The Nigerian Health Sector has been in the news for some time now, as a result of the lingering crisis that has bedeviled the Sector. The HEALTH sector is expected to be a place of total wellbeing but why is there so much hostility in the Sector which has taken a hydra-headed form? Why is the Sector matching towards Tophet; the Valley of Destruction? There is so much misinformation, impunity, violation of Established Rules and Codes of Conduct. Why is the Place polarized with mistrust, and disharmony? Why has the Government allowed herself to become a pawn in the hands of Nigerian Medical Association (NMA) and Medical and Dental Consultants Association(MDCAN) which are not legally recognized Trade Unions? 

 

Why does the Government allow double Standards within the same Sector? 

 

The government that was able to restrain a registered Trade Union from going on strike has not stopped an unregistered body posturing as a Trade Union. Why has the Government allowed the Constitution of the Federal Republic, to be violated by NMA who sees herself as the Imperial Majesty, who must continue to subjugate other workers in the Health Sector? Before we bring answers to these numerous WHYS, let us x-ray the pathogenesis of the crisis in the Health Sector.

 

SALARY STRUCTURES IN THE HEALTH SECTOR

Under the then President, His Excellency Alhaji Umaru Musa Yar’Adua, the Nigerian Government in 2009 had approved two different Salary Structures in the Health Sector. These two Salary Scales were known as Consolidated Medical Salary Scale (CONMESS) and Consolidated Health Salary Scale (CONHESS).Medical Doctors in the Service of the Nigerian Civil Service are on CONMESS, while every other person working in the Health Sector was placed under the CONHESS structure. Before the emergence of the late President UMARU  MUSA  YAR’ ADUA, President Olusegun Obasanjo, had placed all Nigerian Health Workers under a unified Salary Scale.NMA had seriously kicked against this  unified Salary Scale. It was NMA that negotiated CONMESS for her members while the Joint Health Sector Union (JOHESU), a recognized Trade Union made up of all Unions in the Health Sector outside Medical Doctors, negotiated CONHESS for her members. Below is the two Salary Scales.

                                                          

CONMESS  SALARY SCALE

CONMESS   01----- HOUSE OFFICER/YOUTH CORPS DOCTOR –  Grade Level    10

CONMESS   02----- Registrar/Medical Officer-  Grade Level   12

CONMESS   03----- Senior Registrar Grade 11/Senior Medical Officer Grade 2-    Grade Level   13

CONMESS   04---- - Senior Registrar Grade 1/Senior Medical Officer Grade 1-     Grade level    14

CONMESS   05------   Consultant/Principal Medical officer Grade 2-  Grade Level   15

CONMESS   06------ Consultant Special Grade 2/Principal Medical Officer Grade 1-  Grade Level    16 

CONMESS    07-------Consultant Special Grade 1/Chief Medical Officer-   Grade Level    17

                                       

CONHESS SALARY SCALE

CONHESS   7  INTERNS/NYSC-----------     Grade Level     8

CONHESS  8   X -Officer 1-----------     Grade Level     9

CONHESS  9 Senior X-Officer -----------      Grade Level   10

CONHESS 11 Principal X- Officer-----------      Grade   Level 12

CONHESS 12  Assistant Chief X-Officer------------      Grade Level   13

CONHESS 13  Chief X-Officer-------------    Grade Level  14

CONHESS 14  Assistant/ Deputy Director X-Officer-------------   Grade Level   15

CONHESS 15 Director X-Officer-------------  Grade Level   17

Where X is the different profession        

 

THE FACE OF JANUS AND THE MATCH TOWARDS TOPHET!            

In the late 2009, NMA, started a campaign of calumny, against members of JOHESU , that they were Skipping, which  she alleged as a violation of Government policy. And they as Medical Doctors are treated unjustly in the health sector .As shown above, we have seen that NMA members were the greatest beneficiary of the Government approved Salary Scale, with higher entry point and jumbo pay.

 

NMA was of the opinion that any member of JOHESU, who had moved from CONHESS 9 -to CONHESS 11, should be brought down by one grade level. JOHESU members were unjustly accused of skipping and the polity was heated up. The Public Service Rule provides in 020205 and 020205 (e)- To be eligible for appointment into the Federal Public Service (e) possess requisite qualifications as provided for in the scheme of service. 

 

The accusation was faulty because in the Scheme of Service for JOHESU members, there was nothing like Grade level 11.In fact it is a misnomer to term the movement from Grade Level 10 to Grade Level 12 skipping. This is not skipping, because there is no level 11 and what you have in the Scheme of Service is movement from Grade level 10 to 12.The Ministry of Health was seeing through the prism and binoculars of NMA. She supported the recommendation subscribed by NMA that all JOHESU members who have moved from Grade Level 10 to Grade level 12 should be brought down by one Grade level. In a circular dated  11th of January 2010 , with  reference number HCSF /EPO/EIR/RR/B.63755/T1/77 ,the office of the Head of Service of the Federation stopped the movement of JOHESU members from Grade 10 to Grade level 12. 

 

About a year later, the Head of Service in a similar circular dated 10th of February, 2011 with reference number HCSF/EPO/EIR/63755/T1/149 called the movement of Workers from Grade 10 to Grade Level 12 an unauthorized Skipping. 

 

By June 2011, the Health Sector was already heated up with drum beats of war between the Workers under the aegis of JOHESU and the Nigerian Government represented by the Ministry of Health. It should be recalled, that as at June 28th 2010, in a meeting held at JUTH GUEST HOUSE in Abuja all Chief Medical Directors and Medical Directors under the auspices of Committee of Chief Executives, Federal Tertiary Aspect in Nigeria, unanimously agreed and released a memo with the reference number CCEHTH/SEC/V.1/86   on the 29th of June 2010 addressed to all Chief Executives of Federal Health Institutions. Article 3 on the topic was- implementation of circular on CONTISS forbidding skipping of Grade Level 10 or any Grade level. The decision taken was;-(1) Members decided that by July this year (2010) all Federal Tertiary Hospital should  have fully implemented the circular with effect from 1st April 2010.All officers who had skipped Grade level 10 should be brought down by one grade level except those occupying the appointive posts of Director of Administration.(2)To effect this all CF.Os should simultaneously issue a circular to all affected staff on the 12th July,2010 informing them of the plan to implement the circular in July. 

 

This memo was signed by M O. Adeoba for: Chairman CCEFTH. Immediately this directive was later implemented, the Health Sector was thrown into chaos, JOHESU gave the Government ultimatum to change her decisions which was not workers friendly, but the Government refused. Moreover the Government failed to implement agreements signed with JOHESU since 2009. This was now followed with a Strike action by JOHESU who accused, the Government of not keeping with the principle of Collective Bargaining. As a result of the crisis in the health Sector on the 9th of August 2011, The Minister of Labour waded into the matter, but the Ministry of Health was not satistisfied by the resolution, and the matter was later taken to the National Industrial Court for adjudication. After a legal battle between the Ministry of Health and JOHESU, the Court ruled in favour of JOHESU in 2013, that Government was wrong to have denied JOHESU members her right. And that JOHESU members appointed Consultants were wrongfully stopped as consultants. 

 

After the judgment, from nowhere, NMA/MDCAN who were not a party to the suit, cried foul that the Court Judgment should not be implemented. They as usual were the one that hoodwinked the Government, to have taken the wrong decision that was upturned by the Court. Suddenly they started accusing government of favouring JOHESU members, and that they must skip, even though that no JOHESU member was skipping. Now that the Government is trying to muster the courage to do what is right, NMA/MDCAN has chosen to fight the Nigerian patients, by denying them services and declaring a strike action. Note that it is the same patient they have told the world that they own and that all their actions is for the best interest of the patient. Today NMA/MDCAN who insisted that they must have a different salary structure are the ones imposing on the Government what other employees should earn. 

 

The same NMA/MDCAN that wrongfully accused JOHESU members of skipping and even lost this matter in court is the one, now championing skipping for her members, even when doctors scheme of service does not grant such. What a double standard! 

            

Part 2