Late yesterday after close of work, a LUTH ARD communiqué surfaced on social media, calling on all LUTH resident doctors and House Officers to embark on an indefinite strike with effect from Friday, 7th June 2019 unless LUTH Management complies with their following demands:
- Employment of resident doctors and House Officers into all Departments.
- Installation of street lights in all corners of the Hospital
- Payment of all outstanding salaries & arrears to House Officers and Resident Doctors.
This present agitation was started when the ARD demanded the withdrawal of administrative queries given to three erring trainees. They even demanded the Hospital Management should apologise to the ARD, among other things. This detailed explanation is therefore to inform the general public and, especially, our almost 400 resident doctors, all Consultants, over 180 House Officers and the LUTH Community about the facts of the issues raised.
Employment of Doctors and House Officers
LUTH does not employ Resident Doctors and House Officers. Each of these cadres is ADMITTED periodically for training, under specific guidelines, rules and regulations. Each person so admitted into training is paid while in the Hospital for a specified period while completing their study. Each of these programmes operates on a conveyor belt system and the numbers in training vary as some leave and others come in. Admission into each of these training programmes is based on extant approvals from appropriate Government agencies and it is therefore not the call of ARD to dictate when or how trainees are admitted.
A year ago, in June 2018, there were 173 House Officers on LUTH payroll while a new batch was being prepared to resume. A batch of 250 new House Officers was admitted in October and December 2018 and they will finish in September and November 2019 respectively. In June 2019, there are presently 189 House Officers on our payroll. LUTH has enough House Officers for the care of about 400 patients on admission. New House Officers will be admitted for training when the time is due and not before then.
As of today, there are 255 Resident Doctors on LUTH payroll and another 96 Supernumerary Resident doctors, a fair reflection of the general trend in other Teaching Hospitals of comparative size with LUTH. Furthermore, a list of over 180 new Resident Doctors interviewed for admission by the Hospital Management Board is awaiting final approval at the Budget Office in Abuja. Admission into a training programme is an administrative matter and not within the purview of any Association to dictate to the Hospital. It takes a process that must be strictly followed and no Association of trainees has a monopoly of wisdom on this.
Employment is generally predicated on ability to pay, in this case, the budget allocated to the Institution by the Federal Government of Nigeria. Thus, any group's wish-list must necessarily factor-in the budgetary implications of their demands, especially now that Government is sensitive to disproportional cost of funding personnel emoluments.
Street Light in LUTH Premises
As part of our preparations towards the commissioning of the NSIA/LUTH Cancer Centre in February 2019, LUTH Management had secured assurances from a corporate organisation to install bright LED streetlights within the premises. This promised donation however failed to materialise and the Institution on its own commenced the phased installation of the first 150 street lights as earlier planned. This included modifying the existing electricity poles and wire circuits. It is a delight to see what has been accomplished thus far. The ARD's demand for a speedy conclusion of this laudable project, commenced without any input from the Association, smirks of mischief and is merely playing to the gallery. Once upon a time, this same association went out to source for credible projects. Seems times have changed! Every member of the LUTH Compound community should please be assured that the ongoing installation of streetlights within the premises will be completed in due
Outstanding Arrears and Salaries to House Officers & Resident Doctors
A delight to all Federal Tertiary Health Institutions is the recent migration of all staff to the IPPS platform, a centralised payment system which pays directly into the bank account of each Federal employee from Abuja since the beginning of this year. Thus, all salary issues are now between each individual and IPPIS, through an IPPIS Desk Officer in each Institution. The initial challenges encountered by new migrants onto this platform resulted in widespread underpayments, no-payments and even overpayment of workers in the early months of its commencement, akin to what transpired when this same payment platform was first used for all institutions in 2013. These irregularities were gradually removed and such anomalies were corrected in Abuja, not in any Institution, definitely not in LUTH. It is therefore pure fabrication on the part of the ARD President, who knows all these, to claim that LUTH owes salaries to resident doctors. For the avoidance of doubt, LUTH owes no salaries to any resident doctor. Rather, IPPIS does, as no money was paid to LUTH for any resident doctor's salary. The fact remains that salaries are computed and paid directly from Abuja through the Federal Ministry of Finance on the IPPS portal.
In January 2019, there was a circular from the Office of the Accountant General of the Federation that the salary of any Federal Staff who had hitherto not registered, and thus, had no Pension Account Numbers, RSA number and Pension Fund Administration name would not be paid until such details were submitted. The salaries of over 12000 workers nationwide who did not comply were "pegged", (stopped) until those affected provided the details to IPPS. In January and February, 150 LUTH workers were affected. The Hospital has since assisted such staff (who then belatedly complied with the Accountant General's directive) to compute and send these details to IPPIS and their salaries have been regularly paid from March 2019 till date.
The outstanding salaries of January and February 2019 have been paid by IPPIS for all except 36 persons in January and another 53 persons in February. The Hospital's Administration has been regularly in touch with IPPS over the remaining outstanding January and February payments from IPPIS and these facts are known to the ARD. One Dr Ogunbiyi Adewale is yet to receive his salaries from January to May 2019 because his account profile failed to activate as he wrongly registered as a contract staff with IPPS. In fact the Hospital has written that the previous account profile with IPPS should be deleted so he can be re-registered for enrolment on IPPS. So, let me repeat: LUTH owes no salary to any resident doctor. Rather, the Institution has been assisting those affected to be paid by the relevant agency. As a postscript on this, although the ARD is silent on those who were overpaid, the IPPS will ask fora refund, someday soon.
All arrears of examination allowance, update courses and salary upgrade are arrears that have been submitted for payment by the relevant authorities and will be paid when such sums are released by Government. This is known to the ARD executives.
In LUTH, a worker officially resumes on the day he or she finally completes their admission/employment registration formalities. House Officers are however notorious in delaying this for as long as possible, thus making it impossible to place them on the payment list for some months. Those who have outstanding payments belong to this group who sometimes want to delay their payments so they can coiled bulk money for the purposes of travel or vehicular purchase.
The above explanations are necessary to douse the anxiety the present ARD leadership has been trying to create for some time in LUTH. A meeting of LUTH Management, representatives of LUTH Management Board and the ARD leadership was held two weeks ago (during their 2-day "warning strike") at which eminent persons such as Alhaji Bashir Bolarinwa, distinguished Professor Igwilo and The Provost, College of Medicine, University of Lagos represented the Board. It was mutually adjourned to give time for the full Board to deliberate on its several observations in three weeks time. Specifically, the representative of the Board Chairman reminded the ARD that most of the issues it tabled were not within the control of the Hospital, but all the same these would be conveyed to the appropriate authorities. Members of the NMA Executives (Lagos State Branch) also held a useful meeting with the Hospital Management in company of two past NMA Chairmen, on this same issue.
The general public should kindly note that the ARD is but one association among seven others in LUTH and its membership is less than one tenth of the total workforce in the Hospital. The era of strident calls for disorder and anarchy by this privileged group, whereby the Hospital will be shut down and Innocent patients are held to ransom, is gone. Most trainees are now working to quickly complete their training and move on to better things rather than fritter away their allotted time in frivolous posturing with constituted authority.
Let everyone therefore be assured that every effort is being made to assist anyone who may have difficulty adjusting to the new order of payment by the Government on the IPPS Platform. The modest strides recorded by LUTH in the past few years are due to the cooperation and teamwork of everyone, with few strike actions. We have created an ambience of tranquility and progress. We no longer complain of power failures with the new Independent Power Plant supplying our community with 24/7 power, the first of its kind in any Federal institution nationwide. Our facilities are being rehabilitated after decades of uninterrupted usage and LUTH roads are now well paved, even as several other projects have sprung up to reposition LUTH as the place to go for affordable tertiary care. Our Cancer Centre is the best in West Africa. Our X-Ray Department, Kidney Dialysis Unit and Wards are being rebuilt to reposition them for world-class services.
We are aware of a minority group within the ranks of our trainees who have higher political ambitions and who mistakenly think that the quickest path to ascendancy to leadership is through ceaseless, implacable confrontations with constituted authority. The Hospital has gone beyond such antics, even as we leave the door wide open to reasonable and progressive discourse on all topics at all times.
We implore the ARD to tow the path of peace and not disturb or try to disrupt services in LUTH. LUTH is already on the march towards enhanced work ethics, dedication and selfless service to our clients. Only the serious need join this march. It is a privilege to serve in LUTH. It is not a right. We must remind all who want to stay in LUTH's training programmes to obey the rules that govern the Institution, rather than pose as an alternate government. The national confidence reposed, and investment made in the lives of our trainees should not be in vain, but should be reciprocated with renewed commitment by all to serve.
LUTH presently has zero tolerance for anyone who threatens its survival and the duty to serve humanity as we continue to attract investors to assist in bridging our several infrastructural gaps. All are implored to join hands in this renewal.
In closing let me restate the following rules of engagement clearly:
- Each House Officer signed not to participate in any strike action during their training and any House Officer who does so will have their admission and training reviewed in accordance with extant rules.
- Picketing by any group is not allowed within the Hospital premises as it is an essential service area.
- Anyone who wishes to stay off work may do so at their own risk, but no intimidation of other staff willing to work will be tolerated.
- It should be noted that every trainee will be assessed not only on skills acquisition, but also on ethics, morals and character.
- The Government's No-Work-No-Pay rule is in force and will be strictly enforced.
The general public is hereby assured that the Hospital will be open for business and no services will be shut down in LUTH. All peace-loving LUTH workers are also assured that no efforts will be spared to protect lives and property within LUTH at all times.
Olufemi Fasanmade MBBS, FWACP, FACE, FNSEM
Chairman, Medical Advisory Committee
Associate Professor of Medicine, CMUL
Consultant Endocrinologist, LUTH
4th June, 2019.