The practice of medical laboratory sciences VS clinical laboratory

BY OSARETIN AGBONLAHOR

The practice of Medical Laboratory Science (MLS)  is legally professionalized by the Medical Laboratory Science Council of Nigeria Act 11, 2003 (MLSCNA).

Section 29 of the MLSCNA provides that “Medical laboratory science” a. means the practice involving the analysis of human or animal tissues, body fluids, excretions, production of biologicals , design and fabrication of equipment for the purpose of medical diagnosis, treatment and research.

Also, section 22(2) of MLSCNA, 2003 provides that:

A person who is not a member of the profession shall not practise the profession or, in the expectation of reward, take or use any name, title, addition or description implying that he is in practice as a member of the profession.

For the avoidance of doubt and proper enlightenment of the public, MLSCNA 2003 is the only law of the Federal Republic of Nigeria that regulates the *practice* of MLS be it in the public or private health institutions in the country.

Section 22 of the MLSCNA, 2003, forbids any other person other than persons duly qualified and registered as Medical Laboratory Scientists (MLS), Technicians and Assistants from practising the profession of MLS on the pains of fine and imprisonment.

Again, section 29(b) of MLSCNA 2003 specifically gave control of the management of medical laboratories to Medical laboratory scientists. In addition section 4(e) of MLSCNA also cedes the powers to ” regulate the production, importation, sales and stocking of diagnostic laboratory reagents and chemicals to the board it created. This area is one of the most lucrative in public health facilities, hence the Nigerian CMDs/MDs do not want to give it up.

It is laughable to hear my friends on the other side ( Pathologists), claiming legal powers to head medical laboratories on the grounds of false assumptions from the Medical and Dental Practitioners Act ( MDPA).

In order to set the records straight, section 2(e) of the MDPA clearly states that ” the board shall make regulations for the operation of CLINICAL LABORATORY PRACTICAL in the field of pathology, autopsy, cytology…

I harbour no qualms with this provision except for its misinterpretation by Medical Doctors (Pathologists) and I also cannot see how this simple provision in the MDPA , intended for the purpose of regulating laboratory practicals during examinations for students of Medicine and Surgery who take Pathology as a specialty, became a legal backing to practice Medical Laboratory Sciences in the country.

This brings to mind the dissection practicals in Medical school during 200L studies. This was compulsory for all medical students (Medicine and Surgery, Nursing, Medical laboratory science, etc). More so, students of Anatomy also have dissection practicals as students. *Can they claim to be experts and work as Surgeons after graduation?* Please, can the knowledge of Anatomy and Dissection *practicals* be transferred to the *practice* of Surgery?

More so, that the provisions of section 29(b), and section 4(e) of MLSCNA as stated earlier, are lacking in the MDPA and this omission demonstrated a very clear intention of not being rivalled by any other previous contrary statutes on the issues of medical laboratory practice in Nigeria.  For this, we must give kudos to the Legislature for a deliberate and careful job well done.

The very sad and mischievous angle to the demand of the Medical Doctors (pathologists), is the headship of medical laboratories – erroneously stating that it is a unit of Pathology. It is very pertinent to state here, that Medical Laboratory Science is a distinct profession in the branch of human endeavour, deserving specialized training and autonomy of the profession.

A profession can only be so called if it has the independence of existence, and a profession cannot have the independence of existence, if it is tied to the apron strings of another profession by means of supervision and headship.

Besides, the essence of the creation of a profession is the conferment on the members of that profession the toga of expertise in their own field and as such their work cannot be subject to the supervision of any other professional; in this case the pathologists, who lack the requisite knowledge and certification to carry out the expert supervision of Medical Laboratory Scientists. It follows therefore that only senior colleagues who are Medical Laboratory Scientists should head and supervise their junior colleagues.

Therefore, the demand for headship of the Medical laboratories by Pathologists is not only criminal, illegal, unprofessional and unethical, but could be best described as an act of adult gangsterism and professional recklessness which the court had ordered them to stop forthwith having given due recognition to the professional charter granted the profession of Medical Laboratory Sciences.

Consequent upon their deviant nature and disregard for court pronouncements and the rule of law, the CMD and DA of JUTH, are at risk of being jailed eventually if they refuse to obey the order of the court. What a professional embarrassment that would be!

This is also to remind the Minister of Health and all  CMDs, MDs and DAs of all public health institutions in the country, that by virtue of section 29(a)&b of the MLSCNA, Medical Laboratory Science has been given the status of a profession and enjoys equality with other professions, and thus, comes within the ambit of ILO convention No.111 “which is the most exhaustive ILO instrument in respect of discrimination”  so Medical  Laboratory Scientists in the workplace “cannot be discriminated against in their areas of competence in favour of any other profession; which is not empowered by law to perform their functions.” This is also applicable to the scheme of service for MLS made pursuant to MLSCNA. It is inviolable and supercedes any other contrary scheme and as such, it should be implemented stricto sensu in all public health facilities in the country.

Finally, the Medical Laboratory Science profession is not an appendage of Pathology or any other profession in the eye of the laws of the Federal Republic of Nigeria. A proof of this was the advent  of the Ebola crisis in Nigeria. NMA including Pathologists went on strike for three months during that period. However, Medical  Laboratory Scientists stood by the  Nigerian public to ensure accurate and appropriate diagnosis of the  disease hitherto being treated as malaria by some physicians in private hospitals. The story has since been in the public domain. That we are related does not mean we have the same parents!

Let the wise listen and grow in knowledge, not in arrogance. Arrogance gets us nowhere.