The Joint Health Sector Unions (JOHESU) has released a press release condemning the strike action of the Nigerian Medical Association and the Nigerian Association of Resident Doctors.
The press release reads:
The attention of Joint Health Sector Unions (JOHESU) has been drawn to the publication (Advertorial) by the Nigeria Association of Resident Doctors (NARD) the Nigerian Medical Association (NMA) in various newspapers including social media from the 9th of April to 30th of May, 2014.
Whereas the Publications would have been ignored for obvious lack of credence and immaturity aptly demonstrated by the NMA and its appendages, on a second thought, the leadership of JOHESU, considered the inherent danger such malice, misinformation, such publications if not corrected, could impact on the uninformed public and resolved to respond, if only to refute the unguarded and unprofessional utterances of the groups, not to mention the level of absurdity the issues raised epitomize, which further stretched the incredibility to an agonizing crescendo.
The issues taken point to point with rebuttal, are as follows:
1. Threat of Nation-wide Strike and the Chibok Girls
NMA and its groups would be shocked to hear that JOHESU shelved its strike slated for Monday 19th May 2014 because of its sympathy with the Government and the people of this great country over the tragedy that befell the Nation. Again, the leadership of JOHESU offered special prayers at various times and in particular at its meeting with the Government on the 13th May, 2014 over Nyanya Bomb blast and the abducted Chibok girls.
That would not be said of NMA and its affiliates. In spite of the fact that the Nation was thrown into mourning and sadness, the NARD (at that student doctors) in full blast embarked on a 3 day Nation-wide warning strike, a situation widely reported on the electronic and print media with such condemnation. The strike was yet another opportunity for striking doctors to divert patients in public facilities to their private facilities. What could be so callous and insensitive than this!
2. Attack on NLC & TUC
NMA attacked the NLC and TUC for supporting JOHESU in its endeavour to improve on the poor state of the Nation’s health sector being mismanaged by the Medical doctors, is baseless and a clear demonstration of NMA’s attempt to cover up the rot in the sector which is the result of years of mis-management of the health sector by Nigerian doctors who were in charge.
Both Labour Centres, NLC and TUC, have as affiliates all the five member-unions of JOHESU, all of them registered by the Trade union Acts and the extant laws. NMA and its groups are not registered trade unions, yet are known to engage in trade union activities, by negotiating conditions of service and most often incite the government against the rest of the other health practitioners given their privileged leadership position in the sector.
This is contrary to the NIC judgment of 20th June, 2011, in a case of Hon. Attorney General of Enugu State VS National Association of Medical & Dental Practitioners (NAGGMAP), in which NICN ruled “that the right to strike is a right that belongs to a trade union” meaning that NMA and its group, legally lack this right, to embark on or negotiate conditions of service and even enter into collective bargaining with its employers. In other words, NMA has used blackmail to coerce and intimidate the government to enter into agreement, all of which ordinarily are illegal. As the saying goes, two wrongs cannot make a right, therefore we say enough is enough.
Most JOHESU cases went through NIC and were favourably disposed in the JOHESU favour. NMA cases should equally be subjected to judicial process as in that of Enugu NIC in 2011. The Federal Ministry of Health is enjoined to stop playing double standards with personnel issues in the health sector.
3. Crisis in the Health Sector – is it Political?
Perhaps, NMA and its appendages need to inform the ordinary citizen of this country properly on this issue. Since the days of Professor Olikoye Ransome Kuti, a onetime Minister of Health, who awarded the Medical Doctors Super Salary of MSS/MSSS and the others in the health sector, HSS in 1991, thereby removing the single spine salary structure, undermining the issue of salary relativity/parity, thus creating a huge gap differential that has remained unjustifiable till date, crisis has become an integral part of the health sector. Again, in 2009, CONMESS was given doctors, which further expanded the salary band from 1 – 7 at entry point of GL.13 for a newly qualified doctor!
Besides this, the entire health structure came under the headship of the Medical Doctors, thereby giving them privileged positions that the Job Evaluation conducted and supervised by the office of the Secretary to the Government of the Federation, with Head of Service of the Federation, Federal Ministry of Labour and Productivity, Federal Ministry of Health, National Salaries, Income and Wages Commission etc as members in 2007 could still not justify. In fact, the Medical Doctors apart from the consultants in Nigeria were rated slightly below most health professionals including medical lab scientists and physiotherapists, what then forms the basis for such leverages and largesse being given the Medical Doctors, if not corruption and injustice in the sector?
How could NMA justify its press release urging the Federal Government not to succumb to JOHESU ‘cheap blackmail’ and her allies by granting to JOHESU requests that undermine the interest of the Nigerian Doctors”, if not the usual political maneuvering that has characterized the Medical doctors mismanagement concept in the health sector over the years.
4. Issue of skipping of CONHESS 10 is simple.
No civil servant progresses from GL 10 to 11; rather the structure is GL 10 to 12. Why should the Medical doctors compel other health professionals to embrace movement from GL 10 to 11 when the entry point is GL 13 for doctors? That NIC judgment favoured JOHESU shows the legality of JOHESU demands. No more no less.
5. Issue of Relativity
A young graduate of Medicine on internship is placed on GL 10 and on post NYSC placed on GL 13. Other Health professionals on internship start on GL 09; and a post NYSC status of GL 10. The demand for something higher by doctors is therefore not acceptable. A doctor who starts on GL 13 after youth service already has an edge that cannot be covered over a 10-year period by other health workers. What other relativity are we talking about in terms of a benefit package?
Again, while the Medical Doctors within a span of 6 – 8 years rise to the post of Medical Director, the other health professionals spend years on progression, often stagnating and generally are denied such privileges by the Medical doctors. Medical doctors are known to threaten the government with strike should their professional counterpart in the health sector insist on rising to post of Directorship in various health departments, units, Health Management Boards, Tertiary Health Institutions etc. This is a misnomer because Public Service Rules and the relevant schemes of service permit all university graduates to rise to the apex level of director in the civil service.
6. Termination of appointments of other health professionals as consultants.
Contrary to the practice worldwide, the Hon. Minister of Health in December, 2010, acting in concert with the NMA, terminated the appointments of renowned Health Professionals, some of whom are professors in specialized field of Health as consultants. This led to a fierce legal battle which eventually led to NICN ruling in favour of JOHESU, thereby stopping the reign of impunity medical doctors have imposed on the other health professionals for several years, especially since the emergence of the incumbent Minister of Health.
What remains now is whether other health professionals would emerge as heads of their own units, departments or as Chief Executive Officers of Tertiary Health Institutions as is the norm all over the world and previously the practice when the Healthcare sector in Nigeria was the envy of other nations. It is important to put on record that this was the practice before Olikoye Kuti instigated the obnoxious Decree 10 of 1985 under military watch. It is evidence based that since the medical doctors took over the running of the healthcare institutions, the entire sector has been ruined to the extent that Nigeria now tops the list in medical tourism and capital flight as a result of healthcare expenditures.
7. Controversies surrounding the various categories of Medical Practitioners in the teaching hospitals.
NMA has refused to call a spade a spade. The appointments of more Honourary Consultants who are staff of Universities Instead of permanent Hospital Consultants leaves a huge drain on the purse of the Hospitals particularly because this investment on Hon. Consultants is unjustifiable as majority of them refuse to be impactful, because they simply don’t work in the teaching hospitals where they are paid.
Equally is the filling up of the hospitals with resident doctors whose interests border more on passing their exams than caring for the patients. Since these are postgraduate medical practitioners, training to become consultants, they should conform with the rules applicable to those of other health professionals in their category.
The NMA has no justifiable claim of legitimacy to the leadership of the hospitals as the hospitals have become celebrated cases of failure, dysfunction and inefficient institutions where existing infrastructures were last upgraded when health administrators were in charge in the early 80s. The series of Press Releases, and threats of strikes are actions necessary to keep the medical doctors relevant in the Public arena; but the media focus should not intimidate the public. Fact is doctors reap a windfall during strikes because government pays them for jobs not done and they divert patients in guaranteed public facilities to their private hospitals in a process of unprecedented profiteering.
Finally, JOHESU admonishes government to seize this opportunity of another doctors strike to show government can be government by not succumbing to propaganda in the media. Government must treat this as an unlawful strike because NMA, MDCAN & NARD are not trade unions and therefore logically cannot negotiate trade disputes with government for any reason. As vital stake holders we assure government and consumers of health that we shall do our part to legally redress the many aberrations of Nigerian doctors.
JOHESU also calls on all health professionals in its fold in both the public and private sector to continue to render service within their competence and skills to ameliorate the conditions of patients who seek care in the weeks ahead.