TODAY makes it 26 days when doctors under the aegis of the Nigerian Medical Association (NMA) abandoned their patients in hospitals nationwide to protest against the Federal Government’s agreement with other allied health professionals who are under the umbrella of the Joint Health Sector Union (JOHESU). Medical consultants who were supposed to join in the strike, were restricted by a legal case they filed through their umbrella body, Medical and Dental Consultants’ Association of Nigeria (MDCAN) at the National Industrial Court (NIC).The case has since been adjourned to October because judges are on recess. Even NMA itself has been dragged to court by JOHESU.

But while everyone is awaiting the outcome of the legal cases, it seems the Lagos State government has found a soothing balm to the challenge of incessant strikes in the healthcare sector. Today, the tension that usually heralds strikes in the healthcare sector in the state has been significantly reduced. When The Guardian visited some private hospitals in the state, it was discovered that those hospitals were not crowded by patients as it used to be during strikes by medical professionals. The situation at the Lagos State University Teaching Hospital (LASUTH) was as if there was ongoing strike action in the medical profession. Staff at both the accident and medical emergencies of the hospital were working.

A source who spoke anonymously at LASUTH said locum staff (doctors hired on contract) by the Lagos State government have made the difference. “Medical consultants along with locum doctors and other healthcare professionals are working. We have been admitting patients. I think the locum staffing phenomenon introduced by the Lagos State government sometime ago has made the difference,” the source said.

Locum staffing was alien to the medical profession in Nigeria until 2012 when medical doctors and the Lagos State government locked horns over the implementation of the Consolidated Medical Salary Structure (CONMESS) signed in 2009 between Federal Government and medical doctors. Medical doctors under the umbrella of the Medical Guild went on strike. Irked by the action, the Lagos State Governor Babatunde Fashola sacked about 788 striking medical doctors. But there was a big void to fill. To fill that it, the state government recruited locum medical officers, but not without signing a contract with the contract medical doctors.

Details of the terms of contract revealed that the locums are not employees of the state government but contract staff that can be fired at will. The terms of operation also revealed that they have no right to unionism or collective bargaining, and they cannot embark on strikes or any industrial action to seek redress. The only option available to them when they have grievances is mediation. The terms of engagement also reveal that since there is no guaranteed income for them, the locum staff will be paid between N5, 000 to N7, 000 for every four hours worked. The crisis was later resolved. But unlike what many observers had thought, the locum staff remained, even while the employed medical doctors returned to work.

According to the Wikipedia, a locum is a person who temporarily fulfills the duties of another. Locum is a global practice. Wikipedia explains: “In the UK, the NHS (National Health Service) on average has 3,500 locum doctors working in hospitals on any given day, with another 15,500 locum general practitioners. Many of these locum hospital doctors are supplied by private agencies through a national framework agreement that the NHS holds with 51 private agencies.”

Until the ongoing strike, many people had forgotten that locum has become a part of Lagos State medical practice. Affirming how the locum staff practice has become a soothing pill to the strike headache in Lagos, a consultant gynaecologist with LASUTH, Dr. Paul Adekoya (not his real name) said: “Lagos State government has tied our hands with locum staff practice.” He added that the contract type of employment has been effective in reducing the effects of the ongoing nationwide strike. The state government has since expanded the scenario to other healthcare professionals, including nurses, radiographers among others.

It was learnt that the Lagos State government decided to retain the system to curtail the negative effects of strikes in the nation’s healthcare system. Some other public hospitals not owned by the Lagos State government, it was also gathered, have started hiring locum staff. At the Lagos University Teaching Hospital (LUTH), it was discovered that locum staffing has been adopted in the recruitment of gatemen, cleaners and non-medical professionals.

However, as good as the practice may seem in stabilizing the healthcare system, there are fears in some quarters that it may lead to unemployment in the medical sector if continued. “Locum staffing is good for the patient, but bad for the person engaged as locum staff. Government may, as a result of the practice, deliberately refuse to give jobs to qualified medical person,” Mr. Alex Akanji, a pharmacist with the Lagos State government, said.

While many people may attribute the relative stability in government hospitals to the locum staffing, a medical sociologist with Crawford University , Dr. John Ayodele, thinks otherwise. Citing a research that was conducted in Canada, he averred that the absence of patients in private hospitals may be because Lagos residents have learnt how to live in a healthy way.

“A research that was done in Canada some years ago showed that when medical doctors go on strike, there was a decrease in medical problems because people were proactive; they were taking action that would positively affect their health so that they would not see any need to go hospital,” Ayodele said.
http://www.ngrguardiannews.com/saturday-magazine-sp-39442427/172412-doctors-strike-and-the-lagos-locum-alternative

I think things in this country work upside down

the locum staff will be paid between N5, 000 to N7, 000 for every four hours worked.
They work 8 hours a day, 8am to 4pm
you pay them at least 10,000 a day
a month of 30 days amounts to 300k
how much is conmess?
clowns