For long now, there has been acrimony
between doctors and other health
workers, the problems seem to be
intractable, tell us what these problems
are and how to get a solution?
The problem is all about healthcare
administration and the effectiveness of our
activities in the healthcare industry. You
said acrimony; yes but no. What is
happening is a discussion or an attempt to
correct anomalies in the health sector to
ensure that the sector functions efficiently
and is comparable to what is obtainable in
some advanced countries.
The health sector had been moving well
until around 1980 when things started
changing. It is all about one group of
people seeing themselves as the most
important sector whereas what makes other
countries to succeed is that they believe in
team spirit which ensures efficiency.
What group of people see themselves as
the most important?
In Nigeria today, the healthcare industry is
in bondage; in the bondage of medical and
dental practitioners. In the past, merit
matters when you are appointing medical
practitioners but today it is seen as a
birthright, whether somebody is good or
not, nobody cares to know. Even on the
clinical side, before a doctor can say he is
successful in his beat, he needs the
cooperation of nurses, laboratory scientists
and others.
What particular functions do nurses carry
out?
For the nurses, they are the ones that own
the patients, they own the wards and they
are the custodians of the wards. A doctor is
supposed to be a visitor to the ward. How
can you then operate without the owner of
the premises?
Before a doctor can prescribe a drug, you
need the services of a laboratory scientist
who is trained and have qualifications as
well to go into the nitty-gritty of body
chemistry to determine what is wrong.
There is nowhere in the world where you
use your naked eye or your brain alone to
make diagnoses; you need these people.
Today, a radiographer will have to come in
and they will also do their job. At a point, a
nutritionist is also needed and in some
emotional and psychological work, a clinical
psychologist will also be needed. So, it is a
team approach that is supposed to give us
the result.
For example in the nursing profession, the
independent role of a nurse is the one that
you don't need a doctor to tell you what to
do before you make your own diagnoses
and go ahead. Nursing diagnoses is
universally known and adhered to. Apart
from that one, there are some
interdependent roles where a nurse will
have to perform, a clinical psychologist will
have to come in and a doctor will have to
be there. In this team, it depends on what
job you are doing; if you are talking about
comfort for the patient, a nurse is
supposed to be the leader of that team and
a doctor will make contribution but when
you are talking about clinical diagnoses, the
doctor will be the person that will lead and
other people will contribute.
Why is that arrangement not working in
Nigeria?
It was this team spirit that was destroyed
and everybody who gets into the medical
profession either by hook or crook whether
you know how a hospital is ran or not, see
themselves as the head. We have followed
this thing for almost two decades now and
that is why our health indices are falling.
That is what the Joint Health Sector Unions
(JOHESU) is trying to correct for the benefit
of the public; it is not personal at all. That
was why I said there was no acrimony but
only an attempt to correct the anomalies in
the health care industry.
What is the solution to these challenges?
Where there is no harmony, peace, accord
or cohesion, there cannot be progress; the
solution is in everyone of us sitting down; a
professor of medicine, a professor of
nursing, a professor of pharmacy, a
professor of laboratory science, they are all
professors in the field of health sciences
and they have their areas of core
competence but still have areas of
collaboration.
We must realise that every one of us needs
to contribute. When the Minister of Health
Professor Onyebuchi Chukwu was to be
appointed a second time, he was
particularly given the assignment of
ensuring harmony in the health sector but
today, we have not achieved that. That was
why there was a committee on harmony
that comprised all health workers; they
made their contributions but today, the
concocted story in the Federal Ministry of
Health is that the committee that comprised
everybody was lopsided.
Lopsided in whose favour?
They say in favour of other health workers.
Sincerely speaking, the chairman of that
committee was a retired chief judge of the
high court. Such a person cannot do
anything that can denigrate his office. But
we have faith in the new approach and that
is the presidential expert committee on
professional interaction in the health
sector. We have representatives of the
laboratory scientists, nurses, pharmacists
and administrators. It is the combination of
both health workers and people who are
into administration. We believe this
committee will do its work very well and
use the report of Justice Abdullahi Bello's
committee on harmony in the health sector
as a working paper.
You said the president charged the
Minister of Health to ensure harmony.
What are the specific things militating
against harmony?
In the health industry we have a
professional cabal. They are a very strong
mafia. They are the ones impeding the
achievement of harmony because they
believe health care industry is the right of
their profession and it is not done like that
anywhere in the world. It is the right of all
professionals to make their contributions.
When you go through the interviews of
some members of the Nigeria Medical
Association they call others supporting staff.
How can you call a professor of pharmacy,
nursing, laboratory science or
physiotherapy a supporting staff? It is not
done. In countries all over the world, they
distribute duties equitably and things work
well there. For example Botswana; the past
three or four ministers of health in
Botswana have been nurses. Botswana is
one of the countries with the best
healthcare services in Africa. This is
adjudged by the World Health Organisation.
The situation is that these people who think
it is their birthright to lead are not leading
well; if they were leading well, it would be
another thing, our health industry would
not be nose-diving.
How do we arrest the decline?
The solution is to work together in harmony
and respect each other as well as give
chance for merit to reign.
The leadership of your union has been
meeting through the weekend and will
close today (Monday), what is your
message to the government?
The issue of Nursing and Midwifery Council
is long overdue; we need a formidable
council to transact the business. When they
are doing this, let them follow the norms
and the rules. The ideal thing is to have a
professional heading a professional council,
not board.
This is not a board of parastatal; you
cannot choose a carpenter to lead tailors or
a welder to lead butchers. However similar
our work may be in the healthcare industry,
nurses' council must be headed by a
professional nurse.
We also have our unified scheme of service
that we have been thrashing, whatever is
the obstacle, we want the Federal
Government and the office of the Head of
Civil Service of the Federation to conclude
this thing on time. We are also requesting
for internship for our graduate nurses.
Internship will sharpen the intellect,
expertise and practice of professionals as is
being done for doctors, pharmacists,
laboratory scientists and even nutritionists.
We also call on the Federal Government to
as a matter of urgency, empower the
Ministry of Health to enter negotiations on
our professional allowances as the court
injunction directed. On skipping of grade
levels, the court has ruled in our favour
that skipping is justified for our health
workers. As skipping is done in other
sectors; they should likewise release a
circular in conformity with the court
injunction so that there is sanity in the
health sector. They should also work to
equip the schools of midwifery, collaborate
with international agencies to give
scholarship and in due course, we shall
reap the benefits and the life expectancy of
Nigerians will be on the increase and we
shall be able to compete, health wise with
other developed and developing countries.



www.nursingworldnigeria.com/2013/09/nannm-president-interview-on-acrimony-in-health-sector/