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Beyond NMA Strike …Brewing Discontent In Healthcare Sector

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Once again, medical practitioners under the aegis of the Nigeria Medical Association, NMA, have withdrawn their services to public health institutions, over favours done to support unions and alleged non-implementation of agreements reached with the Federal Government. And since July 1, this year, patients in hospitals across the nation have their lives hung on a cliff. And many dead.
Among the doctors’ demands are increase in their hazard allowance from N50,000 to N100,000 and restoration of the post of Deputy Chairman, Medical Advisory Committee in Teaching Hospitals. They also faulted the appointment of directors other than doctors, in hospitals, saying such appointments could distort the chain of command in health institutions and also lead to management of patients.
Other demands include skipping of grade level 12 (COMMESS 2) for medical and dental practitioners and the reversal of the title of Consultants for other professionals in the health care system apart from doctors. The NMA also urged the Federal Government to resolve issues related to appointment of Chief Medical Directors and other federal appointments in the health sector.
Addressing Journalists June 15, this year Chairman of the Lagos NMA, Dr. Francis Faduyile had argued: “The position of the Chief Medical Director or Medical Director must continue to be occupied by a medical doctor as contained in the Act establishing tertiary hospitals. This position remains sacrosanct and untouchable.
“Why did they not ask that the post of Vice Chancellor be open to everyone in the University since members of the Academic Senior Staff Union of Universities and the Senior Staff Association of Nigerian Universities are graduates.
“Can you be a Judge of the High Court or Court of Appeal if you are not a lawyer?  Why do they think the hospitals where, lives are saved everyday should sacrifice the established leadership, the position of a chief medical director?
Curiously, most of these issues form part of suit number: NICN/ABJ/177/2014 before the National Industrial Court (NIC) which stopped the Federal Government from implementing the agreement it reached with the Joint Health Sector Union (JOHESU). The Medical and Dental Consultants’ Association of Nieria secured an interim injunction in the suit which joined the Federal Ministry of Health, Federal Ministry of Labour and Attorney General of the federation as defendants.
In granting the interim injunction on June 27, 2014, the presiding Judge, Justice M.M. Esowe restrained the defendants, ‘from implementing, executing, carrying out or giving effect to the decisions, resolutions and agreements that were reached at a meeting, which was held in the Federal Capital Territory (FCT) Abuja between the Joint Health Sector Unions (JOHESU) and Healthcare Professionals Associations (AHPA) on the one part and Secretary to the Government of the Federation (SGF); Minister of Health, Chairman, Salaries, Income and Wages Commission, Head of Service of the Federation, and other top government functionaries of the other part, on June 5, 2014.
The injunction further ordered that “no party shall proceed to do any act in furtherance of any agreement  reached by the parties, which arguments form the kernel or subject matter of this motion before the court.
The same court also barred the Medical Doctors’ Consultant  Association of Nigeria (MDCAN) from embarking on any strike in protest against the said agreement, stating that ‘nobody or party in the case shall embark on any strike until the motion on notice, which is already filed in the court, is heard and determined. The Judge then ruled that the matter be adjourned to July 10, 2014 for hearing and determination of the motion on notice.
President of MDCAN, Dr. Steven Oluwole had deposed to an affidavit challenging the agreement reached between JOHESU and the Federal Government.
MDCAN went to court to challenge the implementation of a circular recently released by government following the agitation of JOHESU, which among others, provides for the approval of consultancy positions for support staff, abolition of Deputy Chairman, Medical Advisory Committee position and appointment of support staff as directors.
Other aspects of the agreement include referral following the Yayale Ahmed Committee; elimination of medical teachers from eligibility for headship of teaching hospitals, and re-interpretation of “medically qualified”, which is a key phrase in the university teaching Hospital Act.
From the fore-going, it is clear that what the medical doctors are striking for is already before a court of competent jurisdiction. Secondly, most of what NMA is asking for have to do with checking privileges of other professionals in the practice and few additions to theirs.
Infact, there is a growing bad blood between medical doctors and other healthcare practitioners, which if not checked would cause an even greater danger to the sector. This is because each of the unions has employed the same weapon-industrial action. If demands of JOHESU are met by government, NMA would go on strike, as it has. And if NMA’s demand for increase in hazard allowance is met, JOHESU would demand same and go on strike.
The irony is that both groups need each other to function properly. Infact, the days are far gone when the patient was the doctor’s sole responsibility. The Pharmacists, Laboratory  Scientists, Nurses, Midwives among others complement the doctor’s practice.
So while the medical doctor continues to insist on total control and supremacy of the hospital environment the support staff have grown both professionally and in practice and are now asking for their due. It was in acceptance of some of such demands that government issued the recent circular, the subject of the litigation before the National Industrial Court. So why the NMA strike?
This will indeed not be the last strike even if NMA succeeds in arm-twisting government to do its bidding. Already, another dispute is brewing between the NMA and the Association of Medical Laboratory Scientists of Nigeria (AMLSN) over the Central Bank of Nigeria’s (CBN) circular authorising the Medical Laboratory Science Council of Nigeria (MLSCN) to approve licences for importation of In-Vitro Diagnostics (IVDs).
The new NMA President, Dr. Kayode Obembe, had in an open letter to President Goodluck Jonathan warned that the circular would set a “dangerous trend in the nation’s health sector”.
Describing the CBN circular as dangerous, the NMA said it is completely wrong that one would have to go to the MLSCN to get approval in order to import medical laboratory equipment, arguing, “already, importation of medical products is being regulated by the National Agency for Food, Drug Administration and Control (NAFDAC) and the Standards Organisation of Nigeria (SON).
In a swift reaction to the NMA position, the AMSLN also challenged the doctors’ body to go to court rather than threaten the apex bank to withdraw the circular. President of AMSLN, Godswill Okara told newsmen in Abuja, June 29, 2014, “If NMA feels very strongly about the circular, it should go to court, contest it and see the way it will be floored.”
He too warned that if the CBN should succumb to the NMA pressure and withdraw the circular, his association would challenge the withdrawal in court.
Okara urged the NMA to respect the rule of law, jettison ego-tripping and embrace laudable objectives that would improve the health sector.
“The dog-in-the manager attitude would not help the health sector, neither will the first-born mentality often displayed by the NMA and its members.
Modern healthcare practice is multi-disciplinary and multi-professional in dimension and scope” Okara stated.
“The quest to demand for what it wants and also turn around to dictate what others should be given is to say the least reprehensible and nihilistic” and then said “NMA does not have the exclusive preserve to strike action”.
“The CBN circular, unlike the chauvinistic undertone of everything done by the NMA, is not about the MLSCN or any other professional group, but about the citizens of this country, who spend whopping $1.7 billion annually seeking quality diagnosis and treatment abroad, and who have continued to clamour for reliable medical diagnosis”, Okara explained.
Ordinarily, this issue should not generate any controversy, if not for the bad blood that flows in the veins of the NMA and other support bodies and for which the general society remains victims. In fact, what the CBN did is based on law.
Sections 4e and 19d of the Medical Laboratory Science Council Law Act II, 2003 (Cap M25, LFN 2014) specifically mandates the MLSCN to regulate the production, importation, sales and stocking of diagnostic reagents and chemicals and make rules for the maintenance of good standard of medical laboratory practice and services. This is “with respect to regulation and control of private, including statutory inspection, approval and monitoring of all medical laboratories, including those adjoined to clinics, private and public health institutions”.
This means importation of clinical needs by medical doctors would be subject to approval by the AMLSN and with the existing ‘warfare’ that would not be healthy. That is the crux of the matter.
Doctors must realise that the frequent recourse to strikes negates the wording of the Hippocratic oath they took, just as their constant disruption of services in public health institutions in preference for their private clinics, a disservice to the nation.
My agony is that each time doctors go on strike over issues with rival unions in the health sector; it is not the warring factions that feel the pinch. It is the ordinary patient and indeed society, while they feed fat on the desperation of the helpless with outrageous medical bills for services, sometimes not properly rendered.

 

Soye Wilson

Pius Anyim Pius, SSF and Prof. Chukwu, Minister of Health

Pius Anyim Pius, SSF and Prof. Chukwu, Minister of Health

Jamabo

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We’ve Spent N9bn To Upgrade RSUTH, Wike Confirms

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The Rivers State Governor, Chief Nyesom Wike, says his administration has spent N9billion in upgrading structures and installation of new equipment at the Rivers State University Teaching Hospital (RSUTH).
He said the fact that 40 per cent of the 2021 budget of the state is dedicated to provision of quality healthcare delivery was a further demonstration of the priority placed on the sector.
Wike made the explanation at the foundation laying ceremony for the construction of a Renal Centre at RSUTH, last Friday.
The governor said he made promise to Rivers people that the best would be provided to them in all sectors of the society within his capability because of the mandate they gave to him.
“As we came on here, I just looked around and I see the changes in this teaching hospital. I can say that we have put not less than N9billion in this teaching hospital.
“If you look at the budget, the health sector alone, what it’s taking from the Rivers State Government is not less than 40 percent of the 2021 budget.”
Speaking further, Wike said the state government cannot afford to implement free medical service programme in the present economic circumstance.
While dismissing the request for a subvention for RSUTH, Wike, however, commended the chief medical director and his team for their commitment to turnaround the fortunes of RSUTH.
“I have never seen anywhere that health services can be totally free. They’re telling me that people who come here can’t pay. I have never declared that this state is going to take over the health fees of anybody.”
Also speaking, the former Minister of Transport, Dr. Abiye Sekibo, who performed the flag-off, noted that Wike’s achievements in the health sector in particular, surpass what former governors of the state had done.
Sekibo said that the governor has given equal attention to every section of the health sector by providing complete health infrastructure that was positioning the state as a medical tourism destination in Nigeria.
Earlier, the Rivers State Commissioner for Health, Prof Princewill Chike, lauded Governor Nyesom Wike for his interest in the health of Rivers people.
He noted that the renal centre, when completed, would become another landmark development project in the health sector that would handle and manage all kidney-related ailments.
In his remarks, the Chief Medical Director of the Rivers State University Teaching Hospital, Dr. Friday Aaron, commended Wike for approving the renal centre.
Aaron explained that chronic kidney disease was a major burden globally with estimated 14 million cases in Nigeria.
According to him, over 240,000 of these cases require renal replacement therapy in the form of dialysis and renal transplant.
The CMD said the building that would house the centre was expected to be completed in six months and consists of two floors.
The ground floor, according to him, would house the haemodialysis unit with eight haemodialysis machines.
He further explained that the first floor of the centre would house the surgical component where most of the sophisticated equipment for kidney transplant would be installed.
Aaron said Wike has released the funds required to build, equip the centre as well as for the training of personnel locally and internationally.

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Power Generation Falls 23% To 3,172MW

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Power supply in Nigeria has failed to improve on last week’s performance, as it fell by 22.9 per cent from peak generation of 4,115Megawatts on Saturday to 3,172.20MW as at 5pm, yesterday, latest data from the System Operator has shown.
According to the data, most power plants were operating far below capacity due to gas shortage with Olorunsogo Power Plant 335MW capacity; and Sapele Power Plant, 450MW capacity; completely out.
Egbin was generating at 746MW; Omoku 37.20; Omotosho (NIPP) at 105MW; while Afam was generating at 80MW.
The data showed that on the average power generation in the past seven days were 4,120.9MW on Sunday, June 6; 4,249.4 on Monday, June 7; 4,000.9MW on Tuesday, June 8; 3,720.7 on Wednesday, June 9; 3,517 on Thursday, June 10; 3,765MW on Friday, June 11; and 4,115MW on Saturday, June 12.
The International Oil Companies (IOCs), had last warned that despite Nigeria’s huge gas reserves a lot needs to be done to attract investment to the sector to develop gas reserves to boost power generation in the country.
Speaking at the just concluded Nigeria International Petroleum Summit, the Chair, Shell Companies in Nigeria/MD SPDC, Osagie Okunbor, said with 203trillion Cubic Feet of gas reserves, what was needed in the country is to deliver projects that would produce the gas.
“The challenge is not just growing the reserves but in producing these reserves for the benefits of our country. Essentially growing the reserves and delivering on the production is a function of two or three elements.
“I like to see infrastructure that is required for the development of these resources at two levels. Soft infrastructure is often the one that is more important than and that is the one that is actually drives most of what you see at site.”
“Soft infrastructure refers to the enabling environment and nothing pleases me as much seeing both the Senate President and the speaker of the house give very firm commitments about trying to pass the PIB this month.
“That is probably the big one of the enabling environment to provide the kind of stability we also need all sorts of other issues we need to that we have discussed severally in terms of sanctity of contract, stable policies and collaboration and I think we are well on our way there”, he added.

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Wike, Pride Of Nigeria’s Democracy, NUJ Affirms

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The Nigeria Union of Journalists (NUJ) has described Rivers State Governor, Chief Nyesom Wike, as an exhibit of pride to democracy in Nigeria.
The NUJ also noted that Wike has redefined governance through demonstration of democracy in action with his service to Rivers people.
The National leadership, the 36 State Executives, and the FCT, including members of the NUJ across the country made the assertion in Port Harcourt during the inspection tour led by the Rivers State Commissioner for Information and Communications, Pastor Paulinus Nsirim of both completed and ongoing projects being undertaken by the governor in the state.
The National President of the NUJ, Chief Chris Isiguzo, said the 1999 Constitution bestows on the media the responsibility to hold governments accountable to the people.
Isiguzo posited that having placed the projects side-by-side with the expectations of the populace, it was obvious that the governor’s investment in critical infrastructure would remain lifelong empowerment tools for the people.
”We were at the Mother and Child Hospital. We took time to look at the facilities there. That can easily be said to be first of its kind in the country.
”At the much-talked about Real Madrid Football Academy, where they are going to train the young ones, we saw that they have good facilities. At the moment, they have also offered admission to 140 pupils.
”That’s also to catch-them-young, and I want to believe that by the time this kind of resources is continuously invested in sports development in Nigeria, it’s just a matter of time, it will gain its pride of place in sporting world.”
On her part, the National President of Nigeria Association of Women Journalists (NAWOJ), Mrs Ladi Bala said that the projects she had seen were entirely unique, unprecedented and very uncommon in the country.
According to Bala, the Emmanuel Chinwenwo Aguma Judges’ Quarters stand out as first of its kind in Nigeria, with its serene ambiance that would translate into enhancing the productivity of judges of Rivers origin.
”I believe that democracy is at work in Rivers State, and, for Rivers people, I want to congratulate them, and to say, this is the true reflection of what democracy should be across board.
”I want to call on other governors across the country to borrow a leaf from what the governor of Rivers State is doing. Wike is working, and we are very proud of what we have seen here”, she added.
In his reaction, the National Internal Auditor of NUJ, Muhammad Tukur, stated that Wike was a committed leader with the vision of uplifting the standard of life of his people.
Tukur, who expressed gratitude to Wike for his support to the NUJ National Conference in Port Harcourt, said that his show of love for journalists confirms his commitment to the welfare of the people.
On his part, Chairman of Oyo State Council of the NUJ, Comrade Ismail Ademola Babalola, asserted that the Mother and Child Hospital, and the Real Madrid Football Academy were part of projects Governor Wike was using to secure a productive future for the youths of the state because they meet global standard.
Also speaking, the Vice President of NUJ North Central Zone, Chief Wilson Bako, commended the quality of the various roads and flyover bridges constructed in the Port Harcourt metropolis to make the city tourists’ destination of choice.
In the same vein, the Vice Chairman of NUJ in Jigawa State, Comrade Larai Musa, said she has confirmed all that the news media had carried about Wike and his projects’ mantra, and asserted that it was leaders like him that were needed at the national level.
Also, Comrade Ikechukwu Ordu of Enugu State Council of the NUJ noted the need for other political leaders to emulate Wike in providing dividends of democracy to Rivers people and changing the fortunes of his state.
Also from the Enugu State Council of the NUJ, Comrade Ugochukwu Chukwudieke, said she was completely overwhelmed by what Wike has done in constructing the Okoro-Nu-Odo Flyover Bridge, Rumuogba Flyover Bridge, and Rebisi Flyover Bridge delivered within one year.
Chukwudieke also praised the quality of work on the Rumuola Flyover Bridge, Ogbun-nu-Abali Flyover Bridge, GRA Junction Flyover Bridge, and the Orochiri-Wurukwo flyover project at Waterlines Junction by Aba Road.

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