working conditions are forcing medical
doctors in the employment of the Lagos
State Government to seek greener pastures
abroad
Doctors are leaving the employ of the Lagos
State Government for what they consider
better opportunities in Saudi Arabia, Israel
and some Asian countries, according to
investigations.
One of the new employees who spoke with
our correspondent on condition of
anonymity in Lagos on Monday said no
fewer than 30 doctors working in state-
owned hospitals would be taking up
appointments in Saudi Arabia this month
alone.
The doctor, at present, a medical officer in
one of the general hospitals in the state,
said the appointments were facilitated by
an agency that recruits doctors for hospitals
in Saudi Arabia.
He disclosed that not less than 60 doctors,
including consultants, attended the
interview that was conducted at a popular
hotel in Victoria Island last December.
According to him, physicians in the lowest
cadre would be receiving N450,000 per
month, excluding other allowances which
cover the tuition and upkeep of two
children in any school in Saudi Arabia or
abroad.
“We were about 60, including our
consultants who attended the interview, but
I know about 30 that have been shortlisted.
It was a colleague of mine who was leaving
for Israel that told me to register with the
online job placement firm.
“It has a website. The recruitment drive has
been going on in other states of the
federation before now, but doctors in Lagos
State have now indicated more interest
more than ever before,” he stated.
It is not only Middle East countries that
offer better pay packages to doctors, as
countries whose economies are not better
than Nigeria’s are also dangling irresistible
offers before medical doctors.
This was confirmed by another doctor, a
surgeon who also works in one of the state-
owned hospitals. He said countries like,
such as Gabon, Senegal and other East
African countries were engaged in massive
recruitment of Nigerian doctors with
specialties in surgery, orthopaedics and
anaesthesia, among others, and offering
pay packages that were too tempting to
resist.
He said, “I’m relocating to Gabon with my
family next month; I’m at the last stage of
my accreditation. Though I was posted to a
rural area there, for every surgery I
perform, I would be paid $1,500 daily.
What I’m being paid here is peanut,
compared to what I’m being cajoled to
consider in Gabon. In my department, six
surgeons have left for Senegal because of
the offer.”
Forced to resign
The doctors who spoke with our
correspondent said the move was to
prevent a repeat of the labour crises which
led to first, the sacking, and then the recall
of over 788 consultants, specialists, resident
doctors and house officers by the Lagos
State Government last year.
They said doctors could not be blamed for
leaving en masse. According to them, since
last year’s labour crises, the state
government has continued to reel out
“unfriendly policies” which they said
frustrated doctors employed by the state.
They argued that it was part of some
measures that government was using to
ensure that medical workers did not
clamour for the implementation of the
Consolidated Medical Salary Scale.
A medical officer in LASUTH who had also
got an offer in Israel, said he was leaving
because the salary package offered by the
state government was poor, compared to
the services doctors rendered.
According to him, it was not unusual for a
doctor to attend to about 70 patients in a
day, apart from emergencies.
The source said, “During a clinic (meaning
each time he is on duty), I can attend to
between 70 and 80 patients in a day. What
four doctors should do is what a doctor
does here. Worse still, I have not attended
any tangible training in four years because
there is no time. I’m always with patients
all day. How do I learn new techniques or
give my best under such circumstances?
Yet, when we agitate for more pay, they
sack us or intimidate us into silence.”
Earlier, the surgeon who is leaving for
Gabon said victimisation and intimidation
that doctors faced, in spite of shortage of
hands, were reasons why he had decided to
terminate his appointment with the
government.
He said, “An operation that should be done
by five doctors is handled by one or, at
best, two doctors because there are not
enough hands. That is why emergency cases
are not attended to and patients are not
getting surgeries as soon as they should.
“We are overworked. I have been on call
everyday for the past five weeks. How can
that be? In other countries, a patient can
sue just because of that, because it could
constitute a harm to their health if I don’t
give00 them the best medical advice.”
Slavery or medical practice?
The doctors also alleged that instead of
recruiting more doctors in order to address
the shortage, the state government was
recruiting locum (casual) and contract
medical doctors and consultants, a decision
that, they argued, could destabilise health
care delivery in the state.
One of the locum doctors, a consultant who
spoke with our correspondent, lamented
that the terms and conditions of service
they were subjected to were a disgrace to
the profession.
According to her, the state government had
lowered the payment terms and conditions
they had offered before they took up the
appointment.
She said, “They were paying us about
N302,000 monthly before, but they have
stopped. They said they could no longer
afford it and changed our appointments to
Contract Medical Officers. Now, we are paid
N1,000 per hour and we do rotation like
nurses.
“We are just in the system. Even as a
consultant, I’m not entitled to any training,
I cannot sign for anything and I have no
office. I cannot attend clinical meetings and
we are forbidden to unionise, so we cannot
protest this ill-treatment. We cannot use
any of the facilities in the hospital.”
Also, in the appointment letter obtained by
our correspondent, a contract medical
officer on Grade 12 Step 2 would be paid
N242,000 (N1,100 hourly) for a period of
one year in the first instance, and the
contract would be renewed, based on
performance on the attached terms and
conditions.
The consultant said many of the terms
under which they had to work were not
only unfavourable but also creating friction
between the locum doctors and those on
permanent employment in the hospital.
She said, “We cannot run to the Medical
Guild to fight for us to be converted to
permanent employees because they are
also angry that it was our appointment that
frustrated their agitation for CONMESS.
“The state government does not even
reckon with us; they keep changing our
agreements every day, and they don’t care
if we leave because they keep recruiting
doctors on contract terms every day. They
have stopped employing doctors on
permanent basis since the labour crises last
year. Contract doctors are even more in
number than permanent doctors in
LASUTH.”
Asked why she took the employment in
spite of the warning by the Nigerian Medical
Association, which threatened to disaccredit
doctors who were employed by the state
government during the strike by Medical
Guild last year, the consultant said that was
the only offer she had received in the last
two years.
She said, “The politics involved in recruiting
doctors into state and government hospitals
in Nigeria is very dirty. After my programme
in LUTH, I was not retained. I applied to
several parastatals, including the Ministry of
Defence, University College Ibadan, and
Federal Medical Centre to no avail. You
must be connected to get a job, rather than
on merit. Many of the employers were
asking for bribe, which I could not give. Let
us not be deceived, there is no job for
doctors anymore. That was why we jumped
at Fashola’s offer.
“I took it because I had to feed my family,
we had to survive. After two years without
a job, I had no choice but to accept the
offer. I wake up every day defeated since I
took this job because it offers no
opportunities for me as a doctor or
consultant. We call on the NMA to fight for
us. I’m also looking for better opportunity
locally because I don’t want to leave the
country.”
In his reaction, the President, Dr. Osahon
Enabulele, described the act of recruiting
doctors as casual workers by the state
government as an assault on physicians. He
said it demeaned the credence of the
profession and warned that the trend could
affect the quality of medical services offered
in public hospitals in the state.
Enabulele said, “LASUTH is a teaching
hospital, they are to train doctors; but a
situation whereby the state government is
now employing more locum doctors than
resident doctors or consultants in its
tertiary hospitals is wrong and could affect
their credence and re-accreditation as a
tertiary institution. It also shows the
direction they are driving the institution
and health care service in the state. We are
begging them to have a quick rethink of this
policy.”
He also warned that the policy would be
counter-productive by increasing the
already gory doctor-to-patient population
ratio in the state; saying, if not urgently
checked, it would worsen all the health
indices in the state.
He said further, “There is no sane individual
that will stay in that kind of system.
Doctors may be accepting the offers now to
survive, even though we had asked them to
reject such appointments. Right now, the
doctor-to-patient ratio in Lagos is 1-14,000,
which is far from the global standard of 1
doctor to 600 patients. This is going to
impact negatively on maternal and infant
mortality, which is always a direct result of
a distorted medical manpower system. It
will also affect access to health services.
“They should stop employing locum doctors.
Rather, they should employ qualified
doctors on pensionable basis because they
are shortchanging the workers. We are
ready to engage the state government to
convert their appointment to a permanent
basis to encourage them to stay.”
Enabulele urged the state government to
implement CONMESS in order to check the
exit of doctors from its hospitals.
According to him, information gathered by
the association showed that doctors were
emigrating from the services of the state
government on a daily basis due to the
poor conditions of service and skewed
salary structure.
He said, “Everyday doctors are getting
dissatisfied and leaving the system.We hope
that the managers of health in the state
have the correct information to arrest this
exit because when you have this type of
brain drain, it would affect medical services,
especially response to emergency
cases.They should address the root cause
which is the renumeration they give
doctors.Lagos is supposed to be the centre
of excellence; that means other states
should not beat them in welfare packages
for doctors.”
In order to confirm the veracity or
otherwise of the doctors’ claims, on
Monday, our correspondent placed some
calls to the mobile phones of the
Commissioner for Health, Dr. Jide Idris, but
he did not pick his calls.
Again, he did not acknowledge the text
messages sent to his mobile phones and e-
mail addresses on Tuesday. In the message,
our correspondent had requested his
response to the physicians’ allegations.

By Bukola Adebayo

Hmmm. And here I was thinking that the Saudi rush was an eighties,nineties thing. Remember many of my lecturers back in the days who struck gold in Saudi after suffering for years in naija. I don't think the lagos scenario is very common in other states though. I wonder why. can't be because of a better deal. maybe it has to do with information. Eko ni baje

Eko ti'n baje lo die die.