It is of note that of ALL the rejoinders seen by this writer, only that of the ACAPN was specific enough with JUST two examples of the W.H.O head being a "biologist" and a past European Respiratory Society head being a Physiotherapist. Also, the AHAPN made some references to specific countries but in a general sense without any specificity. The PSN with six pages of rejoinder gave just one sentence example of the same W.H.O head having a bias in "microbiology"
Imagine six pages!
ACAPN made reference to a Health Economist who did well as a health minister while the PSN went ballistic on Olukoye Ransome Kuti who brought the Degree 10 to the health sector.
What about citing the specific examples of the present and past Secretaries (Ministers) of Health in the US and UK and Ministers of Health in Canada? Two of the last three secretaries of health in the UK studied PPE and where even former bankers while one studied economics; of the last three secretaries of health in the US, two are lawyers while one studied public affairs and international relations and the last three ministers of health in Canada studied social works, public administration and economics. What happened to examples like these in the rejoinders?
The inherent message and emphases from the rejoinders largely seem to be that "it is only the medical doctors that have been enjoying being the head of hospitals". No! Far from it!
That shouldn't be!
The issue is about global best practices! It is about merit, not privilege by induction! Medical doctors can also be the head of the hospital just like other health professionals; the interested ones who get the positions MUST get them based on merit! That is the crux of the issues!
Anyone vying for the head of the hospital must have "relevant" qualifications and what are those relevant qualifications? Is it an MBA? Is it a MiM? Is it a Masters in Health Administration? Is it a Masters in Medical Management? Is it a Masters in Hospital Administration? Or is it that the applicant must have at least a Master's degree which " must" be one of the aforementioned administrative/management qualifications? These are what the discussion should be centred on with respect to academic qualifications in this circumstance. The first degree matters less in this circumstance, at least based on known global best practices principles. Why are there no recommendations on the specificities of what the requisite administrative/management academic qualifications should be? A good number of the health professionals who presently head hospitals in Nigeria are associate members of professional management bodies who were awarded those titles for recognition basis and not on merit -a good number do not have the actual requirements! What happened to citing cases in this area in the rejoinders?
More, when talking about head of hospitals, what are the possible or available options? Is it the C.E.O path or Clinical path (Medical Director)? The first path has more to do with human and other material resources management while the second path has more to do with the management of disease conditions. And interestingly, both positions can co-exist side by side in the same organisation even though the C.E.O is clearly higher by ranking but the Clinical Head in many, if not in most, cases even earn higher than the C.E.O because of the perks of clinical practice. There are examples from other countries that can be cited to buttress points being made. If nurses largely hold the headship of hospitals in the US as rightly states by AHAPN, what happened to naming specific examples?
In South Africa, there are two paths to hospital headship: clinical headship or C.E.O headship. Even as a medical doctor, you can choose the administrative path, with requisite administrative qualifications, even though the C.E.O may be superior but still earns less than the Clinical head. What happened to verifiable specific examples like this?
The Allied Health Professionals keep making the issues seem as if they are being denied part of the largesse. No! Not at all. The bar needs to be raised far above that!
In fact, in Nigeria's teaching hospitals the position of a C.E.O can be created while the position of the CMAC can be modified to become the hospital's clinical head position with the CMD position being abolished while the Director of Administration is retained and ALL other director positions of the various departments are abolished and replaced with the position of "Chiefs" after a restructured ladder of cadres for the professionals.
Come to think of it, what are the directors of Nursing services, Physiotherapy, Pharmacy, Laboratory science, Social works, Dietetics etc directing in the real sense of it? Are they not health professionals who were trained and are in practice to deal with patients? Look at the present circumstances where we now have up to a quarter of the number of the clinical staff of some departments being on the Assistant Director and above levels. Seriously? The "directorate" cadre in terms of nomenclature is clearly administrative but today with the proliferation of the Assistant, Deputy and Director levels, one often wonders what administrative duties, other than clinical duties, exist in Pharmacy, Radiography, Nursing, Physiotherapy, Dietetics etc that can not be handled by the human resources management department that require Assistants and Deputies to a Director in the clinical professions.
The solutions to be proffered at this stage by the rejoinders should not just be rebuttals or going venomous on the medical doctors, it has to be solutions that go beyond professional rivalries. Good gracious! That's where the exhibition of higher maturity level comes in for Christ's sake!
There is the absolute need to think out of the box in this inter-professional politics! It is about the good and future of the health sector and for the sake of national interest and not just about the salaries to be earned or the positional appellation to be earned!
Things should be better, please!
Uwumagbe Iyare Brain