RE: MATTERS ARISING FROM UPWARD REVIEW OF LICENSE FEE

02.04.2015 15:34:20 | MRTB IT Unit, Tolu Ajiboye
18th March, 2015 
The President,                                                                                                 
Nigeria society of Physiotherapy
C/O Department of Physiotherapy,
University of Benin Teaching Hospital,
Benin City,
Edo State.
 
Attention: The Chairman,
State Chapter of NSP.
RE: MATTERS ARISING FROM UPWARD REVIEW OF LICENSE FEE
I have been directed by the Governing Board of the Medical Rehabilitation Therapists (Registration) Board of Nigeria (MRTB), established by decree 38 of 1988/Acts M9 LFN 2004 for the regulation and control of training and practice of Physiotherapy, Occupational Therapy, Speech Therapy, Chiropractic and Osteopathic Medicine Professions in the health sector in Nigeria to acknowledge the receipt of your letter dated 11th February, 2015 and to enlighten you on the justification for the upward review of Board’s chargeable fees.
The Board MRTB underwent a challenging moment around March - April 2014 when the well known Oransaye white paper was released. It was discovered after a careful study that on page 58, serial number 140 of Reference A, that the committee recommended that the Regulatory Bodies should be self funded from membership registration fees and other organisational activities. There is already reduction in subvention being released to MRTB in the 2015 budgetary allocation.
Furthermore and rather disturbing, it was discovered that beyond the recommendations of the white paper, the committee added that the Ministry of Health should arrange for the merger of the Dental Technicians Registration Board, Optometrist / Dispensing Opticians Registration Board and the Medical Rehabilitation Therapists (Registration) Board.
This surprising addition seemed to have the following negative implications on MRTB and the Physiotherapy profession in particular:
  1. Administrative challenge of regulating clinically incompatible professions.
  2. Overloading of an already heterogeneous Board with consequent regulatory challenge.
  3. Merging MRTB with other Regulatory Agencies will reduce the visibility of medical rehabilitation as a major pillar in health care delivery.
  4. Loss of hard earned assets as the sacrifices of our founding fathers in establishing the Board will be wasted.
Consequently, the governing Board through the Chairman and the former Registrar of the Board MRTB along with NSP swung into action to halt the implementation of the recommendation by sending a strongly worded letter to the Presidency through the Secretary to the Government of the Federation.
 A major reason speculated to have fuelled the recommended merger was non-viability of MRTB to self-funding due to low numbers of registrants and sources of IGR. MRTB however believes otherwise and is committed to fault that speculation. Thus many options are being considered among which is the upward review of the licensing fee in part as a proactive step and to supplement already dwindling fund allocation.

Stated below, please find a comprehensive analysis of regulatory bodies’ options for self funding which has provided reasons for MRTB choices.
A. LOW POPULATION OF MRTB REGISTRANTS:
The total population of MRTB registrants is about 3,666 which is very low and highly disadvantageous to the Board compared to Nursing and Midwifery Council of Nigeria(NMCN) with registrant of 254,000; Nigeria Medical and Dental Council(NMDC) is 61, 469 according to Human resources for Health statistics.

B. NUMBER OF MRTB TRAINING INSTITUTIONS:
MRTB, though heterogeneous, regulates five professions with Physiotherapy constituting 90% of the Board registrants, It will interest you to know that only seven institutions offer the Physiotherapy programme in Nigeria, while other Medical Rehabilitation professions are being offered in only three institutions. Meanwhile other councils such as NMCN have about 207 institutions, NMDC has about 56 institutions and PCN has about 41institutions. These are sources of financial generation to all these boards and councils in terms of accreditation and other regulatory activities.

C. NUMBERS OF MRTB INDUCTEES:
A comparison of a recent induction programme in a renowned Nigeria University shows that where there are about 150 inductees in NMDC and about 133 inductees into Pharmacy council, MRTB has only a meagre number of 36 inductees. These low numbers of inductees will no doubt translate to meagre revenue from induction fees.
Besides the obvious disadvantage of MRTB in comparison with other regulatory bodies regarding sources of IGR, it is important to correct the erroneous impression being circulated by some of our colleagues that MRTB’s fees are exceptionally high. As a matter of fact MRTB fees remain the lowest. Furthermore the upward review of the licensing fees is not peculiar to MRTB. Below is a comparative table of fees chargeable by other regulatory boards and councils.
 
 
 
FEATURES MRTB NMCN NMDN
POPULATIONS 3,666 254,423 61, 469
TRAINNIG INSTITUTION 9 207 56
EXAMPLE OF RECENT TOTAL INDUCTEES OF AN INSTITUTION. 36 - 150
CHARGEABLE FEES:
 
Interns/House Officer/ Basic Registration
INDUCTION-
Provisional License -  N5,000
Board Exam-N10,000
Bulletin-N2,500
Log Book- N2,500
Code of Professional
Ethics-N 2,500
Regulation- N2,500
 
 
Total- N25,000
FOR BASIC-
Application fee- N1,000
Registration -     N13,250
Licensing-         N10,000
Certification-    N5,250
Badge-                N4, 375
 
 
 
 
Total   = N33,875
(a) Provisional Registration -N10,000
(b)Development Levy- N5,000
(c)Pract. License for 2 year-     N12,000
(d) Administrative charges
 applicable for the assessment examination-N15,000
(e) Internship forms-N3,000
(f) Code of medical ethics-                N1,500
(g) Guidelines on Registration-N1,500
 
               Total = N48,000
 
B. Full registration/Post Basic Professional license- N10,000
Certification   -           N5,000
Bulletin           -           N2,500
Code of professional
ethics- N2,500
 
Total  =    N20,000
 
Application fee- N2,500
Registration -     N26,250
Licensing    -    N10,500
Certification -   N5,250
Badge         -       N4,375
 
Total    - 48, 875
Full Registration -   N20,000
Development Levy- N5,000
Practising Licence
for two years   -       N12,000
 
Total   =  N37,000
 
RENEWAL Less than Ten Years Post Qualification:
Professional License –
N10,000
Other chargeable fees based on request.
 
Above 10years post Qualification:
Professional License –    
N15,000
Other chargeable fees based on request.
 
 
Practising License -  for 3 years – N10,500
 
Other chargeable fees based on request
Practising License for two years – N12,000
Other chargeable fees based on request.
 
D. MRTB UNCOMPLETED SECRETARIAT PROJECT:
It will be instructive to mention that MRTB remain one of the few regulatory bodies yet to comply with Federal Ministry of Health Directives that all regulatory bodies should relocate their secretariats to Abuja. This is due to the uncompleted National Secretariat building project going on in Abuja. Other regulatory bodies/councils charged their Registrants developmental levy towards the completion of their buildings. MRTB does not charge such a levy.
 
E. ONGOING ACTIVITIES OF MRTB:
Permit me to intimate you on some ongoing activities of MRTB:
  1. The Board is putting all the resources together to improve on the accreditation exercise particularly in those institutions that are long overdue and those that have never been accredited; this is to create more employment opportunities for our registrants and to curtail quackery practice in the professions.
 
  1. The Board has been organising mandatory Continuing Professional Development Programmes (mCPD) in some geopolitical zones at subsidized fees and planning for more this year in all areas of specialisations. This will be made accessible to the registrants.
 
  1. The website is being upgraded for better communication and networking with our registrants. It will give room for job opportunities and recruitment activities in Physiotherapy and other medical rehabilitation programmes.
 
  1. Modalities are in place to improve public awareness on the role of Physiotherapy and medical rehabilitation professions in health care delivery system through the media.
 
  1. The surveillance/monitoring department are been empowered with enforcement agents and other important paraphernalia of office to combat quackery in our professions.
 
  1. In conclusion, for the Board to effectively carry out all the expected regulatory activities there is a serious need for financial support which cannot be accomplished with government release and the initial charges alone.
 
CONCLUSION:
We should all recollect and not forget so soon, the struggles and sacrifices of our founding fathers and past heroes that culminated in the establishment of decree 38 of 1988 of the Medical Rehabilitation Therapists Board of Nigeria. We have a responsibility to ensure that this hard earned asset is not allowed to die in our time.
I am therefore directed to seek and solicit for your earnest sacrifice and understanding to help prove that MRTB can be viable with regards to self funding.
Let us not play into the hands of those that will want MRTB extinct.
The Board therefore requests that everyone should set aside their grievances and join hands together to ensure the survival of our Board and even elevate it to the level of a full fledged council. The Board is counting on your cooperation and support to have these dreams realised.
Long Live MRTB! Long live our noble professions.
 
Thank you.
 
AKANLE OLUFUNKE T. (MRS.)
ACTING REGISTRAR/CEO (MRTB).