I have watched with keen interest the brouhaha in the health sector over the past few months. As bad as this is, there have been issues raised on both sides. On social media and on newspapers, there have also been arguments for and against these contentious issues. I must say at this point that my opinions are strictly based on facts and not biased. 

 

JOHESU is the umbrella body for joint health workers union including record officers, hospital technicians, porters and cleaners in the hospitals. The Medical Doctors are covered under the umbrella of the Nigerian Medical Association. 

 

Let me start by saying that the strike embarked upon by the Nigerian Medical Association is clearly illegal and a gross violation of the trade union act. NMA is not a registered association and as such it is not recognized under the trade union act. This action is a violation of labour laws and must be condemned in strong terms by well meaning Nigerians. If the NMA wants to be recognized under the labour law, they should go through the due process of registration and then their actions can be justified. The era of impunity and brazen lawlessness against the Nigerian state must stop.

 

It must be noted at this point that the Medical Doctor is the head of the medical team and will always be. It cannot be contested for. A Medical Doctor apart from his rigorous years of training also has an in-depth knowledge about the health of a Patient when compared to allied medical professionals. Sometimes, a Medical Doctor also works round the clock in hospitals when compared to other allied health professionals. This probably makes the issue of relativity a no-go-area.

 

The accusation by the NMA on the issue of skipping by JOHESU members is not tenable. The issue of skipping by JOHESU members is what is required in their scheme of service. It must be noted here that during President Olusegun Obasanjo’s administration, the federal government placed all Nigerian workers on the same salary scale, but Medical Doctors rebuffed the idea and agitated for COMESS structure for themselves. Under the late President Umaru Musa Yar’Adua, they negotiated with the government and had their way through the principle of collective bargaining, accepted the COMESS structure. JOHESU members also negotiated and got CONHESS structure for themselves. 

 

The accusation by the NMA on skipping by JOHESU members isn’t really skipping per se. Skipping is actually when you move from level 8 to level 10 without passing through level 9. The claim by Doctors that JOHESU members skip does not hold water because that was part of the agreement reached with the government. The government was not coerced into signing the agreement. How about Medical Doctors who move from level 10 as a house officer to level 12 as a fresh medical graduate? Why hasn’t that been called skipping? The judgement of the National Industrial Court was very much expected. The court order affirmed that the principle of collective bargaining is a right and not a privilege, and the government must implement the agreement it willingly entered with the union.  

 

The agitation by JOHESU members to be eligible to contest for the position of the Chief Medical Directors of hospitals is totally in place. The work of a Chief Medical Director is purely administrative, and has little to do with years of training in medical school. The Chief Medical Director directs responsibility for key departments like Accounts and finance, internal audit, information and communication technology unit, Public relations, engineering, planning, security services, staff development et al. The statutory role of the Chief Medical Director is that of an over-all coordinator of the entire functions of the hospital. What I however have problem with is the membership of JOHESU. Even if this request is granted, does that mean that a cleaner or a porter in a hospital will be eligible for this post too as members of the JOHESU? 

 

The agitation by the NMA for the office of the Surgeon general of the federation is highly commendable. But the plan to exclude other allied medical professionals is totally uncalled for. In the U.S.A where they have the office of the surgeon general of the U.S Army, Medical Doctors and allied medical professionals are eligible for this post. In fact, in 2011, Lt. Gen. Patricia D. Horoho, a Nurse, was sworn in as the surgeon general of the U.S Army. Why can’t the same be obtainable in Nigeria? Didn’t we copy it from the U.S?  Why is it hard to copy the template too?

 

On the issue of Consultancy by JOHESU members, I do not have issues with that. But JOHESU must be clear on this agitation. Let each organization that makes up JOHESU fight for themselves on this one. I see no reason why a cleaner will be fighting for a Physiotherapist to become a consultant. What sense does that make? Each organization should come out with their blueprint on why they deserve the position of a consultant and highlight the improvements it will bring on the health care system in Nigeria. Then the government can do justice to that.

 

Over time, what I have observed in the part of JOHESU members is inferiority complex. The Medical Doctor is the head of the hospital. Why should a Nurse be comparing his or herself with a Medical Doctor in terms of service delivery? It creates an avenue for an unhealthy rivalry in the health sector. I see JOHESU as a force intentionally created against the NMA. I’m aware we have the Nigerian Society of Physiotherapy (NSP), the Pharmaceutical Society of Nigeria (PSN), Association of Radiographers of Nigeria (ARN) and others. These organizations are like the NMA who can fight their own battles for themselves.  Then the questions that readily comes to mind are, why JOHESU? Why the coalition against Medical Doctors? Why the involvement of cleaners, porters, hospital record officers in the membership of JOHESU? I really do hope to see a constitution guiding JOHESU one of these days. It would be interesting to read.

 

In conclusion, if any headway is to be made, the affected parties must sheathe their sword and come to the negotiation table for a logical end to these endless crises in the sector. Putting the lives of Patients at risk for some selfish interests is highly ridiculous, asinine and preposterous, to say the least. The plan by the government to proscribe NMA will further deepen the crisis in the sector. In fact, that will signal the beginning of the end for the sector. Government must work out modalities to address these contentious issues. The JOHESU members should also stop making this look like a fight of supremacy between them and the NMA. Be it the NMA, PSN, NSP and whatever it is, all that matters is the wellbeing of the Patient. And that is very important. 

                                                                                                                                          

Deji Gbogi

Department of Medicine and surgery

University of Lagos