NMA Strike: New Salary structure to take off in Jan 2015

BusinessDay(25:08:2014)

The House of Representatives in Nigeria on Monday disclosed that the new salary structure for doctors would be reflected in the 2015 budget and takes effect from January 2015.

Ndudi Elumelu, chairman, House Committee on Health, gave the assurance while reacting to the resolution of the Nigerian Medical Association (NMA) to suspend the 55-day old nationwide strike on Sunday.

According to him, the parties during the reconciliatory meetings attended by Federal Government’s team resolved “that the Federal Ministry of Health will grant the request of NMA for a new circular as demanded by NMA.

“That the Federal Government shall pay two months’ salary arrears to members of NMA on or before August 31, 2014; that balance of salary arrears would be reflected in the 2015 budget and paid to members of NMA.

“That the new salary structure of medical doctors would be reflected in the 2015 budget and medical doctors will begin to get the new salary structure effective from January 2015.”

During the overview of the suspended industrial action declared by the association, Elumelu stressed the need for the Federal Government and organised labour unions to honour various agreements reached in the bid to forestall future strike action and ensure industrial harmony in various sectors of the nation’s economy.

“One of such lessons is the need to obey agreements. The law is pacta sunt servanda meaning: agreements must be obeyed. If parties had obeyed previous agreements executed between NMA and representatives of the Federal Government, the strike would have been averted. The lesson to learn here is that we must at all times obey contents of agreements freely entered into in order to avert crisis,” Elumelu said.

The lawmaker, who expressed displeasure over the unpatriotic attitude of the association towards the plight of the citizens in the face of the outbreak of Ebola virus and other life-threatening diseases that claimed the lives of several Nigerians during the strike period, noted that NMA “acted contrary to the revered oath of the medical profession and the code of medical ethics (2004) for medical dental practitioners in Nigeria.

“The leadership of NMA has been described as unpatriotic even by other Nigerian doctors as well as members of the public in view of various health challenges confronting the nation and the scourge of Ebola virus disease, which erupted during the strike period. Patriotic Nigerians both home and abroad have passionately condemned the action of the current leadership of the NMA. Comments have been heard and read from various media platforms concerning the …actions of the NMA president,” he said.

Source: Business Day

Presidential Order and A Populace At Risk!

Medic-ALL (17:08:2014)

It is no longer news that the President of the Federal Republic of Nigeria in his "wisdom", last week Wednesday came up with the most bewildering and drastic of responses to the now over 6-week old nationwide doctors strike by the Nigerian Medical Association (NMA), by indefinitely suspending residency training in the country and the subsequent termination of the appointment of about 16,000 doctors presently enrolled in specialist training in the country.

While I was not particularly shocked to hear the news, I continue to be burdened by the consequences of such an action in the light of the sorry state of the health sector presently. It will be interesting to see what the Government has up it's sleeves in the coming days, weeks or even months, in terms of filling the huge vacuum left by the sacked resident doctors who make up about 60% of registered doctors presently practicing in the country. There is no doubt that the plan of employing locum doctors on a 6-month contract basis alone will not suffice for a populace that has being hugely under-served even in the prior era.

That's true , there's the Nigerian populace!!...A Population Base of 167,000,000 who should be perhaps as worried as I am. They should actually be asking how the Government intends to provide access to adequate specialist medical care if specialists will no longer be trained by hospitals they pay taxes to maintain. Nigerians should be wondering if the Government is going to bring in foreign expatriates (like was once done!) to fill up the hole it would have created in the  sector and at what cost adequate healthcare would now be available to the masses. Whether the Government will pay more to maintain the expatriates than it would have to meet some of the demands of the striking doctors and upgrade infrastructure in our fast-rotting away medical schools built in the 1960s and '70s would also be a valid question at this time.

I do think that it is extremely important that the Nigerian people understand the intricacies of this "remarkable" Presidential order especially in a country such as ours, where a striking majority of our elected leaders and their families seek medical attention for as little as a running nose outside the country. It becomes even more necessary for the populace to be aware of the possible ripple effect of such a decision as made by the Federal Government standing in the coming weeks to months and should subsequently begin asking the questions that really matter, as it stands logical that only the wearer of a tight pair of shoes knows for sure where it hurts.

While the Nigerian Medical Association have openly condemned the obnoxious sack and are ever resolute to challenge the order, I strongly believe, that the Nigerian populace have even more to fight for, not just in response to this preposterous directive but for the quality of healthcare they deserve in every single part of the country.

Medic-ALL.Inc 2014

Nigerian Government Supends Residency Training

(THEWILL)14:08:2014 – President Goodluck Jonathan Wednesday suspended the Residency Training Programme for medical doctors in Nigeria indefinitely and sacked Resident Doctors in all federal government owned institutions.

The President’s directive follows the protracted industrial dispute between doctors under the auspices of the Nigeria Medical Association (NMA) and the federal government over pay and poor funding for government owned health institutions.

An internal memo to all heads of federal tertiary health institutions signed by the permanent secretary in the Ministry of Health, L.N. Awute, on behalf of the Minister of Health, directed them to sack all Resident Doctors in their facilities with immediate effect and directed that measures be taken to restore full medical services in their hospitals.

A member of the board of the NMA has described the sack of resident doctors and the suspension of the Residency Programme as a knee jerk reaction to the dispute between the federal government and the NMA.

In a reaction to the development, the official who asked not to be identified in this report told THEWILL that an emergency session of delegates has been called by the NMA to deliberate on the development adding that a formal statement condemning the decision of the president will be issued momentarily.

The official said the President targeted the weakest link amongst doctors by going after thousands of the residents adding that with their sack those hospitals no long qualify as teaching or specialist hospitals because you cannot operate them without residents and consultants. “It is just like you cannot have a school when there are no students and teachers” the official said.

“We have been through this before at least twice. Government never learns. The action of the President is disappointing. Instead of addressing the serious issues we want dealt with the President is escalating the problem,” the official added.

A Dying Health Sector...

Medic-ALL (14:08:2014)

"Work Hard and Get Out" !!! Said in the meanest and most scary tone I have heard in a surgery lecture room. Those were the words of one of the foremost Plastic surgeons in West Africa to my graduating class after a tutorial class on the eve of our final medical school exams. As puzzling as those words may seem, I was perfectly in tune with the heartfelt and sincere burden on the mind of this very senior colleague that would have prompted him to render such counsel to a focused group of medical students on their way into the real world of medicine in a country like ours.

This was a class that had to spend an extra 6 months in school, because of a strike action by resident doctors in the state to challenge the decision of the State Government to pay less than the stipulated CONMES(Consolidated Medical Salary Scale) approved by the Federal Government to it's doctors, in spite of the obvious fact that these doctors are overworked as compared to their Federal counterparts due to a perennial under-staffing. At the time the State Government eventually went ahead to issue sack letters to the doctors (including residents and Consultant specialists) in the state and employed contract medical-officers in their place. The sack-scare paid off and the strike was subsequently called off ,but the state doctors never got a decision in their favor.

Fast-Forward to 2014 , and its a nationwide strike by the Nigerian Medical Association to challenge certain Federal Government health sector policies which the body believes does not augur well for the future of the sector in the country as well as to see the implementation of other demands summed up in the union 23-point demand sent to the Federal Government a few weeks before embarking on a withdrawal of service.

The strike has lingered on for weeks , despite the outbreak of the deadly Ebola virus in the country and  several meetings have being held among the various stakeholders to ensure a resolution of the issues surrounding the 45-day old strike, no positive conclusions are yet to be reached. There have being rumours regarding how the Federal Government will choose to tackle the problems in the barely thriving health sector, including reports indicating that the Government was planning to privatise the Public Hospitals (including Teaching Hospitals!). This of course raised several questions and sparked debates particularly as it relates to the Act that created Teaching Hospitals for the primary purposes of training and research as opposed to Private Hospitals which are more or less profit-making establishments.

An authoritative answer to these questions was received earlier today in the form of a Federal Government directive suspending residency training (training of doctors into specialists) in the country indefinitely and the immediate sack of the doctors presently in residency training. While the directive was said to be for the purpose of appraising the problems in the health sector, many are wondering if this drastic step would not leave the health sector in shambles!...and hoping that this is not the "Beginning of the End" of Nigeria's already "Frail" health sector as we know it.

Genuine Questions Arising?

Did the Federal Government take this decision in order to force the hand of the striking doctors to come to a compromise?

Was the decision taken to weaken the resolve of the NMA (Nigerian Medical Association) , keeping in mind that it is believed that the NARD (National Association of Resident Doctors) serves as the mitochondria of the sister body?

Is this a way of pitching the doctors against each other (as was the case between the Lagos State resident Doctors and the locum doctors employed on contract during the CONMESS struggle)? Moreso as the Presidency has ordered immediate employment of locum doctors on a contract basis.

Is there still anything to fight for as far as the Nigerian Medical Association (NMA) are concerned?

In a country where the health sector already suffers a huge shortage of personell, particularly doctors ,thanks to the daily mass exodus of Nigerian doctors to countries were they are perhaps more appreciated(40,000 on the United States halth care system). Will such a decision force many more out of a system that seems to be in need of help as it is?

How well can the health sector thrive without specialist training?

What is the future of medicine and healthcare in this country?

Where do we go from here?....

Medic-ALL.Inc 2014

Read Also:
Diagnosis : A Troubled Health Sector
Doctors' Strike : Will the NMA be banned?
Brain Drain:The Mass Exodus of Nigerian Doctors

Nationwide Doctors' Strike Continues!!!

Medic-ALL (09:08:2014)

In the midst of controversies and conflicting reports over the suspension of the nearly 6weeks old nationwide strike by the Nigerian Medical Association (NMA), The National President of the body, Dr. Kayode Obembe earlier in the week tendered his resignation.

Dr. Kayode Obembe

Obembe had on Thursday announced the suspension of the strike action embarked upon by the union following the appeal by the government sequel to the outbreak of the Ebola Virus Disease in the country.

However, the Lagos State chapter of the union said the suspension of the strike was not agreed on by the leadership of the NMA at its meeting on Thursday.

Ohembe’s full letter, titled: Clarification, reads: “There has been a request for clarification about the two postings from the NMA secretariat on the NMA blog.

“I want to make it categorically cleared that I stand by the very letter of the document that I signed – THAT THE STRIKE WAS SUSPENDED.

“And since upon my INTEGRITY AND HONOUR, I cannot continue to drive the doctrine that ‘STRIKE CONTINUES’, I hereby tender my letter of resignation as NMA President”.

It should be recalled that Dr. Obembe had, a few weeks after his election, premised the strike action on the failure of the Federal Government to address their demands saying there was no going back, the NMA subsequently sent 24 demands to the government including discontinuation of recognition of non-medical doctors as Directors and Consultant title to any other health worker, other than medical doctors before embarking on the withdrawal of service on the 1st of July.

The demands also include appointment of a Surgeon – General of the Federation, clinical duty and hazard allowances and withdrawal of the Central Bank of Nigeria circular on medical laboratory equipment.

Meanwhile, there are strong ndications that the  Joint Health Sector Union (JOHESU) are threatening to commence an industrial action if the Government goes ahead to accede to the demands of the NMA.

While the country's health sector continues to be in a state of turmoil as the doctors' strike clocks day 40, more suspected cases of the Ebola epidemic continue to be discovered, with 139 persons presently under surveillance, we can only hope that sooner than later ,all the authorities concerned particularly the Federal Government will come to favourable and healthy compromise.

Medic-ALL.Inc 2014

A SURGEON-GENERAL: The Solution or An Agenda

Monday 04:08:2014

As the Nationwide doctors' strike by the NMA lingers into it's 5th week!!!, one wonders if ever the demands of the Nigerian Medical Association will be met by the Federal Government and how effective the withdrawal of service embarked upon since the 1st of July would have been.

But what exactly is the way forward?

The strike by doctors' or the other health workers is fast becoming a yearly routine, maybe not always at the National level , but sometimes in key states like Lagos, were the burden of healthcare is greatest considering the population.

There have being calls for the establishment of the Office of the Surgeon-General of the Federation in Nigeria in the past few months and in fact the theme of the NMA Annual General Meeting held last week was "Improving the Healthcare Delivery of Nigeria, The Role of the Surgeon General of the Federation.

The Question is whether the creation of such an office will put an end to the frequent strike actions which have often being on the basis of policies, infrastructure, welfare packages and agreements on same.

There is indeed a bill to these end, which was sponsored a while back by Senator Olorunimbe Mamora. The NMA like most doctors believe the appointment of  a Surgeon-General who will be the Chief Medical or Health Adviser of the country will be  beneficial to the health sector, reduce political interference in the operations of the nation’s health sector and help mitigate industrial disharmony and its attendant incessant withdrawal of service that has plagued the sector in recent times.

There is however a huge outcry by the ever opposing Joint Health Sector Union (JOHESU), as well as the Nigerian pharmacists under the umbrella body of the Pharmaceutical Society of Nigeria (PSN)and the Nurses and Midwives Association of Nigeria (NAMN), who believe there is no need for the office and continue to resist it's creation.

One concern raised by the Nursing body is the said tendency of medical doctors to hijack every appointment in the health sector and are determined to oppose appointment of a doctor as the Surgeon-General if and when the office is established. 

What then is the way forward if nearly every move of the Government to seek a lasting solution to the problems in the health sector in order to salvage a continually decaying health sector will be frustrated by this ugly inter-professional rivalry which has never augured well for the sector ???

Are we looking at more strike actions from the other professional bodies if some of the demand of the striking doctors are met?

Should the Doctors submit their roles as the head of the medical team to the other professionals?

Is there a way to make every party happy?

Where do we go from here???

Courtesy: Medic-All. Inc 2014

Related Posts : DIAGNOSIS: A Troubled Health Sector 

Doctor's Strike: Will the NMA be banned?

NMA Strike to continue despite Ebola threat -Lagos NMA

In spite  of  the imminent threat of the Ebola Virus in Lagos, striking medical doctors under the aegis of Lagos State branch of the Nigerian Medical Association, have said they will not suspend the ongoing strike .

The Chairman of the association, Dr Tope Ojo, said the ongoing strike was not called because of Ebola and could not be called off because of the threat of the viral infection in the state.

He said, “We are not on strike because of Ebola. It was never part of our demands. It wasn’t our fault.”

He, however, said the doctors would continue to partner with the state government to monitor the trend of the disease to check its spread.

Ojo, who spoke at a press briefing organised by the newly elected officials of NMA in the state, said the association regretted that his team had to take over the leadership of the association during the industrial dispute.

He blamed the  ongoing crisis in the health sector on the Federal Government’s  mismanagement of the sector.

He said, ” Why should a government be willing to concede the headship of the medical institutions to the hands of allied health workers?

“Will the same government not concede to a hostess  the right to fly a plane or court bailiff  the post of a judge or the head of a university maintenance unit to be the vice chancellor because of the so-called opportunistic explanation of team work?”

Speaking on the contentious issue of granting the prayers of other health workers to become consultants , Ojo said the decision of the government, if allowed, will only create unending anarchy.

Ojo stated, “The title of ‘ Consultant’ in  medical practice is preserved exclusively for a doctor that has gone through a minimum of six years excruciating full time, postgraduate academic training.

“The patient is traditionally registered under a consultant, who owns the patient and reserves the right of success or failure in the chain of events.  We therefore warn the Nigerian people of the inherent danger of this conspiracy to deceive and confuse them as they attend hospitals for their health needs.

“NMA is not against the normal professional advancement of any allied health professional. Our position is that the situation must not arise where there will be anarchy and disruption of the chain of command that is bound to jeopardise patients’ lives.”

He added that a situation, where doctors are paid N5,000.00 monthly allowance for hazard was not only laughable but unbelievable.

Ojo said,“A doctor’s life can be lost in an instance when exposed to fatal illnesses such as Ebola, Lassa fever or he may be subjected to a life-long suffering from HIV or Hepatitis B infection