Posted on: Fri 25-05-2018

Association of Hospital and Administrative Pharmacists of Nigeria (AHAPN) Press Release

The attention of the Association of Hospital and Administrative Pharmacists of Nigeria (AHAPN) has been drawn to yet another rejoinder by the Nigerian Medical Association (NMA), to the current JOHESU led strike action as contained in her latest Press Release titled “RE: ONGOING STRIKE ACTION BY JOHESU AND ITS EXTENSION.” We are amazed at the despondency and sheer desperation with which the NMA has pursued this issue of adjusted salary for members of JOHESU, even when the government had earlier done same for her members.

1. At a time when Nigeria’s healthcare indices are at an all time low, and indeed one of the lowest in the world, at a time when the dreaded Ebola scourge is about resurfacing close to our borders, all a supposedly elitist group like the NMA has done is to bug the government of the day with unnecessary distractions, blackmails and empty threats about bringing down the government and shutting down the health sector if the government as much as adds one naira to the salaries of non medical doctors, even when the government has increased their salary twice in the not too distant past. How demeaning! How shameful! How belittling! We wish to observe that if the NMA had expended half as much energy in tacking Nigeria’s healthcare challenges, the country would have become a centre of medical tourism like the rest of the world.
2. i. According to the NMA “In view of the above, the NMA painfully wishes to inform the Federal Government of Nigeria that any award to the non- medically qualified health professionals that violates the January and July agreements of 2014 shall result in the resumption of the suspended withdrawal of  service of 2014. Please take this as a notice sir.”

ii. The NMA continued “The above reminder is predicated on the extension of the ongoing strike action embarked upon by the amorphous body called ‘JOHESU’ to states and local government areas, the basis of which is to strengthen its callous and ill motivated agitation for pay parity between her members and doctors with the resultant erosion of relativity and further hierarchical distortion in the health sector vis-à-vis her clandestine romance with some top government officials.”  Oh, is the NMA afraid? What is she afraid of? Realizing that she no longer enjoys monopoly of strike action, the NMA has suddenly become jittery and desperate and like the proverbial drowning man that will clutch at anything to survive, has started casting aspersions at “some (imaginary) top government officials.”

iii. It is public knowledge that in 2009 when late President Musa Yar ‘adua was in office, NMA clamoured for salary increase for her members as usual, but met with a rebuff from the then president, who insisted that any increase in salary would cut across all professionals in the healthcare sector, and not only medical doctors. A committee was set up to work out the modalities for the increment which resulted in the Consolidated Health Salary Scale (CONHESS). This was approved by the then president and implemented in January 2010. Medical doctors and other healthcare workers were together on CONHESS then; and there was relative peace in the sector.

Iv. By 2014, when the CONHESS was due for review, the NMA as usual went behind to lobby the then president for their separate salary scale, and ended up with CONMESS which was far more robust than CONHESS. The CONMESS was quickly approved and doctors were paid their arrears promptly. Even though an adjustment in salary was calculated for non medical doctors, it was never implemented for them till date.

 v. The medical doctors had their salary increased again between 2016 and 2017, under the guise of maintaining relativity. They (doctors) were initially opposed to skipping for CONHESS, for which they argued then that it was criminal to skip any level, but JOHESU went to the National Industrial Court and won the case. The doctors suddenly changed their song and started demanding for skipping for CONMESS, which was quickly approved by the Minister of Health (himself a medical doctor) and they were paid arrears pronto, whereas many health care workers on CONHESS have not been paid their skipping allowance since 2010. This is one of the reasons JOHESU is on strike today.   

 vi. The fact remains that medical doctors enter the CONMESS Scale at the equivalent of GL12, which is by far higher than other healthcare professionals who enter at GL 10. That in itself is relativity. At no point in time is JOHESU asking for same pay with medical doctors as the NMA and the Honourable Minister of Health would erroneously want the world to believe. All JOHESU is asking for is salary adjustment as was done for medical doctors.  What erosion of relativity is NMA talking about when they are already advantaged at entry point?

3. i. On the issue of consultancy, hear the NMA “The demand for the appointment of other health workers as consultants (with payment of specialist allowance) is a self-centered agitation aimed at ensuring they are in charge of clinical care. This is not only an aberration (considering international best practice) that will add no value to clinical/patients care, it will certainly worsen morbidity and mortality indices in Nigeria. We therefore affirm the rejection of this demand.”  Again we are tempted to ask what is the NMA afraid of? Is she acting out of ignorance of what consultants from other health professions are capable of in putting into health care or is it just a case of NMA refusing and rejecting change?

ii. Whether the NMA likes it or not, consultant pharmacists have come to stay. All over the world, including the United Kingdom, consultant pharmacists are collaborating with physicians and other professionals for optimal patient care; no wonder medical tourism is very high in those countries. That explains why even our own very President is compelled to patronize medical services in UK where the practice is close to ideal. In UK for instance, consultant renal care pharmacists work hand in hand with renal physicians and other professionals to optimize patient care, but in Nigeria, a medical officer with an MBBS or at best an internal medicine physician will claim to know it all and prefer to consult alone so that their inadequacies will not be public knowledge. No wonder our health indices in Nigeria are competing with those of Somalia, Sudan and Togo (among the lowest in the world). We make bold to state that the NMA is not in a position to reject appointment of consultants from other health disciplines including pharmacists, because it will run counter to international best practice.

4. On the issue of headship of hospitals, hear the NMA “The demand for headship of Departments/Units in the hospital by members of JOHESU/AHPA will lead to unprecedented chaos in the health sector with ripple effect on the health of Nigerians. We reaffirm our rejection of this demand.”  Again we state emphatically that nothing can be further from the truth. It would appear that the NMA is afraid of even its own shadow. It is common knowledge that when hospital administrators were managing hospitals before the coming of (Olikoye Ransone Kuti in 1985), there was peace, tranquility, serenity and convivial atmosphere in the hospitals. But as soon as medical doctors usurped the management of hospitals, chaos has become the order of the day. We state without equivocation that you do not need to have an MBBS or be a surgeon (FWACS) to successfully manage a hospital. You could argue about heading clinical services in a hospital, but certainly not the administration of the hospital.
5. i. The NMA concluded by threatening the government in what has now become their hallmark “In conclusion, the Nigerian Medical Association wishes to once again remind government of the implications of acceding to any demand that violates the collective bargaining agreement of January 2014.”

ii. We wish to observe that government’s acquiescence to previous NMA demands over the years is one of the factors that emboldened the NMA to act in the way she has carried on so far. The NMA has been systematically milking Nigeria dry under the guise of collective bargaining, such that today in Nigeria, a medical house officer who just left medical school, is placed on CONMESS 1, the equivalent of CONHESS 12 (What a nurse earns after 15 years in service) while a Registrar earns same salary as an Assistant Director of Nursing Services (ADNS)!. A pharmacist who rose through the ranks to become director of pharmaceutical services, even with a Masters degree and after 35 years of service, earns about 500,000 thousand naira monthly, whereas a freshly qualified consultant (6 years post NYSC) earns over 600,000 thousand naira monthly, while older consultants earn one million naira and above monthly (there are close to ten thousand of them currently) thanks to NMA’s machinations. The irony or is it tragedy of all these is that these so called consultants see patients once a week, and a fixed number of patients at that. Other days of the week, patients are left at the mercy of house officers, medical officers and at best registrars. For how long will this treachery continue in the healthcare sector?

iii. This is the disparity that the NMA wants to maintain between their salary and those of other healthcare workers at all costs. This explains why they are so jittery and keep issuing threats to various ministers and indeed the presidency not to honour JOHESU’s demands, because of their narrow mindedness.

CONCLUSION

• From the foregoing, it is very obvious that the NMA is not fighting a just cause, and as such, we demand that government should call her bluff and accede to JOHESU’s demands once and for all.
• NMA is threatening government with strike if government grants JOHESU’s demands; as the NMA must have observed by now; she no longer enjoys monopoly of strikes in the health sector. Any strike called by the NMA in future over salary of other health care workers will meet with further strikes by JOHESU members.
• We insist on our earlier call for a Unified Salary Scale for all healthcare workers, including consultants, with workers entering the scale based on their qualifications and years of service.
• We demand that appointment of minister of health should be rotated among the various health professionals (in line with international best practice) and should not be the exclusive preserve of medical doctors, who most of the time exhibit bias towards medical doctors at the detriment of other health care workers. This practice has unwittingly prolonged the strife in the health sector. A case in point is the World Health Organization (WHO), whose Director General is not a medical doctor, yet the world body continues to make giant strides.
• We insist on appointment of pharmacists and other duly qualified healthcare professionals as consultants and medical directors of federal tertiary institutions as a way out of the current quagmire.
• We believe it’s time to call a spade a spade. The federal government should summon the political will to call the bluff of the NMA, before she finally destroys the healthcare sector beyond repairs. As it stands now, the NMA has lost her respect and credibility among other health care professionals because of her pursuit of mediocrity and this has not augured well for service delivery in the sector.
• Where the government chooses to continue to treat the NMA with kid’s gloves, then Nigerians should be prepared for a long drawn out crisis in the health sector with terrible consequences for all. A stitch in time saves nine.

 

Please accept assurances of our esteemed regards.

 

Pharm. Martins Oyewole MAW                       Pharm. Jelili Kilani

National Chairman AHAPN                                National Secretary

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