In 1807 slave trade was abolished by the British but in 1885 Lagos was captured as a whole by the same British who started moving inwards into Nigeria. By the early 1900s Sir Fredrick Lugard had reached Sokoto and hence the control of resources started. By the 1930s, thank God for visionaries like late Sir Tafawa Balewa, late Chief Awolowo, late Dr Azikiwe to mention a few all rallied together and fought for independence which we got in 1960. Unfortunately, coup d’ etats and civil wars never helped matters. Also, the military lost focus and started to enrich themselves hence the oppression started and another round of agitations started but this time for democracy which we finally got and so far uninterrupted from 1999 and so shall it be, Amen. 

 

The problems in the health sector is not new but why has it got so bad? Why are other health workers as the Medical Doctors call them “CONGLOMERATES OF NONENTITIES” or “JAMB DROP OUTS” trying to be Doctors? After all they should know thier place. Don’t they know that Doctors are Alpha and Omega and it’s their Birth right from God to dictate to others with an iron fist. 

 

In a matter of fact let us privatize other health workers so that they would SHUT-UP and submit to our dictates. I don’t know if one gets the picture of what is happening in the health sector? Well that’s why I started with a very brief history of Nigeria and it’s struggles. I was watching ‘House’ the other day, I think its seasom 7 and a patient (a woman) went in to see Dr. House, she had some complaints and knowing "House" he was not interested. He just dismissed her complaints and said its nothing but the woman asked him a question, ‘Why are you Doctors so arrogant and believe that you are better than everyone else?’ House replied, ‘Well because we have brought alot of dying people from death to life’ I laughed but later connected with what Dr House said and I discovered that the Nigerian health sector is no different. 

 

Its a known fact that if you play God, pride will come and that’s exactly what is happening here in Nigeria. Before 1985, the health sector that is the Hospitals were run or governed by the Administrators but there was a struggle or should I say an agitation. The health professionals including Medical Doctors, Nurses, Pharmacists, Physiotherapist etc all came in unison and proposed that the health sector should be run by them. Their reason was that an administrator has no knowledge of medicine and that they (administrators) were biased and OPPRESSING health workers. 

 

Late Professor Ransome Kuti a Pediatrician and then Minister of health quickly used the opportunity to convince General Babangida that health administrative staffs need NOT to head the health sector but they (Doctors). Even though it was a collective struggle but the headship was quickly hijacked by the Doctors hence the term Birth right was born. 

 

Now, a question may arise, ‘ why are other health workers crying wolf and not then’? Well let the truth be told, other health workers at that time never saw themselves as leaders but followers. They believed that Doctors were superior to them especially due to their 6 years in the Universities as compared to their’s which at the time was just 4 years. But over time the taste of power by Medical Doctors, the fun of control and the ability to determine once fate became insatiable and tentacles grew not only in hospitals but even in the ministry of health. 

 

Presently, the Ministry of health has at least 5 directories and all are headed by Doctors as Directors. The Minister of health must be a doctor, the CMD must be a doctor, the C’MAC must be a doctor, the medical lab scientist must be headed by a doctor, etc. 

 

All these now resulted in a MASTER AND SLAVE mentality: we the masters want more and if these half blocked heads (other health workers) want more we will fight with the government for even calling them for discussion. We the Medical Doctors are to DICTATE what others should get as we see fit! Does that sound familiar? Well, I will go over some of the burning issues both NMA and MDCAN raised and their justification for this total indefinite strike; 

 

1. Salary Increament: 

Everyone wants to have an increment in salary from time to time no complaints there but the clamor for an increment goes beyond a better pay, it’s all about ‘margin’. Doctors don’t want any other professional earning the same or near same salary with them that’s why they are asking for more, the gap once enjoyed or should I say the relativity enjoyed is no more and now other health workers are ‘flexing muscles’ with Doctors. That they HATE. You see going by the agreed salary structure reached by FG and NMA in January, a Doctor working in Federal institutions will earn at least N250,000 per month and a very senior consultant will earn about N500,000 per month. 

 

But what the public don’t know is that most Doctors don’t work in just one place (I mean a Consultant). They consult in at least two other places with attractive pay. 

 

Also in a Teaching Hospital setting Doctors are employed by the university to lecture up coming medical students and are being paid attractive salaries, even with the just agreed salary increase between FG and ASUU last year. But these same Doctors employed FULL time by the Ministry of Education are the once also heading and collecting the said amounts in Teaching Hospitals under the Federal Ministry of Health. That is to say double salary. The total net pay is ….. Abeg make I no mention am. 

 

Why do you think IPPIS and Doctors are having problems? 

 

Dr (mrs) Ngozi Okonjo-Iwela had said that the number of Medical Doctors from the universities that are consultant for Teaching Hospitals are too many and that it was not proper to collect two salaries from the same government. Yes, IPPIS had alot of problems, they did not pay Doctors working in LUTH and they owed some others else where but the truth was that they were not alone. Other health workers had the same problems but the consultants were smart. They tricked ARD ( Association of Resident Doctors), they instigated them to go on strike last year August/September 2013 and part of their demands was that they did not want the IPPIS, what ARD did not know was that it payed the Consultant from the Universities. You see IPPIS cannot register a Federal Government worker twice, which mean you must pick one, either Ministry of health or Ministry of Education. By pulling out of IPPIS the Consultants can continue to enjoy. This is why they will NEVER allow the health institutions to be headed by workers employed directly by the Ministry of health. 

 

2. Disapproving the appointment of any other health professionals as CMD: 

I have already spoken about the events of 1985 and how Medical Doctors had seen it as a birth right of theirs but it may interest you to note that the claim ‘as provided by the act establishing tertiary hospitals’ stated that a Medically qualified officer can head the health sector. 

 

Now, what is medically qualified? That’s why the matter is in court, for interpretation. But I believe that since it was all health workers that fought for Autonomy and not just Doctors, the term was written to include everyone or else it would have been written ‘Medical Doctors’ instead of Medically qualified. Alright then, why are other health worker gunning that post? Two words explains it all ‘VICTIMIZATION’ and ‘INTIMIDATION’. This has been going on for years and other health workers have been groaning, praying for a Moses to take them to their promise land but NMA has always made sure that such a Messiah will not stay in the service. Most of the time they are sacked. But I heard of one man who has been trying to fight for justice and fairness for other health workers. Will he succeed or will he be stoned by even his own people if things go wrong? Well only time will tell. 

 

In my own unbiased opinion, let the administrators come back after all the goal for chasing them in the first place has been defeated, secondly, I took my time to check the American and UK system. They use CEO’S and they must be well qualified in administration NOT MEDICINE. Please take time and study their system of operation. 

 

3. No to extention of the word or title CONSULTANT to any other health professionals: 

This in my own opinion is very myopic to say the least. In the UK we have Consultant Nurses, Consultant Physiotherapist etc. Also, the definition of a consultant is ANYONE who gives PROFESSIONAL advice or services. So if this is an English definition them please I want to know if there is a Medical definition. What I expected NMA and NDCAN to fight for is that other health professionals MUST have detailed or comprehensive training like their counterparts in UK or USA before they can be recognized as consultants. It may interest the public to know that a Consultant Doctor here in Nigeria is not recognize in America or even Canada. You have to start all over again. 

 

Now why all the fuss about Consultancy belongs to me and no other or is NMA saying that other health workers are not professionals? Hmm… 

 

4. Opposition in the appointment of directors in the hospitals: 

Everyone should be allowed to reach his full potential if he is well suited for it. Also, is there an existing scheme of service for other health workers in the ministry? The answer is yes. Then at what heights or should I say at what maximum grade level can they get to? The answer funny enough is that of a Director that is level 17. 

 

So why are Doctors against it? Very simple, POWER! 

 

Remember I mentioned that at least 5 directorates in the Ministry of Health exist and all are headed by Doctors, now if they allow others to become directors their stronghold in the Ministry will be threatened and any of them (other health professionals) can be picked to head a department in the ministry. This will not Seattle well with NMA and NDCAN. 

 

Now what I want to know is:

Is the Nigerian scheme of service inferior to two associations? 

Can really, an Association NOT a registered labour union dictate what others must have? 

Can an association sneeze and GEJ and his government ‘pick race’? 

 

Well then I would conclude that “the fear of both boko haram and NMA is the beginning of wisdom”. I am not insinuating that NMA are Boko haram but I am saying that the Federal Government is yet to have solutions or answers for this show of irresponsibility. Both have the capacity to hold the nation at ransom and as I have predicted, FG will cave into their demands after all their are NMA members in GEJ government who will keep giving him wrong advice. These are a few things going on in the health sector that has been allowed to degenerate into bad blood between Doctors and other health workers. Nurses and Doctors exchanging hot curses, Medical lab scientist vs Doctors, Pharmacists vs Doctors etc no wonder NMA suggested privitation. Privitation will definitely shut the mouths of other health workers but the cost of receiving health services will sky rocket. Please read well about the American health system, why do you think Obama was praised for Obama care? 

 

Conclusion: 

Let neutral people take over! Look at the present Ministers of health for both UK and America. In America, Ms Sylvia Mathews Burwell had her first degree in Government and then another in politics NOT medicine and you don’t hear of any fighting do you? Also in the UK Mr Jeremy Hunt MP had his first degree in PPE (Philosophy, Politics and Economics) and they never studies medicine so why this no one is worthy except me. Also both parties must come together, if possible a public debate and trash out the all these issues and settle this dispute once and for all. FG should stop having separate talks with each part but rather remain stong and make sure both come to around table compromise. But remember the minister of health must not be a Medically qualified or must not be related to health or else either party will accuse the other of bias. But who knows, government may ignore this advice and succumb to pressure from NMA today then tomorrow succumb to pressure from JOHESU. Then the battle between the MASTER AND THIER SLAVES CONTINUES.

 

By Alli John Adeolu

Chief Medical Laboratory Scientist