Toying With Human Lives …Bickering, Rivalry In Health Sector

It is now almost clear that Nigerians may not have heard the last of strikes and counter-strikes in the country’s health sector. With deep-rooted inter-association quarrels, bad blood and avoidable rivalry holding sway, the patient may well be the ultimate loser, if the authorities continue to pander to one group against the other, rather than address issues.
That same rivalry in part, informed the nationwide strike called by the Nigeria Medical Association (NMA), to among other things, checkmate implementation of concessions granted other support workers within the hospital community.
Apart from the NMA, there is the Joint Health Sector Union (JOHESU) and Healthcare Professionals Association (HPA), who, as support staff of the medical doctor now insist that being professionals, without whose vital services, the doctor cannot operate well, they require a better deal.
After series of negotiations, threats and even strikes, the Federal Government agreed to some of their demands. It was based on that government issued a circular mid this year, which among others, provides for the approval of consultancy positions for such support staff; abolition of deputy chairman, Medical Advisory Committee position and also the appointment of support staff as directors.
Other aspects of the agreement reached between government and JOHESU, upon which Federal Government issued the circular include, elimination of medical teachers from eligibility for headship of teaching hospitals and the approval for the headship of government hospitals by other qualified hospital professionals.
Among these support staff are Pharmacists, Laboratory Scientists, Radiologists, Midwives, Nurses, among others, some of who, by their training, spend equally long years in schools of study as do the doctors. These crop of professionals insist that the days, when, the medical doctor single-handedly owned the patient were over, in view of the ever-expanding scope of medical sciences.
But the doctors, under the aegis of the Nigerian Medical Association and the Medical and Dental Consultants’ Association of Nigeria (MDCAN) cannot accept such displacement of the status quo without a fight.
It was for that reason that MDCAN approached the National Industrial Court (NIC) to stop the implementation of the agreement government had earlier reached with officials of JOHESU. In the suit, number: NICN/ABJ/ 177/2014, MDCAN secured an interim injunction to restrain government from implementing the agreement.
Joined in that suit were the Federal Ministry of Labour and Attorney General of the Federation as defendants.
In granting the injunction, the presiding Judge, Justice M. N. Esowe, on June 27, 2014, 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 City, Abuja between the Joint Health Sector Unions (JOHESU) and Healthcare Professionals Association (HPA) 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 on 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 court also barred MDCAN from embarking on any strike in protest against the said agreement, warning, ‘Nobody or party in the case shall embark on any strike until the motion on notice, which is already filed in this court, is heard and determined’.
The Judge then adjourned the case to July 10, 2014 for further hearing and determination.
It was within the same period that the NMA embarked on strike, to demand, as did MDCAN, rejection of the agreement reached with JOHESU, and an upward review of doctors’ Hazard allowance from N5,000 to N100,000, among others.
During the period, JOHESU seemed helpless because of the injunction and could do little but threatened that it would embark on strike if government reneged on its agreement with its body in favour of NMA. JOHESU has said no association had the monopoly of strike,s and urged the doctors to challenge government decision in court and not employ strike as a ready weapon to force compliance.
This is the crux of the matter. Where individuals and organizations are aggrieved over any action or impending actions, the proper thing to do is for such issues to be resolved by a court of competent jurisdiction..
For instance, there are in existence Acts that established Teaching Hospitals, and spell out functional organogram, among other details. Such Acts also specify the reach and limits of professionals.
In times of crisis like the type between doctors and support professionals, actions to be taken by government should be based on such laws, and where amendments are required, same be done. Any aggrieved party can then find no basis to challenge any contrary action outside the law.
For instance, if government reached agreement with JOHESU on a wide range of issues which inadvertently or intentionally breaches existing rights of NMA provided by law, the doctors’ body does not need a strike action to get relief. Strike should, indeed, be the last resort if dialogue, and legal action fail.
But while MDCAN went to the industrial court to challenge government’s decision, NMA did not, and instead embarked on nationwide strike at great loss to a nation then battling the Ebola Virus Disease (EVD).
In fact, it was towards the peak of the final battle against Ebola, that the doctors eventually called off their strike, assured that their demands would be met.
Expectedly, what is NMA’s gain will be JOHESU’s loss. And since the only weapon available is strike, health workers under the aegis of JOHESU have also embraced the effective option.
This means, public hospitals would operate without support staff if, the all-embracing strike is embarked upon. How can the medical doctor work alone? Who superintends diagnostics and other laboratory needs? Who handles x-rays and scans?
Of course, the consequences of the absence of these workers would indeed be grave on the hospital community. And as usual, force government to bend over backwards to meet the needs of the striking workers.
Last week, support staff called a warning strike which would become indefinite on the long run. Their demands are the same which the medical doctors would not want implemented.
So, should government please the doctors at the expense of the support staff, or please the support staff at the expense of the medical doctors? Since either choice means doom for the health sector, what is the way forward?
To avoid disastrous consequences on the health sector, still surviving an Ebola scare, all interest groups within the health sector should be joined in the MDCAN/JOHESU suit number: NICN/ABJ/177/2014 to help streamline all demands, rights and privileges, based on law.
All parties must place their demands on the table, debate them based on facts and law, and then let the court of competent jurisdiction decide on the matter.
Unless that is done, and early too, Nigerians shall continue to witness one form of industrial action or the other  within the delicate health sector, at great risk to the patient.
My Agony is that each time these health unions embark on strike, like two elephants, it is the grass, the poor patient that suffers, while patients with means are diverted to their many private clinics, pharmacies and even science labs. Methinks, a law needs to be made to withhold salaries and allowances of workers who embark on strike without laid down legal procedures.

Soye Wilson Jamabo

Sampson Parker And Onyebuchi Chukwu