Nigerian Medical Association, Lagos Press Release on Lagos State Government Circular on Consultant Pharmacist & Related Issues


Posted on: Mon 21-05-2018

RE: LAGOS STATE GOVERNMENT CIRCULAR ON CONSULTANT PHAMARCIST AND RELATED ISSUES; THE NEED FOR THE PRESERVATION OF SANITY IN PATIENTS' CARE 
 
The Nigerian Medical Association, Lagos State Branch, as a critical stakeholder in the Lagos State health project wishes to intimate the good people of Lagos State and in deed the general public about recent unpalatable development in the health sector of the state which if not urgently addressed has the capability to cause chaos in healthcare delivery and consequent poor health outcome. 
 
This development appears to be the design of the detractors of the current Lagos State administration as it's in conflict with her laudable agenda for the health sector of the state vis-as-vis her key achievements in the last 3 years. 
 
THE ISSUES 
In circulars dated 10th and 11th May, 2018, both of which emanated from the office of the Head of Service of Lagos State, the approval of His Excellency, Mr Akinwunmi Ambode, for the creation of the Consultant Pharmacist Cadre and separate Directorates for allied health professionals in the Lagos State Hospitals, were communicated to relevant authorities in the state. 
 
1. Consultant Pharmacist
Item 2 of circular no: 036, states, "Consequently, the scheme of service as regard the Pharmacist Cadre will henceforth include Consultant Cadre".
 
As it is the practice all over the world, consultants are medical and dental practitioners who are appointed in hospital settings to oversee clinical/patients care after completing post graduate residency training in specific areas of medicine. This training takes a minimum of 6 years of intensive clinical training in a teaching hospital or specialist hospital approved for such by either the National Post Graduate Medical College or the West Africa Post Graduate Medical College. 
 
The residency training is not diploma or sandwich like as we have seen in the training leading to the acquisition of some post graduate degrees currently being ranked as equal to the residency medical training by this amorphous body, JOHESU. 
 
For instance, a medical or dental practitioner in Lagos state service who intends to pursue residency training in a specific field of medicine after passing the primary examination of either of the colleges stated above will proceed to the Lagos State University Teaching Hospital or any other specialist hospital that has accreditation for such within the state or elsewhere. There is no place for sandwich like residency training in medicine! 
 
Government Is therefore advised to put urgent measures in place that will lead to the revision of this pronouncement, and recruit more Clinical Pharmacologists to complement the good work already being done by medical and dental practitioners in other fields of medicine In the state's health services.
 
2. The creation of Directorates for Laboratory Scientists, Radiographers, Nurses etc Is alien to international best practices In health care business. This will further polarize the heath sector of the state and worsen the decadence in professionalism occasioned by the 111. conceived agitation by these professionals allied to medicine and ultimately affect the quality of care as this Is tantamount to given them autonomy in respect of patients' care. 
 
We therefore implore government to stick to the previous arrangement In Pathology/Clinical Laboratory Services algorithm, where only a Directorate exist le the Directorate of Pathology, for which the most senior Pathologist Is the Director. The same practice applies to Radiological Services.
 
3. Government through the Lagos State Ministry of Health and the Health Service Commission should ensure unhindered access to service points In all the state owned hospitals including Primary Health Care Centers with necessary logistic support and the provision of adequate security for doctors to continue with the sustenance of services to the populace while the ongoing nationwide strike action called by JOHESU lasts. 
 
4. The NMA is not against the career progression/the Improvement In the welfare of any professional or group of professionals in the health sector of the state but strongly oppose any pronouncement(s) that could lead to hierarchical distortion in the sector with negative outcome on patients' care or any adjustment in salary scale with consequent pay parity between medical practitioners and allied health professionals including pharmacists,  Laboratory Scientists, Nurses, Radiographers, Physiotherapists etc.
 
5. While restating our commitment to continue to work with government in its effort to ensure lasting peace in the health sector of the state, we wish to declare our support for measures already being taken by the Medical Guild, the association of medical and dental practitioners In the employment of the state, to ensure the preservation of sanity in patients' care in the state owned health facilities.
 
We wish to encourage Lagosians to continue to seek care at public hospitals in the state regardless of the ongoing strike by the amorphous body, called JOHESU, which is driven by her callous and III quest for pay parity with doctors
 
The ill quest of the Joint Health Sector Union/Pharmaceutical Society of Nigeria for her members to be appointed as consultants in hospital setting Is part of sinister rivalry agenda aimed at hijacking the primary responsibility of patients' care and ensure- pay parity with medical and dental practitioners rather than the attainment of career peak. This has been ongoing for years at the federal level with all their efforts In futility. 
 
The court order in the case of the Joint Hearth Sector Union JOHESU) vs Federal Ministry of Health in suit No: NICN/ABJ/228/ 2012 in respect of the appointment of consultants, which was In favour of the Federal Ministry of Health, Is worthy of note, thus; The NICN affirmed that the Federal Ministry of Health had the right to direct that non-medically qualified health professionals should not be appointed as consultants in the federal Government  institutions. 
 
It is pertinent to state that the surreptitious role in patients' care that JOHESU and PSN are canvassing for is the duty of clinical pharmacologist, a specialist medical practitioner in the field of pharmacology. 
 
It Is also important to inform Lagosians and the general public that the Tayale Ahmed Committee on professional harmony in the health sector was necessitated by the selfish agitation of JO HES U/A HPA. The report Is a valuable document in this regard.
 
2. Creation of Conflicting Directorates for Allied Health Professionals 
In the hospital setting, allied health professionals are components of the various teams with medical and dental practitioners as heads. This is in conformity with best practices in healthcare delivery the world over.
 
For example, the clinical laboratory team consists of the pathologist, the laboratory scientist, the laboratory technician etc with the pathologist, a specialist medical practitioner In laboratory medicine, as the team head.
 
Creating parallel directorates for allied health professionals eg for laboratory scientists in the Lagos State hospital setting, will not only lead to unprecedented hierarchical distortion and chaos in clinical laboratory services but has a great potential in worsening quackery in patients' care with consequent Immense danger to the health of Lagos 'ans.
 
OUR POSITION 
The Nigerian Medical Association, Lagos State Branch, being a key stakeholder in the Lagos State health sector, wishes to state and advice government as follows: 
1. The creation of Consultant Pharmacist Cadre for pharmacists in Lagos state hospital setting is a pronouncement that is not in tandem with global best practices In healthcare delivery and capable of causing anarchy in the health sector with resultant negative health outcome. 
 
In conclusion, we appeal to well-meaning Lagosians and Nigerians to prevail on the Lagos State Government to urgently put mechanism in place to prevent an unprecedented industrial crisis in the health sector of the state.
 
Thank you. 
 
Signed:
Dr. S.K. Adebayo 
Chairman
 
Dr. Sunday Luro
Secretary