The Nigerian Health Sector has been in the news for some time now, as a result ofthe 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? Beforewe bring answers to these numerous WHYS, let us x-ray the pathogenesis of the crisis in the Health Sector.SALARY STRUCTURES IN THE HEALTH SECTORUnder the then President, His Excellency Alhaji Umaru Musa Yar’Adua, the NigerianGovernment 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 SectorUnion (JOHESU), a recognized Trade Unionmade up of all Unions in the Health Sectoroutside Medical Doctors, negotiated CONHESS for her members. Below is the two Salary Scales.CONMESS SALARY SCALECONMESS 01----- HOUSE OFFICER/YOUTHCORPS DOCTOR – Grade Level 10CONMESS 02----- Registrar/Medical Officer- Grade Level 12CONMESS 03----- Senior Registrar Grade 11/Senior Medical Officer Grade 2- Grade Level 13CONMESS 04---- - Senior Registrar Grade 1/Senior Medical Officer Grade 1- Grade level 14CONMESS 05------ Consultant/Principal Medical officer Grade 2- Grade Level 15CONMESS 06------ Consultant Special Grade 2/Principal Medical Officer Grade 1- Grade Level 16CONMESS 07-------Consultant Special Grade 1/Chief Medical Officer- Grade Level 17CONHESS SALARY SCALECONHESS 7 INTERNS/NYSC----------- Grade Level 8CONHESS 8 X -Officer 1----------- Grade Level 9CONHESS 9 Senior X-Officer ----------- Grade Level 10CONHESS 11 Principal X- Officer----------- Grade Level 12CONHESS 12 Assistant Chief X-Officer------------ Grade Level 13CONHESS 13 Chief X-Officer------------- Grade Level 14CONHESS 14 Assistant/ Deputy Director X-Officer------------- Grade Level 15CONHESS 15 Director X-Officer------------- Grade Level 17Where X is the different professionTHE FACE OF JANUS AND THE MATCH TOWARDS TOPHET!In the late 2009, NMA, started a campaignof 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 ofthe 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. ThePublic 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 youhave 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 warbetween 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- implementationof 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 skippedGrade level 10 should be brought down byone 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 followedwith 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 Sectoron 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 thesuit, cried foul that the Court Judgment should not be implemented. They as usualwere 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 andeven 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!

nursemyke: 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 andeven 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!

NMA/MDCAN AND CALCULATED SABOTAGE.Since July 1st 2014,NMA AND MDCAN have denied patients the right to treatment even when the National Industrial Court had ruled that all parties involved should maintain status quo ante.Dr Obembe the leader of NMA, who also happens to be a member of MDCAN has continued to defy Court orders under the guise that it is MDCAN that went to Court. One is forced to ask, “Is Dr Obembe not a member of MDCAN”? Again, does NMA have the moral justification to call for strike when she is not a Trade Union? Can NMA go on strike on an issue that is already before a Court of competent jurisdiction? How does NMA think that the Government will be negotiating with her on an issue before the Court? MDCAN in acalculated ploy to deceive the Nigerian populace came on air to declare that they are not on strike and that they are not joining NMA in the strike action.The truth of the matter is that MDCAN is on strike they are not on ground, and they are not working. MDCAN and her fellow consultants, who have so designated themselves as the owner of the patients, have abandoned the patient they say theyown. On the so called minimal achievable demand, NMA should be told in clear terms that they are not achievable. In the immortal words of the erudite Justice Niki Tobi, JCA ( as he then was) “when an issue is before a Court of competent jurisdiction,even though it takes time, the parties must wait ,they must not jump the gun, they cannot go for self help” What NMA isdoing now is self help and transfer of aggression on the innocent patients they have acclaimed to own. The issues raised by NMA/MDCAN are before a court, so negotiations and decisions cannot be taking on such matters.NMA/MDCAN strike is a strike of Prejudiceand Ego trip, and Government should be firm to stop this hydra-headed problem. The Members of the National Assembly and the Government should not cave in to the blackmail by NMA/MDCAN. They mustbe firm to make NMA/MDCAN see that their actions are against the state. This is the only way to make NMA/MDCAN amenable to the laws of the land and eschew impunity. The Government should know that Nigerians and indeed the world is watching! JOHESU members account over 95% of the Healthcare work force, so the Government must be careful not to be seen to show favoritism. But must stand on the pedestal of equity and justice to call a spade a spade.The agitation by NMA/MDCAN that only they should be Directors, Hospital Chief Executives, and Consultants should be jettisoned in a jiffy. This is because such demands are not supported by any statutein Nigeria. If one is to use the principle of balance of convenience, how does appointing other healthcare experts as Directors, Consultants in their specialized disciplines, affect members of NMA/MDCAN? Even when the different approved scheme of service, for all these professionals, allows them to reach the zenith of their career and recognizes such appointments. How does it affect NMA/MDCAN?.NMA/MDCAN should know that the other Healthcare Workers are not a conquered people and that the hospital is not their capitalist empire. The hospital is a government parastatals set by law and must operate within the confines of the law setting it up.NMA/MDCAN should throw away the toga of medical capitalismand imperialism by embracing medical humanism. A Physician is expected to be compassionate, and service oriented devoid of prejudice.NMA/MDCAN should go and study the preamble to the declaration of Independence of the United States of America, composed in 1776 which reads thus,“We hold these truth to be self-evident that all men are created equal, that they are endowed by their creator with certain inalienable rights; thatamong these are life, liberty and the pursuit of happiness”So do all medical personnel in the health sector who is not an allopathic physician do affirm. NMA/MDCAN should know that for a nation to excel, it must be build on equality of all men, rights of life, liberty and pursuit of happiness.NMA/MDCAN are not the employers of the Nigerian Health Workers, so she cannot decide what Nigerian Health Workers get.The issue of relativity is unfounded and has nobasis on any Nigerian Statute book even indeed world over. No professional’s wagebill is determined by the wage bill of another, but by Governments’ Terms of Appointment into the Service.On the floor of the Nigerian National Assembly, when, the incumbent Minister of Health, Prof Onyebuchi Chukwu ,was being screened to become a Minister, he was asked, “how would he maintain peace in the health sector that has been so laden with interprofessional disharmony?”. The Minister answered thathe would do all it takes to bring harmony into the sector. Again, he was also asked, “what are his views that only one professional group is the one virtually in control in the health sector and that other healthcare professionals are not so involved in leadership of the System?”. The Min. of Health again answered; that “we will get there that it is a gradual process that things are changing.”To the Most HIGH be the glory that the Hon Minister told the world ,that his action of stopping the consultancy status of other health workers, was as a result of the complain made by NMA. It is on the same issue, that the National Industrial Court has said that, that action was in error, a violation of workers right to collective bargain. Now that the Hon. Min. of Health has started seeing that NMA/MDCANS’ actions, are in bad faith, he must be firm to right the structural injustices in the Health Sector. So that he would have lived up to his words, “that he would do everything in his power to bring harmony in the health sector.”The crisis in the health sector has gotten towhere it is today, because of the over bearing attitude of some allopathic physicians, who have forgotten that medicine is the art, act and science of healing, whose scope is beyond allopathic medicine. It is highly unfortunate that NMA/MDCAN leadership personified in the person of Dr Obembe has suddenly forgotten that the word medical is an adjective which means related to the art, act and science of healing. A situation, where allopathic physicians in a false mindset sees only themselves as being medical and other healthcare experts as non medical breeds/creates a wrong image. The future allopathic physicians must be nursed and nurtured to have a mind set of medical humanism to give a good medical image that does not thrive on rancor, falsehood and a doctored ideology. The word medical is not a synonym for a doctor, for if it were, it would not be seen placed in front of the word doctor as in the term “medical doctor” for that will be tautology. Every healthcare professional involved with the act, art and science related to healing are all medical personnel. So the word medical is not an exclusive term to designate allopathic physicians but all thatis involved with healing and healthcare services.ConclusionNow that it is so glaring that NMA/MDCANstrike is sabotage against the state, because they are causing untold hardship to the citizens of Nigeria. This as a result of their ego driven demands. And have failed to obey Government orders, because most hospital Chief Executives being members of MDCAN are in sympathy with them. They have failed to call NMA/MDCAN to order to suspend the strike, even when there is a court order. As a result of the death of Nigerians, based on this sabotage, the Federal Government should invoke the powers conferred on her in section 18(1) and 18(2) of University Teaching Hospitals (Reconstruction of Boar

nursemyke: 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 andeven 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!

. Which doctor scheme of service does not allow skipping?. Skipping should cut across board for equity. why is Johesu against doctors skipping if they are skipping? Why does johesu want docor to be in a grade level that does not exit because they skip that level in scheme of service? Answer these questions to convince me that doctors demand about skipping is not geniune.