I write once again, particularly to Dr Paul John and to the general reader that comes across this piece. It still amazes me that Dr John Paul is yet to bury his arrogance, which he earlier manifested in his article titled: “Another ultimatum from JOHESU Part 1 & Part 2?” I gave him a reply in an article titled “A Reply To Dr Paul John's “Another Ultimatum From JOHESU?”: Be Humble In Service”.  He replied the article but I read the article severally to see whether he joined the cogent issues that I raised. Instead, he went off the moral track into insults! I simply decided not to issue another reply as a matter of principle until I saw another article that he wrote titled, “THE UNENDING CRISIS IN THE HEALTH SECTOR: An Open Letter to Mr. President”.

 

I was surprised Dr Paul continued to fan the arrogance which I had perceived in his previous write ups. I still do not understand the real problem of Dr Paul. Maybe be he can go ahead and lobby the FG to create a separate Civil service Rule for the doctors and doctors only. But won’t that be most absurd? Are the medical doctors in the health sector no longer civil servants like their other colleagues and health professional workers? Are they “superstar civil servants” while others health workers (physiotherapists, pharmacists, nurses, health administrative officers etc) are simply nothing?

 

On the issue of Consultancy, I want to first of all thank the FG for finally issuing the circular granting consultancy status to other health works apart from surgeons/physicians. This is really a breakthrough. But the NMA/MDCAN has not been happy; well their unhappiness will never sweep the circular under the carpet this time around.

 

Who is a consultant in the first place? On a general note, a consultant is professional adviser; He is an expert who charges a fee for providing advice or services in a particular field (according to Encarta dictionary). In the field of medicine, a consultant is the title of a senior hospital-based physician or surgeon who has completed all of his or her specialist training and been placed on the specialist register in their chosen speciality. Their role is entirely distinct to that of general practitioners, or GPs.

 

In the UK, fully qualified medical practitioners are placed into two categories, doctors and consultants. The term doctor usually applies to General Practitioners (GP), which is somebody trained in a broad range of medicine.

 

When a doctor diagnoses a particular condition and is unable, or equipped to treat it, or the doctor can’t identify the condition, or the condition requires extensive treatment, the doctor may refer the patient to a consultant. Consultants have the same basic medical training as doctors but have specialised in one particular field of medicine. Thus we have Consultants in Anaesthetics (the use of medicines to anaesthetise patients during surgery and medical procedures anaethetics), Obstetrics and gynaecology (female reproduction, including pregnancy), Ophthalmology (treatment of conditions of the eye), Paediatrics (treatment of children), Pathology (the study of disease and its effects), Psychiatry (treatment of mental disorders), Radiology (the use of imaging such as x-ray and ultra sound), Oncology (the treatment of tumours and cancer), Surgery (treatment of conditions by internal operation) etc. 

 

All consultants receive the same basic medical training as doctors, but also receive specialisation training and experience, so becoming a consultant often takes longer than becoming a GP. Also, it is generally taken for granted that, because of the additional training a consultant receives, consultants are more senior to doctors.

 

It is worthy to note that just as we have Consultant Obstetrician, Oncologist, anesthesiologists, there are also consultants in other health professions, a fact that Dr Paul is, either unaware of or have deliberately ignored. 

 

Let us hear Dr Paul, He made this comment in one of his articles titled, “Elegy to my distinguished medical elders”: “My most distinguished medical elders, our most graceful government has decided to compensate you for a job well done in our last nationwide strike by approving consultancy levels to all professionals in our tertiary hospitals .I nearly committed suicide when I first read the news ………… It dawned on me that we are finished in this profession”. 

 

 

I thank God Dr Paul did not commit suicide!!! In my research, I came across Anna Hamer who is Consultant Neurological Physiotherapist.( Neurological Physiotherapy has become one of the leading practices in the UK as at present. She is a post-graduate clinical supervisor with 20 years of NHS experience and has worked at The Royal Free Hospital, UK and set up the neurological physiotherapy service in a district general hospital as well as a multi-disciplinary neurological rehabilitation unit). I came across Diana Finney who is a Consultant Rheumatology Nurse (She trained at Kings College Hospital in London and has a 26-year career in nursing. She was a Rheumatology Nurse Specialist for 10 years at Worthing Hospital and came to Brighton and Hove as a Consultant Nurse in 2008. She is an Honorary Consultant for Brighton and Sussex University Hospitals where she is a visiting Lecturer). I came across Johan Holte who is a Consultant Physiotherapist ( He started working at Kings College Hospital as a Consultant Physiotherapist in 2007. In that role he worked closely with the GP consortium setting up musculoskeletal assessment services for spinal and peripheral conditions).  If you go to the US or Canada, one finds the American Society of Consultant Pharmacists and Canadian Society of Consultant Pharmacists respectively, just as we have Medical and Dental Consultants Association (MDCAN) here in Nigeria.

 

From this, one finds that there are Consultants in other health professions (who offer professional advice and expertise in a particular field) in western countries. Dr Paul John may have even forgotten what the Chief Medical Director (CMD) of University College Hospital, Ibadan, Prof. Temitope Alonge, once said, that the title of ‘consultancy’ should not be reserved for doctors alone (Prof Alonge himself who is an Orthopaedic surgeon). Dr Paul may have forgotten that medical practioners and the highly trained health professionals (e.g nurses, emergency medical technicians, paramedics, laboratory scientists, pharmacists, podiatrists,  physiotherapists, respiratory therapists, speech therapists, occupational therapists, radiographers, dietitians, and bioengineers) work together as an interdisciplinary team with one common goal: efficient delivery of modern health care.

 

These Consultants in other health professions have gotten expert knowledge in their various fields. Can one ask Dr Paul why a doctor for example would refer a patient suffering from stroke or Bell’s palsy to a Physiotherapist to handle? Of course, he could have handled and rehabilitated such patients!!

 

Dr Paul John went ahead to label these health workers/professionals (that make up JOHESU) as “medical insurgents”. It is really pitiable that he made such a remark! That is so uncharitable and uncomplimentary, which deserves unequivocal criticism and unhesitating condemnation.  Let’s define the word ‘insurgent’.  According to Encarta dictionary, an insurgent is a rebel; somebody who rebels against authority or leadership. So, Dr Paul is calling the nurses, physiotherapists, pharmacists, medical laboratory scientists/technicians, health administrators rebels! Is that not an insult on the collective sensibility of the integrity of these health professionals? Is that remark not offensive? How then do we describe the action of NMA when it unilaterally embarked on an unjustifiable strike action on July 1st 2014, when there was a subsisting court order (in June 2014) from competent court authorities, restraining NMA/MDCAN and JOHESU from embarking on strike until the Court determined the suit (which NMA/MDCAN) brought before it?

 

Dr. Paul John also went to state in his open letter that the FG should ‘wield the big stick’ on JOHESU. Let us hear his unceremonious remark, “The government can never please the two warring parties (the doctors and the non-doctors). It has come to a point that the government chooses one party and wield the big stick against the other party.

 

Even our law court cannot please the two parties. Our Lord Jesus taught us not to serve two masters at the same time. Wielding the big stick can come in different ways like privatising all paramedical services in our tertiary health institutions. Employment of the services of locum paramedical workers while JOHESU national strike lasts. Also wielding the big stick can come in different ways. Let the hospital managements and the federal ministry of health that employed the JOHESU members introduce no-work-no-pay. What strength does a striking worker have when he cannot either feed himself or his family?”.  Of course, the FG under Jonathan “wielded the big stick” upon the NMA by sacking all the resident doctors/suspending the residency program. They cried, wept, begged eminent Nigerians and even met the senate president who told them to first of all call of their immoral, illegitimate and unjustifiable strike, before he meets the president through the ‘back door’ (back door negotiation). It was after the NMA called off their strike, that the FG lifted the sack/suspension and yet “paid them in full their two months emoluments”. It did not end there. The FG also went ahead to implement the new enhanced salary scale for the doctors (worked out in January 2014). They were paid two months ‘index of commitment’, and told the remaining would be captured in 2015 budget!

 

Click Here For Part 2

 

BY IBE, V.C.N

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