Appointments of officers into choice positions in the nation’s public health institutions may tear apart the sector, BUKOLA ADEBAYO writes

Some health workers, including pharmacists and nurses, are threatening fire and brimstone over the alleged preferential treatment given to doctors.

Doctors, other professionals in the sector allege, are getting all the choicest postions in the nation’s public health institutions. Positions such as the chief medical directors, consultants, they add, are now the exclusive preserves of physicians.

Crying foul over this, pharmacists, nurses as well as other health workers, therefore say they cannot continue to tolerate the “marginalisation”. In fact, they have threatened to drag the Federal Government and the Nigerian Medical Association to court over the alleged marginalisation.

Though many disputes have ensued between doctors and other dealth workers in the industry in recent times, none may be as weighty as the planned one.

For instance, doctors in federal and state-owned hospitals, under the auspices of the Nigerian Medical Association, have already threatened to abandon their duty posts and embark on a nationwide strike on July I, 2014 should the Federal Government accede to the demands of the Joint Health Sector Unions, the body representing other professionals in the sector.

But as they are planning the action, JOHESU on the other hand is insisting that the doctors demands are outrageous.

JOHESU has thus vowed that should the Federal Government bow to pressure by reversing appointment offers given to the union last May, its members, who account for more than 70 per cent of workers in the industry, would not only embark on strike, but also take a legal action against the Federal Government and the NMA.

Who should be called a consultant?

The Federal Government in April aceded to one of the demands of pharmacists and other health workers by approving the title of consultants for deserving professionals.

This move has angered doctors who have been the only ones privy to this prestigious appointment for decades in the nation’s hospitals.

The NMA, in a 24-point demand letter to the Federal Government, directed that either such positions be reversed or doctors would embark on a total nationwide strike in the next seven days.

The letter reads, “The title “consultant” in a hospital setting describes the relationship between the specialist medical doctor and his patient. It will be a source of confusion if the title is applied to any other health worker who statutorily does not own a patient.

“NMA therefore declares with unmitigated emphasis that if “non-doctor consultants” are appointed, it will lead to chaos and anarchy in the health sector. This should not happen.”

However, the National President, Pharmaceutical Society of Nigeria, Mr. Olumide Akintayo, notes that by protesting such appointments, the NMA and its members have demonstrated that they want to ‘colonise’ the multi-disciplinary sector

Akintayo states, “We must caution doctors in this country. How will a group of professionals say that others should not be called consultants because of their ego? How does calling pharmacists or medical laboratory scientists consultants, when they have the skills and are consulting in their field affect, the work of a medical doctor?

“The resistance of doctors to approval of consultancy status for qualified members of the health team is laced with abysmal ignorance. It is baffling that people who mouth international best practice and claim to stand on hippocratic platitudes would say that expanding the consultancy frontier can create chaos in hospitals. The logical question to ask is: why does it not create chaos in other climes?”

However, a look at health appointments in the United Kingdom, countries in Europe, Canada and the United States of America shows that, indeed, consultancy status are conferred on nurses, pharmacists and other health professionals when deemed so by the awarding institution.

Who should be the chief medical director?

Pharmacists have also been agitating that it is high time, they occupied the position of chief medical directors in the various public health institutions where they work.

But doctors disagree, arguing that the position of the CMD or medical director of any hospital, as the title connotes, should always be occupied by a seasoned medical doctor.

Defending this, the Lagos NMA Chairman, Dr. Francis Faduyile, say the post of a CMD in a hospital setting is sacrosanct.

Faduyile says, “In other climes, the chief medical director or medical director is a doctor. It must continue to be occupied by a medical doctor as contained in the Act establishing tertiary hospitals. This position remains untouchable.

“Why did they not ask that the post of vice-chancellor be open to everyone in the university since members of the Academic Senior Staff Union of Universities and the Senior Staff Association of Nigerian Universities are graduates.

“Can you be a judge of the High Court or Court of Appeal if you are not a lawyer? Why do they think the hospitals where lives are saved everyday should sacrifice the established leadership, the position of a chief medical director?”

Also, the Lagos NMA Publicity Secretary, Dr. Peter Ogunnubi, argues that the training of a medical doctor has equipped him/her with the necessary skills and experience needed to oversee the clinical affairs of a hospital.

Ogunnubi notes, “A doctor undergoes training in various specialties in medicine and health, including nursing, pharmacy, laboratory science, physiotherapy and radiotherapy.

“He/she is made to go through this rigorous process because of the position of leadership that he/she would have to take in the hospital setting. Why should this be in contest? It is chief medical, meaning medical doctor. The rife on who deserves this position is unnecessary. Doctors will not go to a pharmaceutical plant to start compounding medicines or fighting to be the head of that plants; it is their job not ours. Our roles are defined let us stick to it.”

Meanwhile, the NMA is displeased with a new directive of the Central Bank of Nigeria authorising the Medical Laboratory Science Council of Nigeria to approve licences for the importation of In-Vitro Diagnostics being some medical equipment, into the country.

The body has called for the immediate withdrawal of the circular, declaring that this could violate standard practice in medicine.

It also insists that its other 20-point demands, including the immediate appointment of a surgeon-general and increment of other allowances, be met by July 1.

We will go to court – PSN

Akintayo says in the face of the demands by the doctors, which according to him, will frustrate other health professionals’ needs, their members may seek justice in the court of law.

He stresses “We may go to court should this continue. We also call on JOHESU and its labour allies to proceed immediately to the appropriate arbitration courts to seek judicial redress if the government goes on to dialogue with any unlawful group in trade disputes from now on in the health sector.

“It should be a matter of embarrassment to seasoned bureaucrats in Nigeria that it is only in the health sector that you find a professional body agitating for the welfare and uplift of its own members, but also goes ahead to peg or dictate what its contemporaries in other professions which it chooses to denigrate. This cycle of delinquency which was the norm will no longer find space in our relationship with our medical friends who have the mentality of emperors.”

While the war of words goes on, critics and stakeholders, say it is high time medical doctors and various health professionals sheathed their swords and face the business of saving lives.