Members of the Nigerian Medical Association have been on strike since last week Monday. the government said the strike was unnecessary while a splinter group, the medical consultants association of nigeria said it would not participate in the strike. A senate intervention produced little result, allowing speciaists to attend only to very serious cases; they said they were determined to carry on with their action, despite the suffering they acknowledged it could cause.

 

NMA president Dr Lawrence kayode obembe said that contrary to beliefs that its members were insensitive to the plight of patients, it was the government that should be blamed for its alleged failure to honour agreements. 

 

The joint health sector union (JOHESU) noted recently that the NMA and the nigerian association of resident doctors (NARD) cannot negotiate any dispute with government becasue they are not considered to be trade unions. With salary differentials being an important part of wage negotiations, any settlement made independently with the doctors will have repercussions on the industry as a whole. 

 

However the doctors apperar to always want to go it alone in negotiations on working terms and conditions. FOOLISH PRIDE AND SELF GLORIFICATION APPEAR TO BE THE PROBLEM.

 

Some of the issues in contention include reserving the position of chief medical director (CMD) to only medical doctors, appointment of surgeon general of the federation, passage of the national health bill and providing security for doctors to avoid being "unwarranted victims of kidnapping". Others are increase in duty, hazard and specialist allowances, and a budget for residency training program, reintegration of NMA members into the payroll system.

 

They also demanded that the title "consultant" should not be given to any other health professional other than medical doctors. this untenable position arises from the wrong notion that medical doctors are superior to health workers in the health sector. There are huge numbers of school leavers who want to study medicine but cannot because medical schools do not have the required facilities to take in all those who qualify. The alternative for many is to pursue courses like biochemistry, the result of poor planning by the government. Any meaningful plan must include expert assessments of the number of doctors the country would need in future years and collaborate with the universities and matricutlation agencies to ensure that the goals are met. 

 

It is the absense of such development plans, not just in the health sector, but in virtually every other one, that a country of about 170 million people is being served by just 270,000 doctors. with such acute disparity, even the mildest withdrawal of service will only aggravate the already deficient state of the public health sector.

 

Thereford the "total and indefinite strike" that the NMA has instigated its members to embark upon is a terrible repudiation of the Hippocratic oath by which doctors swore to serve under any condition. As in previous strikes, this one is based on pecuniary benefits, regardless of the consequences on patients.

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The minister of health, professor onyebuchi chukwu, stated that the position of the government, where he argued that "almost all the issues in contention were either issues that had been satisfactorily resolved or issues that could be treated merely through administrative machanism. The doctors have disputed that assertion. 

 

However, the NMA Missed the point when it sought to compare the remuneration of political appointees and elected officials to doctors emoluments; both are unrelated. But the government would be failing in its duty if it does not ensure that the working condidtions of doctors in the country are comparable to other countries.

 

For now, the NMA should recall its members to return to work to create the environment for Negotiation with government to proceed, and for the nation's health institutions to begin full operation again.