of bureaucracy that will increase compliance costs without necessarily improving patient outcomes.”
And who pays that cost?
“Setting up a national regulatory agency will create a loss of funds; it will result in more money being charged by providers, and ultimately, the patients will not be able to afford it. Whatever burden you feel economically, who bears the brunt? The common man out there will bear the brunt, much more than even the man who owns a car.”
He drew a parallel everyone understood: fuel subsidy removal.
“The government thought it was going to offend those who have cars. But no, the common man out there will bear the brunt because the transportation of foodstuffs and all that affected everything. So if the government wants to say, ‘Oh, we are doing it for the poor man,’ maybe the poor man suffers more.”
Strengthening Existing Institutions
Perhaps the most human moment came when Dr. Aipoh spoke about capacity. The bill proposes that the NHFRA can outsource inspections because it may not have enough staff.
To him, that admission said everything.
“After you have not started something, you are already saying that you don’t have enough manpower. If you want to build a house and you don’t have enough blocks, and you say, ‘Come and lay the foundation’… So for them to say they want to set up that body by themselves, they have knocked themselves out.”
He asked a question that hung in the room: why create a new agency when existing ones are underfunded?
“We have the Medical and Dental Council of Nigeria, we have the Pharmacy Council of Nigeria… and so many other regulatory bodies that are recognised by law and the Constitution. So why do you want to smuggle in another one?”
This was not a rejection of the government. On July 9, 2026, HACPAN had presented a formal memorandum at the Senate public hearing. Their tone was respectful, and their task was clear.
“HACPAN respectfully submits that the establishment of the proposed Agency is not the appropriate solution… Our position is not based on opposition to regulation. Rather, it is founded on the need for efficient regulation without unnecessary duplication.”
Their four requests were to withdraw the bill in its current form, strengthen existing institutions, harmonise mandates to remove duplication, and invest money in digitisation and inspection capacity instead of new offices.
“Nigeria does not necessarily need another healthcare regulator. What Nigeria needs is stronger coordination among the regulators that already exist,” Dr. Aipoh urged.
“We remain fully committed to working with the National Assembly… to develop reforms that improve healthcare quality while promoting efficiency, accountability, and ease of compliance.”
The Faces Behind the Statistics
After the briefing, a woman who runs a 10-bed maternity home in Ajegunle waited to speak. She didn’t give her name. She didn’t need to. She spoke for many.
“If they add one more inspection fee, I will have to increase antenatal. If I increase antenatal, Mama Tolu will go back to the TBA. Is that safer?”
That is the heart of HACPAN’s argument. Policy is not made in a vacuum. It lands in a clinic, on a bill, and in a mother’s pocket..
Dr. Aipoh closed the briefing with gratitude to the media because, he said, without them the story would not travel.
“We appreciate the indispensable role of the media in promoting transparency, accountability, public enlightenment, and national development. We are counting on you to propagate what we believe in about the bill.”
His final warning was not shouted. It was said quietly, like a doctor giving a diagnosis: “Nigerians should look deep. We should be circumspect about that agency that is trying to come because it will not make life better for Nigerians; it will make it worse for Nigerians.”
Outside, Lagos traffic roared on. Inside clinics across the country, nurses were changing gloves, doctors were writing prescriptions, and patients were hoping the cost of care would not rise again next month.
For HACPAN, the fight is not about politics. It is about that patient, and whether the next bill from Abuja helps her or breaks her.