In an open letter written to the
secretary to the Federal Government of Nigeria, Senator Anyim Pius Anyim, on
the 10th of June and sent to him on the 11th of June 2014, the Nigerian Medical
Association (NMA) under the leadership of Dr. Kayode Obembe as President and
Dr. Adewumi Alayaki as secretary had written 24 demands that must be urgently
met. They have given the Government a 14-day ultimatum, failure of which NMA
would call her members out on an indefinite strike nationwide. NMA is made up
of ASSOPON- Association of Pathologist of Nigeria, MDCAN - Medical and Dental
Consultants of Nigeria, ARD-Association of Resident Doctors and smaller sister
Associations, who are doctors in public and private practice.
For many years, Allopathic
Medical Doctors in Nigeria have always hoodwinked the Government and the
general public, through falsehood and blackmail. They have coerced the
Government to take unfavorable decisions which have always been detrimental to
the health sector and the Nigerian populace. They have continually done this as
a result of the structural injustice that has been perpetuated by many members
of NMA in high places in Government. They undermine the laws setting up the
hospital system, the Public Service Rules and above all the constitution of the
Federal Republic of Nigeria.
At this juncture let us have a critical look
at those demands.
1. APPOINTMENT OF THE POST OF
THE DEPUTY CMAC IN HOSPITALS. In line with the University Hospitals
(reconstruction of boards) cap U15, LFN 2004 commonly called decree 10 of 1985
which governs Hospital practice in Nigerian, there is the office of the CMAC
but it never provided for the office of the DCMAC. In section 4, it provides
thus; “there shall be for each Hospital, a Chairman of the Medical Advisory Committee
who shall be appointed by the Board and responsible to the Chief Medical
Director for all the Clinical and Training activities of the Hospital”. Section
2i provides that; the CMAC is a member of the board. There is no place in the
organic law setting up the hospital that created the office of the DCMAC and
there is no place it says that only Allopathic Medical Doctors should be
appointed as such. Yet NMA is insisting that the Government must appoint four
DCMAC in every Teaching Hospital and three in every Federal Medical Centre. All
along, Boards of Hospitals as a result of threats from NMA have been allowing
this illegal office to be used to undermine statutory approved Scheme of
Service of other professional groups. The Public Service Rule in section
1-general in 160101 provides; ‘A Parastatal is a government-owned organization,
established by statutes to render specified service(s) to the public. It is
structured and operates according to the instrument establishing it and also
comes under the policy directives of government. In line with 160201 (a)
statutory boards/council shall set operational and administrative policies in
accordance with government policy directives and supervise the implementation
of such policies. A situation where Allopathic Medical Doctors in Nigeria wants
the Government to continue to create post and responsibilities not backed by
statutes undermines the principles of good governance. It is gross violation of
the law setting the Government owned institution. Moreover, it is trite law
that you cannot add to a statute. That will be ultra verse.
2. NMA IS OPPOSED TO THE
APPOINTMENT OF DIRECTORS IN HOSPITALS: It should be noted that this statement
is laden with deceit as postulated by NMA, that having Directors in hospitals
will affect patient care negatively. This is fallacy of the highest order. The
truth of the matter is, NMA does not want professional departments as
directorates in the various Scheme of Service, rendering professional duties
like the department of Pharmaceutical Services headed by the Director of
Pharmaceutical Services who is a Pharmacist. Department of Nursing Services
under the Director Nursing Services, who is a Nurse. The Department of Medical
Laboratory Services under the Director of Medical Laboratory Services, who is
Medical Laboratory Scientist etc. And all are answerable to the Chief Medical
Director. It should be noted that, NMA and her members were the ones who
negotiated their present Scheme of Service that all their members can rise to
level 17 without being called Directors. Other Healthcare Personnel have
continued to follow their own Scheme of Service where only one person gets to
level 17 and is designated the Director, which is the most popular path in the
Public Service. Again in the criteria for employment as stated in the Public
Service rule in 020205,-“to be eligible for appointment into the federal Public
Service, every applicant must 020205(e) possess requisite qualification as
provide in the Scheme of Service.” The Scheme of Service of all other
Healthcare Personnel in the hospital provides for a Directorate system. Now NMA
and her members want to go on strike for Government to jettison the Public
Service Rule which is a Government Policy Document. The Scheme of Service for
Allopathic Medical doctors provides for a non Directorate system. AND NO
PROFESSIONAL GROUP IMPOSES HER OWN SCHEME OF SERVICE ON THE OTHER. SECONDLY NO
EMPLOYEE DETERMINES THE CONDITION OF SERVICE OF ANOTHER EMPLOYEE. They are
agitating for this in order to entrench professional imperialism, so that all
other healthcare staff will not reach the zenith of their career. That is the
singular reason, a doctor on level 15 is called a Head of Department heading
someone already on level 17 and is designated a Director .This is gross
absurdity against the Public Service Rule. There is no Government Institution
in Nigerian where such is seen, only in our Hospitals. And that is what NMA
wants to perpetuate. Rule 160103 of the Nigerian Public Service Rule provides
–“Parastatals are to retain and improve existing rules, procedures and
practices in their establishments and ensure that there are no deviations from
the general principles contained in the Public Service Rules………………………………however
in the absence of internal rules and regulations on any matter, the relevant
provisions of the Public Services Rule shall apply”. This can also be seen in
section 5(5) and 17 of the act governing hospital practice in Nigeria. NMA’s
demands are anti- Public Service Rule.
3. NMA DEMANDS THAT GRADE LEVEL
12 SHOULD BE SKIPPED BY DOCTORS: This demand is not in line with Government
approved Scheme of Service for Doctors.NMA in her usual falsehood has always
accused JOHESU members of skipping when in actual sense there is nothing like
that. The term is a misnomer this is because skipping is when a Civil Servant
moves from a grade level to a higher grade level that is not provided for in
the Scheme of Service e.g. when a worker moves from 8-10 and there is no
approval for such a special promotion ,this is skipping. But when you move from
10- 12 this is not skipping because this is provided in the Scheme of Service
and there is no level 11 in the Scheme of Service. A baby physician enters the
Service on level 12, which is a principal grade. Now NMA is insisting that they
must be appointed on level 13, which is an Assistant Chief Cadre. Haba! How can
a beginner enter the Civil Service on an Assistant Chief Cadre? There is no
Nigerian worker that enters the Service on such grade. There is no Nigerian
Civil Servants that skips. This is not provided in any known Nigerian scheme of
Service.
4. APPOINTMENT OF OTHER MEDICAL
PERSONNEL AS CONSULTANTS: NMA is threatening to go on strike because the
Government has chosen to obey Court judgment in favour of other Health
Personnel that they can also be appointed as consultants in their chosen field.
In a false sense of well being, NMA insists that they own the patients and as
such only the medical doctor can be called a Consultant. Nobody owns the
patient; rather the patient is the epi-centre of Healthcare Service. Medical
doctors are just one of the professional skilled healthcare attendants in a
hospital, attending to the healthcare needs of the patient. Each medical
personnel are given a license to practice their chosen field. The various
scheme of Service for Pharmacists, Physiotherapist, Nurses, Medical Laboratory
Scientists etc provides that they can be appointed as consultants. All over the
world, it is not only Allopathic Medical Doctors that are appointed as consultants.
A simple google search will show that there are different consultants in the
Health Field. The word consultant is not an exclusive term to designate
Allopathic Medical Doctors who are specialists. William A. Cohen, PhD, in his
bestselling book “How to Make It Big as a Consultant” has this to say on pages
2 and 3. “Consultants operate in many different fields. Import-export,
management, human resources, engineering, and marketing are some of the more
common ones. There are consultants in archeology and consultants in clothes
selection. There are even consultants to help authors overcome writer’s block.”
On page 3 he has this to say. “A consultant is simply anyone who gives advice
or performs other services of a professional or a semiprofessional nature in
return for compensation”. NMA wants to stop working because other Healthcare
Personnel are appointed as consultants. Is NMA saying that they are the only
Professionals in the Health Field?
5. RELATIVITY IN HEALTH SECTOR: On
what basis is NMA still agitating for relativity when at the point of entry
this has been taken care of and resolved based on the number of years one
spends in school. Those who spend four years have their entry point as level
8,those that spend five years on level 9 ,those that spend five years with one
year of internship on level 10,while those that spend six years with one year
internship on level twelve. The agitation for the so called relativity is
discriminatory and violates the Nigerian Constitution as stipulated in section
34-(1). NMA insisting that this must be sacrosanct in the Health Sector is on
what basis? It should be noted that members of NMA are just employees of the
Government, just like every other Civil Servant, and as such no employee
determines what another employee is to be paid. It is never done anywhere in
the world. This is a sense of megalomania, and so this jack of all trade
mentality must stop.
6. NATIONAL HEALTH BILL: NMA is
calling for the implementation of the National Health Bill which has been shown
to contain a lot of clauses that are anti-people. Many professional
Associations, Civil Societies and well meaning Nigerians have called for the
removal of these obnoxious sections of the Bill. But NMA in the bid to
actualize her set selfish agenda has refused to give good reason a chance.
Again some part of the Bill undermines the Nigerian Constitution in use in a
Federal System of Government. No Nigerian Health Worker is against having a
Health Bill but all we are saying is that in order to meet Government set
objectives to enhance the total wellbeing of the citizenry the obnoxious
sections has to be expunged.
7. THE APPOINTMENT OF SURGEON
GENERAL: This office is not created by law. There is no Nigerian statute that
says that we must have the office of the Surgeon General. Creation of this
office will lead to more agitation and anarchy in the Health Sector which is
already polarized. Every professional group will be agitating for the creation
of X-general, e.g. Pharmacist general, Nurse general, Optometrist general,
Radiographer general, Physiotherapy general, Dietician general; Medical
laboratory scientist general etc. The creation of this post will lead to more
problems in the health sector. Secondly of what role and benefit is the office
of the Surgeon general when we already have two Ministers of Health and there
are many Directors also having such functions?
8. THE ENTRY POINT OF HOUSE
OFFICER TO BE ON COMMESS 1 STEP 4: This level is equivalent to grade level 10
steps 4. On what is this agitation predicated on, when such entry point is not
supported by any Scheme of Service, used as one of the criteria for appointment
into the Public Service of the federation? It should be noted that house
officers are intern or Pupil Medical Doctors. There is no intern in Nigerian
that enters the service on step four. Moreover, steps are indicators of the
level of experience or years the person /officer have spent on that grade
level. On what criteria is a neophyte/green horn in his profession placed on
step four? What you have is either step one or step two. Government should not
accede to this demand that undermines ethical procedural practice in the Public
Service.
9. CLINICAL ALLOWANCES FOR
HONORARY CONSULTANTS TO BE INCREASED BY 90% OF CONMESS: Early this year, under
the immediate past President of NMA, Dr Enabulele, NMA had had an upward salary
increase for their members. Not up to 5 months, NMA is now calling for another
bloated allowance. Note that consultants are meant to render quality service as
Attending Physicians, but what do we see daily in our hospitals? Most of the
times, the “consultants/honorary consultants” are never around. Yet they want
to be paid such a jumbo allowance. Those that are around, work four times in a
month, having one clinic day in a week.
Written by Benjamin Chukwunonso Ajufo (click to continue reading and LIKE our Facebook page)
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