Posted on: Wed 08-02-2023

A fresh crisis in the healthcare system is imminent before the general election as workers in the sector allegedly vowed to stop working following the Federal Government’s repeated failure to fulfill its responsibility to meet their welfare demands.

The workers under the auspices of the Joint Health Sector Unions (JOHESU) and Assembly of Healthcare Professional Associations (AHPA) gave the warning in a letter to the Minister of Health, Federal Ministry of Health (FMoH).

In a letter, titled, “Looming Industrial Action Over Non-Implementation Of Adjusted Consolidated Health Salary Structure (CONHESS) And Other Pending Demands,” JOHESU and AHPA urged the Federal Government to quickly intervene to avert the impending health sector catastrophe.

The letter dated January 30, 2023, was signed by Comrade Matthew Ajurotu, Acting National Secretary for Josiah Biobelemoye, National Chairman, and copied to the Director General, Department of State Security Service, Abuja.

Reiterating appreciation to President Muhammadu Buhari, for paying – April and May 2018 withheld salaries and implementation and arrears of new hazard allowance, JOHESU/AHPA drew his attention to pending obligations of the Federal Government to the union.

According to JOHESU/AHPA, the Federal Government Salary Negotiating Teams in the FML&P, FMoH, and Presidential Committee on Wages have continuously disrespected the union’s patriotic stance of refraining from strike action over the past five years.

Due to this development, JOHESU/AHPA has instructed its members to issue a strike ultimatum to the Federal Government by the first quarter of 2023, the group said in its letter.

Furthermore, it vowed that there would be no going back from the industrial action if there was no clarity from the Federal Government on meeting the lingering union demands, some of which have been unmet for nearly ten years.

JOHESU in its letter chronicled the unresolved welfare demands that the Federal Government owed the union in a seven-point agenda, beginning with the CONHESS adjustment. The letter partly reads, “In a larger bid to enable you to appreciate the veracity of our position, we shall highlight the current state of events with regards to major areas of our demands.”

CONHESS Adjustment

The letter further reads, “JOHESU/AHPA requests for your intervention to urgently convene a High-Level Body (HLB) meeting to put to rest the CONHESS adjustment matter that has been responsible for major trade dispute in the health sector. The delay on this matter is already heating up the peaceful atmosphere in the public health institutions which have been sustained since JOHESU/AHPA suspended its industrial action in 2021 to allow for re-negotiation of CONHESS adjustment and other issues contained in the strike notice to the Federal Government. This patriotic gesture is gradually being eroded by the slow-paced approach in which the Federal Government through the Federal Ministry of Health is handling this matter.

“Adjustment of CONHESS as was done for CONMESS: We find it necessary to inform you that agitations for this started eight and a half years ago when the Federal Government adjusted the CONMESS for Physician Cadre in Federal Public Service,” it added.

The union lamented that the trade dispute which commenced in September 2021, over the CONHESS adjustment is still lingering to date.

Despite the Technical Committee’s July 2022 meeting, where it successfully completed its work of preparing FMoH for the distribution of funds for the CONHESS adjustment to significant personnel, no progress had been made since then.

The letter reads, “Recall Sir, that upon JOHESU/AHPA declaration of the trade dispute in September 2021, the Chief Conciliator of the Federation and Hon. Minister of the Federal Ministry of Labour and Employment at a conciliatory meeting on September 7, 2022, suggested that issues in dispute especially CONHESS adjustment be returned to the negotiation table between the Federal Ministry of Health and JOHESU/AHPA. Consequently, you set up a Technical Committee to redress the pain of adjusting the CONHESS after eight and a half years of rigmarole. This assignment was concluded in December 2021 and no action has been taken so far.”

Retirement Age For Health Workers

Similarly, JOHESU/AHPA called for approval and implementation of new retirement age for health workers. The letter says, “We strongly urge you to once again facilitate the implementation of the increase in retirement age of Health workers from 60 to 65 years while that of Healthcare Professional Consultants be increased to 70 years. This is the format in the Education Sector where all Federal Tertiary Health Institutions (FTHIs) are affiliated to and should be regularised to enhance delivery and retention of experienced hands to the trending brain drain in the Health Sector,” it added.  

Full Implementation Of Consultant Cadre

The union drew the attention of the Federal Government to delay the implementation of a consultant cadre for pharmacists and the creation of a Directorate of Medical Laboratory Science in the public service.

The letter also reads, “The Consultant Cadre was first approved by the National Council on Establishment in 2011. Various attempts were made to sabotage this approval but we held on until the office of the Head of Service of the Federation confirmed to the FMOH on March 6, 2020, in a letter ref no. HCSF/SPSO/ODD/NCE/CND.100/S.8/39 that the NCE had approved Pharmacist Consultant Cadre again.

“The FMoH referred to the National Salaries, Incomes and Wages Commission in a letter of May 13, 2020 ref no. C.400/11/217/T/21 to develop the appropriate benefits package based on the memo from the HOSOF.

“The National Salaries, Incomes and Wages Commission responded to the FMoH via a letter of June 17, 2020 ref no. SWC/S/04/S.218/T//9. In the letter, the NSWIC stated that “the salary structure of Medical Professionals including Consultant Pharmacists have since been developed.” It concluded its letter by stating that “Consultant Pharmacists are entitled to be paid relevant allowances including Specialist Allowances as contained in Circular No. SWC/S/04/S.410/Vol 11/349 dated December 8, 2009.

“In view of the fact that due process had been met, the OHCSF on September 13, 2020, finally released the circular ref no. HCSF/CSO/HRM/1274/T3 for the Pharmacists Consultant Cadre. The immediate past Permanent Secretary of the FMoH on March 18, 2021, issued an internal circular to all Heads of Departments, FHIs, Agencies/Parastatals, and Regulatory Bodies directing the immediate implementation of the approved scheme by the OHSOF.”

It noted, “In yet another internal circular ref no. FMH/FDS/CSPTH/1/95 of August 2, 2021, while citing precedents in the creation of cadres in Civil Service Clarified the mode of application of the Consultant Pharmacist Cadre.

“It hinged this on the Fellowship of the WAPCP for officers already in the Directorate Cadre or the equivalent of GL 15 and above stating without ambiguity that such officers shall transit to the corresponding GL as Consultants without stepping down any grade. We put on record that it is only a few FHIs (less than 5) that have honourably respected the OHSOF’s circular, etc, to implement this Consultant Cadre in Nigeria,” it added.

In addition, JOHESU/AHPA lamented the withheld April and May 2018 salaries of its members in Federal Medical Centre, Owerri (FMC) Jos University Teaching Hospital(JUTH), and Lagos University Teaching Hospital(LUTH) who had challenges with their Management.

It said, “This development is worrisome as it continues to generate entropy in those facilities,” even as it complained of non-payment of hazard inducement allowance 2022 and outstanding four months of hazard allowance to its members.

COVID-19 Hazard Inducement Allowance  

The letter noted, “JOHESU/AHPA once again draw the attention of the Hon. Minister to the omission of its members in a few health facilities during the payment of COVID-19 Hazard Inducement Allowance in 2020. JOHESU had written several letters to the Federal Ministry of Health in this regard without a positive response to date.

“We find it necessary to remind the Federal Government that Hazard Allowances were approved after months of negotiation for a total of 13 months. While nine out of 13 months have been paid, we request the immediate payment of the outstanding four months which are pending,” it added.

Conclusively, JOHESU/AHPA appealed to the Federal Government to intervene by addressing pending matters on its welfare. It noted with some concern the current efforts of the Federal Government to affect a general review of all health workers on the CONHESS and the CONMESS.

It said, “This effort might jeopardise the pre-January 2, 2014 relativity in the wages of workers on the CONHESS and CONMESS because there has been an adjustment at least on three occasions on the CONMESS without a corresponding increase contrary to the 2014 Collective Bargaining Agreement (CBA) between the Federal Government and JOHESU.

“We, therefore, demand that any salary review of Health Workers must take cognisance of factoring the three increments on CONMESS which we were not privileged to enjoy for sake of justice and equity.”

It also frowned at the non-inclusion of its members on the Job Evaluation committee which is presently visiting the FHIs on a zonal basis. It is apparent that the Job Evaluation exercise is at the heart of the ongoing salary review of Health Workers by the Federal Government.

In 2019 the consent judgment of the NICN, Abuja, provided that members of JOHESU/AHPA must be entrenched as members of the Job Evaluation Committees anytime they visit the FHIs. This order of the NICN is apparently being violated in the current disposition of the FMoH.

“We, therefore, call on the FMoH to immediately invite members of JOHESU/AHPA as part of the Job Evaluation Committees currently traversing the FHIs across the country.”

It demanded that the office of the Head of Civil Service of the Federation (OHCSF) come up with Schemes of Service for the cadre of all Health Professionals who have received approvals from the NUC for new curriculums and those that have received the approval of the OHCSF for Consultant Cadre.

“We do hope the various apparatus of the Federal Government will initiate a prompt intervention and response to checkmate the dark clouds gathering over the Health Sector in Nigeria before it is too late,” JOHESU/AHPA stressed.

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