When I was in primary four with 23 other pupils in 1959 at AUD Primary School Agbogbo in Iwo, Osun state, we were asked to write a composition on “My ambition.” More than 15 of the pupils elected to be medical doctor in future. Why? Doctors were seen in the mode of the third saviour of humanity.

God occupied the topmost position with prophets Muhammad and Jesus at distant second spot while the doctors were also perceived as the best and always very considerate. That feeling was deep and inspiring among the pupils throughout the Nigeria of our time. I doubt if there has been any drastic change in this perception till today in spite of the changing circumstances of our nation; but it will be pretentious to state that there has not been any change in perception.

 

What is responsible for this change? There is general frustration among most Nigerians about the incessant strikes and closure of our public health institutions by medical doctors protesting one issue or the other in the last three decades. The strikes were not mindful of those who were or are critically ill and undergoing treatment which could lead to their recovery if they were attended to by doctors; or death if there is no doctor to attend to them.

There was also no consideration for periods of national emergencies when the doctors decide to go on strike. The first major ethical consideration in the practice of medicine is high premium to save lives above any other consideration. The motto of medical practice is “We care but God heals. To me this is what made the profession a very noble one. Anything that will erode the perception must be jealously guided by the Nigeria Medical Association (NMA) and its members.

The NMA is a professional body under the law and has the authority to regulate medical practice, admit and register practitioners throughout the country. Nobody can practice medicine in Nigeria without NMA certification. Why, how when did the NMA get transformed into a Labour union?

 

Historically, the NMA allied with labour in the struggle to push out military regimes out of power. They were on the side of popular demand by the people for the return of the country to civil rule. These efforts were recognized and all Nigerians were ready to pay the prize. However the NMA took advantage of these strikes to negotiate better conditions of service and they got the backing of all right-thinking member of the society.

 

Strikes also became a major weapon to pressure government to accede to demands by various other unions under the Nigeria Labour Congress NLC and the situation has become so notorious that many sectors of the public economy have in the recent past witnessed closures and disruptions of services to the detriment of the ordinary man, even at the critical moments of national needs.

 

Strike by one union or association had always led to chains of reactions and followed up strikes by the other unions. Once Academic Staff Union of Universities, ASUU, and the NMA concluded theirs, it is expected that the nurses and non-medical health workers in the hospitals, the Nigeria Union of Teachers, NUT, the Academic Staff Union of Polytechnics, ASUP and a host of the others would join the strike cue or train for demands for improved condition of service though masquerading it under demand for better facilities and equipment for optimum professional performance. Unfortunately as soon as the remuneration aspect of the demands is ironed out, the strike is called off. The issue of inadequate facilities and equipment are ignored, to be used as bait for other future negotiations. Who is fooling whom?

The tragedy of our nation is that workers are now demanding special allowances to do their primary duties. What is the meaning of hazard allowance for doctors working in public hospitals? What were they employed to do in the first instance? Is there any job without hazards? What about doctors working in private hospitals without pensions and other related bonus already granted to the doctors in previous agreement with the NMA? Has the association the right to negotiate for condition of service throughout the federation? Is it right for doctors in Osun, Jigawa, Ekiti or Kwara states to earn the same remunerations with those in Abuja, Lagos and Port Harcourt? Where is the justice and equity in all these? Where will Ekiti, Kwara, Osun and other low-revenue states find the money to pay?

 

In my opinion, the unions or associations or whatever name they may be called have contributed more to economic, social and educational disruptions and depreciation of national standard than government failures in these sectors. The NMA holds the federal government to ransom and force the state governments to implement un- implementable agreements.

 

Health is on the concurrent list of the constitution. The federal government constitutionally does not have the power to negotiate on behalf of the state governments. That they do so is abnormal, unconstitutional, unacceptable, null and void. This is one of the unfortunate carryover aberrations of the military era. It is time to review this situation and allow the states of the federation to pay according to their financial capacity on all issues on wages and remunerations to all categories of workers. Let there be choice by both employers and employees. Those who prefer to work for the federal government or any state government who can meet their wage demand can do so. The tendency to federalize negotiation must stop now.

 

Strike negates professional excellence and ethics. It erodes the foundations of the claim for improved medical services as past strike actions have failed to achieve the target and one of the reasons is federalization of negotiations. The NMA executives are not ignorant of the provisions of the constitution in this regard; but they keep blind eye for their group interest against the collective interest of the nation. Now that the entire West Africa region is under the threat of epidemical Ebola virus, it is important for the doctors to rethink the strike. That the doctors are keeping mute even with two or three reported cases in Nigeria is a dangerous precedent. Why is this insensitive disposition? Why can’t the NMA end the strike summarily in the interest of the nation? Is morality dead in the NMA or is professional ethics now secondary? What manner of people is leading the association?

 

The doctors should not wait for people’s revolt before they end the strike. The NMA should de-unionize itself and face professionalism. There are several other ways of conflict resolution beside the disruption of national health care services, besides perennial, long and insensitive strikes on the lives of thousands in public hospitals. There could be one or two days warning strike to call the attention of the government to the need of the health care delivery system; there could be work to rule which will not limit services to critically sick peoples and emergencies. There could also be institutionalized five year joint review of the health sector by the NMA at the federal and state levels to stave-off the tendencies for strikes. Those who have died as a result of the current strikes can never be brought to life again. Improved services can only benefit the living not the dead.