The recurring face-off between doctors and other health workers may worsen this year unless the Federal Government intervenes decisively, Bukola Adebayo writes
Seventy-six-year-old Mrs. Funmilayo Ayobo was in lively spirits on Monday, narrating some folktales to her five grand children in the sitting room, until about 10 pm when a broadcast medium began its 10 ‘o’clock news. Just a few minutes after the television station commenced the exercise, Ayobo’s countenance changed. The change in her complexion, as it were, followed an announcement by the electronic medium that health workers under the auspices of Joint Health Sector Unions would embark on a five-day warning strike from January 15.
Of course, she had every reason to feel this way. For the septuagenarian, health workers embarking on strike is akin to preparing her death warrant. As an individual suffering from chronic kidney disease, she frequently visits the Lagos University Teaching Hospital, Idi-Araba, for dialysis weekly. And the last time health workers embarked on strike, the experience of the action was not an interesting one for her. No wonder, the announcement greatly affected her personality that night.
The Ayobo experience is a pointer to what many Nigerians encounter when health workers embark on industrial actions. The planned warning strike will, of course, jolt many of them, coming especially at the beginning of a new year. Indeed, feelers so far show that the health sector will, this year, witness some ugly developments in relations to industrial action.
The threat by JOHESU is a signpost of what may likely befall the sector in 2014. JOHESU is an umbrella body for physiotherapists, nurses, pharmacists, radiographers, medical laboratory scientists, health information officers and social workers.
Already, the association has urged the Federal Government to meet all its demands or be ready to witness an industrial action. Again, as a purveyor of what is to happen, workers in public hospitals by January 15, will begin a five-day nationwide warning strike to press home their demands.
The chairman of the unions, Mr. Wabba Ayuba, who spoke to our correspondent, warned that the failure of the government to fulfill its agreement in two weeks would result in an indefinite industrial action.
The union had, between April and June last year, also embarked on several industrial actions. Also, resident doctors embarked on a 21-day nationwide strike last October, just as the parent body of doctors, the Nigerian Medical Association, embarked on five-day nationwide strike in December.
The NMA would have proceeded on an indefinite strike this week if not for the last minute effort of the Minister of Health, Prof. Onyebuchi Chukwu.
However, by trying to placate the doctors, other health professionals, who spoke to our correspondent, said the minister had only incurred their wrath.
According to the National President, Pharmaceutical Society of Nigeria, Mr. Olumide Akintayo, by acceding to the majority of the demands of the doctors, the minister has placed the needs of other health workers beneath those of doctors
Akintayo said, “In the last few weeks, our sensibilities as health workers have been traumatised by doctors who have more affinity for strikes than saving lives. Government has unwittingly compounded the situation by conceding privileges to one profession, while refusing valid court orders and signed agreements in favour of other health professionals.
“But we are going to resist this new oppression with all our God-given strength. Those who want peace must prepare for war. We (health care professionals) know that these privileges would not be served to us a la carte and we are ready to fight the grandstanding of the NMA to an end.”
Much ado about office of the surgeon-general
Doctors and pharmacists, nurses and other cadre of health workers have been at loggerheads right from the days of the late Prof. Olikoye Ransome- Kuti.
However, the new memorandum of understanding that the government signed with the NMA last December has currently stirred the hornets’ nest.
In the MoU, provisions were made for the Office of the Surgeon-General, whose duty would be to certify the state of health of government officials and coordinate the public health sector, among other responsibilities.
The surgeon-general, when and if appointed, would give travelling permit to any government official to travel abroad for medical check ups. He/she must first be satisfied that such medical services do not exist in Nigeria.
Health workers have kicked against this post, saying the appointment amounts to duplication of the functions of some top officials in the Federal Ministry of Health.
The National President, Nigerian Union of Allied Health Professionals, Dr. Felix Faniran, on Monday, said previous governments and many health committees, including those in the National Assembly, had debated and rejected the introduction of the position of Surgeon-General.
He again noted that the assumption of the position by a medical doctor was capable of escalating the crisis in the sector.
Faniran also urged President Goodluck Jonathan to suspend or withdraw his approval for the position or be ready to face industrial unrest from the other over 90 per cent health workers.
“Any attempt to make a medical practitioner to be a perpetual head of the managerial position in the health sector as the present Surgeon-General appointment connotes, would meet with stiff opposition.
“Unless Mr. President suspends and withdraws his support for the creation of this position, our union cannot guarantee any further industrial peace in the sector. Otherwise, Mr. President should create various posts of Physiotherapist-General, Pharmacist-General, Medical Laboratory Scientist-General, Dietitian-General, etc with immediate effect.” he added.
But doctors say the appointment of a surgeon-general will curb the excess of government officials who waste public funds in foreign hospitals treating malaria and other ailments that can be treated in Nigeria.
The Lagos NMA Public Relations Officer, Dr. Peter Ogunnubi, who spoke to our correspondent on Monday, wondered why health workers were opposing the appointment, which he said would reduce medical tourism.
Ogunnubi said, “When (Nelson) Mandela was sick, South Africans and the world were briefed regularly because they had a medical doctor in this position who could disclose the health status of public health officials without breaching the patient /doctor confidentiality.
“We have had similar scenarios in Nigeria, like when the late President Musa Yar’Adua was sick, Nigerians were shielded from the truth because we had nobody in this position to do so. Many governors have been sick and flown abroad without any disclosure to the public on the nature of their illness.
“With a surgeon-general, no public official can use public funds to treat any ailment that can be treated effectively in Nigeria. He/she would determine if the treatment of a condition should be at home or abroad. This will curb waste of public funds and development of our health sector. It is a medical doctor that will be a surgeon-general, because in the care of a patient, the doctor makes the final decision. Why is it being opposed?”
Denying that doctors were favoured over other health workers, Ogunnubi added, “Government has not even met our demands. Why the noise about favouritism? We have given them till February 8, but I hope that they won’t go to sleep before that time and wake up February 7 and start pleading just to stop us from going on strike.”
Cost of strikes: Increased mortality and loss of revenue
Perennial strike is the cancer eating into the fabric of the nation’s health sector. The yearly practice whereby once doctors go on strike and get their demands, other health workers would declare their own industrial action would only worsen the nation’s health indices this year.
According to the National President, Association of General and Private Medical Practitioners of Nigeria, Dr. Anthony Omolola, the cost of a day’s strike in an essential sector such as health is unquantifiable.
Omolola said, “What price do you place on the life of a patient that died because there are no doctors or nurses to attend to him in an emergency during a strike? It is unquantifiable. Every time health workers withdraw services, the nation loses a soul.This cannot be translated into cash because no man can recreate a life that was lost. Also, more people who are sick will not get treated. There will also be postponement of surgeries. The incidence of deaths and diseases will rise dramatically.”
Omolola, the medical director of St. Raphael Specialist Hospitals, Ikotun, said industrial action also affected the economy.
He added, “If a CEO who is sick dies due to a strike in the hospital, that business may collapse. Many will be out of work. The health system of the country is pictured from outside as being sick due to strike. International donors will not invest or bring health care programmes to a country whose medical workforce goes on strikes.
“When a tertiary health facility is shut down for six weeks, the loss runs into millions of naira. All these sophisticated medical equipment in the hospital may develop fault due to lack of use. By the time you get back from strike, you will need to put them back in shape. The hospital cannot generate any internal revenue when it is not treating patients. Those with critical conditions who have the money will have to travel out of the country to spend millions of dollars which should have been spent here if there were no strikes.’
Moving ahead in 2014, the task to end the power tussle between doctors and other health workers lies in the Federal Government.
Players in the sector note that the President and the health minister must tread carefully and responsibly in its negotiations with the different professionals in the sector.
The National President of the Nigerian Medical Association, Dr. Osahon Enabulele, said the government’s failure to address the grievances of professionals might lead to brain drain.
Enabulele added, “Painfully, we can authoritatively say that there are over 3,500 Nigerian trained physicians actively practising in the United Kingdom. Many more are in the United States and other nations of the world, and several are still leaving on a daily basis. This is partly due to the poor remuneration and unhealthy competition in the sector.
“We insist that Nigeria has all it takes to attract and retain the best medical work force in Nigeria rather than allowing our country to be drained of this very useful human resource.”
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