After an expanded National Officers Committee (NOC)
Meeting Nigerian Medical Association (NMA) held at the NMA
National Secretariat, Abuja which lasted till 5am on Friday
23rd May, 2014.
The following decisions were reached and attached is the
letter to the President of the Nation, Dr. Goodluck Ebele
Jonathan, GCFR.
Meeting Nigerian Medical Association (NMA) held at the NMA
National Secretariat, Abuja which lasted till 5am on Friday
23rd May, 2014.
The following decisions were reached and attached is the
letter to the President of the Nation, Dr. Goodluck Ebele
Jonathan, GCFR.
RESOLUTIONS ADOPTED AT THE EMERGENCY MEETING OF
NATIONAL OFFICERS' COMMITTEE (NOC) OF THE NIGERIAN
MEDICAL ASSOCIATION (NOC), HELD ON THE 22ND MAY,
2014 ON THE LETTER WRITTEN BY NLC/TUC/JOHESU ON
THE CURRENT HEALTH SECTOR ISSUES.
NATIONAL OFFICERS' COMMITTEE (NOC) OF THE NIGERIAN
MEDICAL ASSOCIATION (NOC), HELD ON THE 22ND MAY,
2014 ON THE LETTER WRITTEN BY NLC/TUC/JOHESU ON
THE CURRENT HEALTH SECTOR ISSUES.
NMA RESPONSE TO THE NLC/TUC/JOHESU-JOINT THREAT
AT A TIME OF NATIONAL PAIN AND HEART BREAK
AT A TIME OF NATIONAL PAIN AND HEART BREAK
The Nigerian Medical Association (NMA) has noted with
utmost displeasure the threat of strike action jointly issued by
the Nigerian Labour Congress (NLC) and the Trade Union
Congress (TUC) in solidarity with JOHESU to deploy all
resources within their reach to collapse the entire Nigerian
nation using a nationwide mass action in the event of failure
of the Federal Government to meet some of their irrational
and inordinate demands.
We also note with shock the level of deep seated and possibly
genetic anger some leaders of the allied health workers (who
are civil servants) have continued to exhibit against doctors,
to the extent of describing Prof. C. O. Onyebuchi Chukwu, a
serving Hon. Minister of The Federal Republic of Nigeria as
"INTRANSIGENT". This is not only despicable but highly
condemnable by all men of good conscience.
We regret that the NLC and the TUC have particularly chosen
this period of national grief and severe trauma occasioned by
series of bomb blasts with mass casualties; the kidnap of our
daughters and sisters in Chibok by insurgents and several
other calamitous events bedeviling our beloved nation to
issue a threat to the Federal Government. Without prejudice,
we have always noted and voiced out the fact that the crises
in the health sector are politically motivated and counter
productive to efforts at sustainance of our fledging
democracy, spirited efforts at achieving the health related
MDGs in particular and in the overall improvement of our
health indices in general. This threat of strike and other
recent events have proven us right. This is an attempt to
blackmail the Federal Government to do what it knows, that if
done, will trigger a vicious circle of industrial disharmony in
the health sector.
It is sad to note that given the status of NLC/TUC as the
umbrella body of all labour organizations in the country, the
leadership have NEVER bothered to investigate the issues
surrounding industrial disharmony in the health sector but
chose to exhibit bias and lopsided support for their affiliates
not minding the grave consequences these pose to the
overall health and well being of Nigerians.
THE ISSUES
Salary and Emoluments
It is important at this juncture to let the whole nation know
that for more than twenty years the Nigerian doctors were
short-changed due to an error during the conversion of salary
scales from the Grade level system to the HATISS scale. The
NMA was in discussion with government to correct the error
all this while, preferring the option of dialogue to strikes. It
was only in December 2013 that the Federal government
accepted that truly there was an error against the doctors. It
is also pertinent to note that the error was magnified over the
20 years period. NMA in a rare show of maturity and
demonstration of unparalleled patriotism waived all the
arrears and requested that the correction takes effect from
January 2014. A circular effecting a partial correction was
issued on January 3rd, 2014, which is yet to be implemented
till date. It is worthy of note that the drop in call duty/shift
duty allowances which hitherto was not reflected , was
corrected across board at the January 3rd, 2014 meeting
courtesy of NMA vigilance. This correction was extended to
all health workers; which is a practical demonstration of the
egalitarian leadership of Doctors who carry everybody along
and ensure that every health worker get his/her rightful due.
ABERRANT SKIPPING OF SALARY GRADE LEVEL 10
The general public is probably not aware of the issues
surrounding skipping of salary grade level as it concerns
members of JOHESU. To put it in a very simple way; a
JOHESU member on grade level 10 or equivalent (CONHESS
9) moves to Grade level 13 or equivalent (CONHESS 12) on
promotion. There is no other set of workers in Nigeria that
enjoy this type of unusual advancement. This has been going
on for more than ten years before the office Of the Head of
Service of the Federation directed that it should be stopped.
This ultimately led to a suit action at the National Industrial
Court (NIC). For reasons best known to the NIC it ruled that
since they have been enjoying it for some time, they should
continue to do so.
The Federal Ministry of Health (FMOH) appealed against the
judgement on the basis of potential danger of causing
conflagration in the entire workforce of the nation and
injustice to other workers in the sector. Today, NLC, TUC and
JOHESU are querying why the FMoH should appeal against
an overt fraud, and threatening to shut down the entire
nation. The same court that granted skipping also told
JOHESU and her members that they have no basis to earn
the same salary as doctors, but they will take non of that;
everybody wants to be paid the same as doctors. NMA
wishes to use this medium to ask JOHESU sympathizers,
where else in the whole world does this anomaly take place?
CREATION OF DIRECTORATE
Doctors have never been concerned with obstructing
processes which are to lead to better illumination for all
concerned through referral of issues to appropriate bodies for
considerations. Some are pleased to note the burden on the
office of the Chairman of the MEDICAL Advisory Committee
who also is the Director of clinical services, research and
training but still do not want it supported by Deputies. This is
the understanding and love they have for the activities of the
offices concerned and the implications of their
recommendations for our society at large.
NMA had warned years ago that certain schemes of service
obtained through the back door will be difficult to implement
in a hospital system. We are aggrieved at how these strange
schemes and cadres are awarded to certain group of workers
without considerations for overall harmony or hierarchical
order, ultimate responsibilities in patient care and financial
burden on the nation. This explains from time immemorial
why doctors from grade levels 15 and above have retained
their professional designation without causing bogus
expansion of the hospital organogram. How would a hospital
with multitude of Directors without portfolio function, if
efficient patient management is the vision?
ALLEGATIONS OF DOUBLE SALARY FOR HONOURARY
CONSULTANTS IN HOSPITALS
The concepts, bases and philosophy of 'Honorary
Consultants' appear to be unclear to some people just as the
titles of the leaders are not. These Honorary Consultants are
the lecturers of the University that own the teaching hospitals
and award degrees to their students. They plan and
implement the curricula including evaluation of the programs.
These lecturers are the only staff whose promotions are
based on research and publication. It is a well known and
verifiable fact, that these Honorary consultants receive their
only salary from the university, while the Teaching Hospitals
merely pay them allowances for the clinical services they
render to the hospital in addition to teaching their students.
This is the practice all over the world. It is unimaginable how
NLC/TUC was convinced by JOHESU to subscribe to the
BLATANT LIE that Honorary Consultants receive double
salary.
APPOINTMENTS AS CMDs AND MDs OF TERTIARY
HOSPITALS
The view that a Chief Medical Director needs not to be a
doctor is absurd. It is also on record that the current
arrangement was birthed as a child of necessity having noted
the gross incompetence of non-medically qualified
personnels (non doctors) to run hospitals taking cognizance
of the fact that the hospital is a complex institution that
requires a broad view knowledge and experience of workings
of the entire medical sector in addition to cognate managerial
experience.
We call on the entire nation to condemn this fierce,
unwarranted and provocative competition for positions,
relevance, and leadership roles in the health industry, as the
scenario where the leadership of the healthcare delivery team
is in perpetual contest will not do anybody any good, and
bring to naught all the efforts made so far to improve
healthcare delivery in Nigeria. In settings like the private
hospitals where doctors are not faced with the suffocating
contest for roles and positions, resounding successes and
breakthroughs are evident. NMA asks: Why is it that headship
crises fail to occur in private, mission and military hospitals
where there are respects for hierarchical order?
RELATIVITY IN HEALTH SECTOR:
It is one of the best global practices that every worker is
rewarded according to education, training, skills, job
description, and levels of responsibilities as it affects
patients' management. This is why all over the world, the
doctor is the undisputed leader of the health team. We are
greatly perturbed that the hierarchical order which promote
discipline, efficiency, and accountability is being rudely
challenged in our country. Even the much celebrated NIC
judgement stated that JOHESU and her members have no
basis to be remunerated as doctors, this international best
practice is yet to take root in Nigeria health sector. This
unique type of disparity called relativity exists in other sector
of the economy - Judiciary, Aviation, Armed Forces etc,
Doctors have at all times been considerate to all but insist
that the global standard MUST be maintained.
WAY FORWARD
In the circumstance of the continuing industrial quagmire,
with the attendant negative consequences on performance of
the healthcare sector despite efforts of Government to
improve the health indices of our country.
The NMA states as follows,
1. That the Federal Government must not succumb to the
cheap blackmail of JOHESU and her allies by granting
requests that undermine the interest of the Nigerian doctors.
2. Should Government accede to the request that DISTORTS
RELATIVITY and other partially corrected injustices meted out
to doctors for over 20 years, NMA will have no other option
than to stay outside the hospitals till the anomalies are fully
corrected including payment of 20years arrears accruing
from the years of distortion.
3. That Government should expedite action on proper job
evaluation for all cadres of workers and professionals in the
health sector according to international standards.
4. In view of the dwindling returns on investments, using
scarce resources of the nation due to ever increasing levels of
indiscipline, unbridled unionism and gangsterism witnessed
in the health sector, NMA advises that Government should
scale up public private partnership (PPP) options including
outsourcing and concessioning of certain units and services
that would be effectively and efficiently managed.
5. That Government should without further delay institute
appropriate disciplinary measures according to the provisions
of the Public Service Rules, to curb this unfortunate
phenomenon of unregulated unionism turned into political
activism and gangsterism to the extent of total lack of respect
to constituted authority. The earlier this scenario is arrested
the better for the nation.
6. We wish to call on other arms of government, the
Legislature, Judiciary, MDAs concerned with Establishment
matters to do a due diligence and conduct an extensive
investigation on issues concerning the health sector, as
otherwise upsets the hierarchical structure and certain
tradition unique to it.
Finally, NMA as a responsible professional body and the
custodian of the peoples' health, would continue to support
the Government as it strives to improve the health of our
citizens through committed zeal in the discharge of our duties
and constructive engagement even when certain situation
arise. We shall at all times identify with progressive policies
of Government and be by her side as she wins this war
against the emerging perilous emergency-insecurity.
Long Live NMA
Long Live Federal Republic of Nigeria
NMA – The Custodian of the People’s Health
Dr. Kayode OBEMBE. Dr. Adewunmi ALAYAKI
President Secretary-General
utmost displeasure the threat of strike action jointly issued by
the Nigerian Labour Congress (NLC) and the Trade Union
Congress (TUC) in solidarity with JOHESU to deploy all
resources within their reach to collapse the entire Nigerian
nation using a nationwide mass action in the event of failure
of the Federal Government to meet some of their irrational
and inordinate demands.
We also note with shock the level of deep seated and possibly
genetic anger some leaders of the allied health workers (who
are civil servants) have continued to exhibit against doctors,
to the extent of describing Prof. C. O. Onyebuchi Chukwu, a
serving Hon. Minister of The Federal Republic of Nigeria as
"INTRANSIGENT". This is not only despicable but highly
condemnable by all men of good conscience.
We regret that the NLC and the TUC have particularly chosen
this period of national grief and severe trauma occasioned by
series of bomb blasts with mass casualties; the kidnap of our
daughters and sisters in Chibok by insurgents and several
other calamitous events bedeviling our beloved nation to
issue a threat to the Federal Government. Without prejudice,
we have always noted and voiced out the fact that the crises
in the health sector are politically motivated and counter
productive to efforts at sustainance of our fledging
democracy, spirited efforts at achieving the health related
MDGs in particular and in the overall improvement of our
health indices in general. This threat of strike and other
recent events have proven us right. This is an attempt to
blackmail the Federal Government to do what it knows, that if
done, will trigger a vicious circle of industrial disharmony in
the health sector.
It is sad to note that given the status of NLC/TUC as the
umbrella body of all labour organizations in the country, the
leadership have NEVER bothered to investigate the issues
surrounding industrial disharmony in the health sector but
chose to exhibit bias and lopsided support for their affiliates
not minding the grave consequences these pose to the
overall health and well being of Nigerians.
THE ISSUES
Salary and Emoluments
It is important at this juncture to let the whole nation know
that for more than twenty years the Nigerian doctors were
short-changed due to an error during the conversion of salary
scales from the Grade level system to the HATISS scale. The
NMA was in discussion with government to correct the error
all this while, preferring the option of dialogue to strikes. It
was only in December 2013 that the Federal government
accepted that truly there was an error against the doctors. It
is also pertinent to note that the error was magnified over the
20 years period. NMA in a rare show of maturity and
demonstration of unparalleled patriotism waived all the
arrears and requested that the correction takes effect from
January 2014. A circular effecting a partial correction was
issued on January 3rd, 2014, which is yet to be implemented
till date. It is worthy of note that the drop in call duty/shift
duty allowances which hitherto was not reflected , was
corrected across board at the January 3rd, 2014 meeting
courtesy of NMA vigilance. This correction was extended to
all health workers; which is a practical demonstration of the
egalitarian leadership of Doctors who carry everybody along
and ensure that every health worker get his/her rightful due.
ABERRANT SKIPPING OF SALARY GRADE LEVEL 10
The general public is probably not aware of the issues
surrounding skipping of salary grade level as it concerns
members of JOHESU. To put it in a very simple way; a
JOHESU member on grade level 10 or equivalent (CONHESS
9) moves to Grade level 13 or equivalent (CONHESS 12) on
promotion. There is no other set of workers in Nigeria that
enjoy this type of unusual advancement. This has been going
on for more than ten years before the office Of the Head of
Service of the Federation directed that it should be stopped.
This ultimately led to a suit action at the National Industrial
Court (NIC). For reasons best known to the NIC it ruled that
since they have been enjoying it for some time, they should
continue to do so.
The Federal Ministry of Health (FMOH) appealed against the
judgement on the basis of potential danger of causing
conflagration in the entire workforce of the nation and
injustice to other workers in the sector. Today, NLC, TUC and
JOHESU are querying why the FMoH should appeal against
an overt fraud, and threatening to shut down the entire
nation. The same court that granted skipping also told
JOHESU and her members that they have no basis to earn
the same salary as doctors, but they will take non of that;
everybody wants to be paid the same as doctors. NMA
wishes to use this medium to ask JOHESU sympathizers,
where else in the whole world does this anomaly take place?
CREATION OF DIRECTORATE
Doctors have never been concerned with obstructing
processes which are to lead to better illumination for all
concerned through referral of issues to appropriate bodies for
considerations. Some are pleased to note the burden on the
office of the Chairman of the MEDICAL Advisory Committee
who also is the Director of clinical services, research and
training but still do not want it supported by Deputies. This is
the understanding and love they have for the activities of the
offices concerned and the implications of their
recommendations for our society at large.
NMA had warned years ago that certain schemes of service
obtained through the back door will be difficult to implement
in a hospital system. We are aggrieved at how these strange
schemes and cadres are awarded to certain group of workers
without considerations for overall harmony or hierarchical
order, ultimate responsibilities in patient care and financial
burden on the nation. This explains from time immemorial
why doctors from grade levels 15 and above have retained
their professional designation without causing bogus
expansion of the hospital organogram. How would a hospital
with multitude of Directors without portfolio function, if
efficient patient management is the vision?
ALLEGATIONS OF DOUBLE SALARY FOR HONOURARY
CONSULTANTS IN HOSPITALS
The concepts, bases and philosophy of 'Honorary
Consultants' appear to be unclear to some people just as the
titles of the leaders are not. These Honorary Consultants are
the lecturers of the University that own the teaching hospitals
and award degrees to their students. They plan and
implement the curricula including evaluation of the programs.
These lecturers are the only staff whose promotions are
based on research and publication. It is a well known and
verifiable fact, that these Honorary consultants receive their
only salary from the university, while the Teaching Hospitals
merely pay them allowances for the clinical services they
render to the hospital in addition to teaching their students.
This is the practice all over the world. It is unimaginable how
NLC/TUC was convinced by JOHESU to subscribe to the
BLATANT LIE that Honorary Consultants receive double
salary.
APPOINTMENTS AS CMDs AND MDs OF TERTIARY
HOSPITALS
The view that a Chief Medical Director needs not to be a
doctor is absurd. It is also on record that the current
arrangement was birthed as a child of necessity having noted
the gross incompetence of non-medically qualified
personnels (non doctors) to run hospitals taking cognizance
of the fact that the hospital is a complex institution that
requires a broad view knowledge and experience of workings
of the entire medical sector in addition to cognate managerial
experience.
We call on the entire nation to condemn this fierce,
unwarranted and provocative competition for positions,
relevance, and leadership roles in the health industry, as the
scenario where the leadership of the healthcare delivery team
is in perpetual contest will not do anybody any good, and
bring to naught all the efforts made so far to improve
healthcare delivery in Nigeria. In settings like the private
hospitals where doctors are not faced with the suffocating
contest for roles and positions, resounding successes and
breakthroughs are evident. NMA asks: Why is it that headship
crises fail to occur in private, mission and military hospitals
where there are respects for hierarchical order?
RELATIVITY IN HEALTH SECTOR:
It is one of the best global practices that every worker is
rewarded according to education, training, skills, job
description, and levels of responsibilities as it affects
patients' management. This is why all over the world, the
doctor is the undisputed leader of the health team. We are
greatly perturbed that the hierarchical order which promote
discipline, efficiency, and accountability is being rudely
challenged in our country. Even the much celebrated NIC
judgement stated that JOHESU and her members have no
basis to be remunerated as doctors, this international best
practice is yet to take root in Nigeria health sector. This
unique type of disparity called relativity exists in other sector
of the economy - Judiciary, Aviation, Armed Forces etc,
Doctors have at all times been considerate to all but insist
that the global standard MUST be maintained.
WAY FORWARD
In the circumstance of the continuing industrial quagmire,
with the attendant negative consequences on performance of
the healthcare sector despite efforts of Government to
improve the health indices of our country.
The NMA states as follows,
1. That the Federal Government must not succumb to the
cheap blackmail of JOHESU and her allies by granting
requests that undermine the interest of the Nigerian doctors.
2. Should Government accede to the request that DISTORTS
RELATIVITY and other partially corrected injustices meted out
to doctors for over 20 years, NMA will have no other option
than to stay outside the hospitals till the anomalies are fully
corrected including payment of 20years arrears accruing
from the years of distortion.
3. That Government should expedite action on proper job
evaluation for all cadres of workers and professionals in the
health sector according to international standards.
4. In view of the dwindling returns on investments, using
scarce resources of the nation due to ever increasing levels of
indiscipline, unbridled unionism and gangsterism witnessed
in the health sector, NMA advises that Government should
scale up public private partnership (PPP) options including
outsourcing and concessioning of certain units and services
that would be effectively and efficiently managed.
5. That Government should without further delay institute
appropriate disciplinary measures according to the provisions
of the Public Service Rules, to curb this unfortunate
phenomenon of unregulated unionism turned into political
activism and gangsterism to the extent of total lack of respect
to constituted authority. The earlier this scenario is arrested
the better for the nation.
6. We wish to call on other arms of government, the
Legislature, Judiciary, MDAs concerned with Establishment
matters to do a due diligence and conduct an extensive
investigation on issues concerning the health sector, as
otherwise upsets the hierarchical structure and certain
tradition unique to it.
Finally, NMA as a responsible professional body and the
custodian of the peoples' health, would continue to support
the Government as it strives to improve the health of our
citizens through committed zeal in the discharge of our duties
and constructive engagement even when certain situation
arise. We shall at all times identify with progressive policies
of Government and be by her side as she wins this war
against the emerging perilous emergency-insecurity.
Long Live NMA
Long Live Federal Republic of Nigeria
NMA – The Custodian of the People’s Health
Dr. Kayode OBEMBE. Dr. Adewunmi ALAYAKI
President Secretary-General
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