sadoz:
This senseless strikes will not end until Nigerian hospitals are privatized and modernized. Outsource bulk of laboratory and pharmacy services etc. Govt should fund universal health coverage via health insurance with the support of private sectors. All these unions only care about their pocket. They have no shred of concern for the patient. Anyone afraid of privatization is a Fraud

I never said privatization was bad. Am just amused that when y'all talk of privatization you speak of every health worker, and leave out doctors. So, Pharmacy and med. Lab are mere services??! It's all good... And I belong to neither NMA nor JOHESU. I just firmly believe that this battle over supremacy between doctors, and other health workers started from somewhere, and asking health workers to accept a wrong status-quo and pretend that all is well will not improve the system.

sadoz:
Make your points without insults. Exude some class please. It LL be hard to take JOHESU seriously if you are always emotional.

Emotional? Nah. Am just an unbiased, and amused observer of the whole unnecessary drama... And regarding what I said about doctors and godhood, every observant individual knows that. Ask most patients that receive medical attention especially in government hospitals. I just call it as I see it!

xreal:


Adon hear.

my brother she is right....All over the world radiology is a specialty of medicine and surgery....

Radiographers carry out the procedure (xray, mri etc) while the radiologist interprets the result...only doctors who specialize in radiology are referred to as radiologist

Gr8amechi:

Do you know their is a branch of medicine that is called clinical pharmacology??
Are you also aware there is a branch of medicine called laboratory medicine which include the three branches of pathology??
Now I agree with you that a doctor can't know it all but the public needs to know that you can have 20 doctors in a hospital and each of them specializes in 20 different fields, so when you hear that a doctor is heading the laboratory try and ask which doctor is that, definitely a surgeon or a physician can't head a laboratory, a microbiology lab is headed by a clinical or consultant medical microbiologist, this person first studied medicine for 6 years then did another 6 years of postgraduate studies on medical microbiology, so ask yourself is it wrong if such a person heads the microbiology lab

Are you also are aware Sir that all these other professionals in the health sector counterpart abroad do postgraduate studies but the selfish and what I do not know how to describe attitude of the conglomerate of Medical Doctors are blocking these opportunity in Nigeria? So that these all other health professionals do not get the opportunity to rise to the qualification to head an hospital? Common! you can only pretend not to be aware of this. I am a Physiotherapist if I have my cash today and I establish a Physiotherapy clinic/ hospital. I can establish a clinic and recruit a Medical Doctor, a nurse, a pharmacist or any other health care professional as far as I can pay him/her and he accepts the terms of agreement. I will run my clinic successfully without inviting a specific personnel somewhere because it is an administrative position, I have Medical Doctors as friends while I was in school and after school and there was no part of their curriculum that they were thought on how to run an hospital. Running an hospital is a inbuilt skill (leadership) that any professional in the health sector can do.

symbianDON:

while i agree with your submission, i must stress that what i wrote earlier was that doctors MUST NOT always head medical facilities and other should also be given the opportunity. remember that other professionals can equally get higher academic qualifications too.

Do you know where these whole issues are coming from??
Nigerian as a country don't have a complete template, in the USA, hospitals are mostly privatised and their CEO are not even medical people, they are core business men who all they want to make is money.
Now the only place a doctor has a chance of rising to the top as head is the hospital head, a pharmacist heads the pharmaceutical industry, no doctor has ever asked to head a pharmaceutical industry, more so do you know pharmacy has lots of other branches but only the clinical pharmacist works in the clinical setting while every aspect of medical professionals works in the hospital.
Lastly all teaching hospital has medical students but definitely not all teaching hospital has pharmacy, med lab or radiographer undergraduate. Now the fear lies, with the current hatred of doctors how will the JOHESU treat those students in those facilities if they were to take full headship??
For me I want government to create the CEO different from the cmd, let the CEO be someone entirely different not even related to health at all.
But how will you run an organization were you have no idea??
This fight will go in for long until we all learn to value our individual professions

xreal:


OK.

Thank you.

You welcome

Angelfrost:


Emotional? Nah. Am just an unbiased, and amused observer of the whole unnecessary drama... And regarding what I said about doctors and godhood, every observant individual knows that. Ask most patients that receive medical attention especially in government hospitals. I just call it as I see it!

When did your opinion become that of every observant individual. Only facts are sacred. Let's focus on the issues alone, express your opinions and not conjure opinions as alternative facts.

OgaInnocent:

The hospital belongs to the patients. True. The doctor is the best person to head the hospital because he know the situation of the patient more than any health worker. He makes diagnosis, he prescribes the drug. The patient cannot receive any drug without the approval of the doctor. Hence the doctor should head the hospital.

The heading of hospital is purely administrative, their are health administrator for God sake, let the health administrator manage the hospital and doctor manage everything clinical, hospital does not consist only of doctors and patients, it also consist of other professionals, these other professionals have rights as well as the doctors to manage the hospitals.

Angelfrost:


I never said privatization was bad. Am just amused that when y'all talk of privatization you speak of every health worker, and leave out doctors. So, Pharmacy and med. Lab are mere services??! It's all good... And I belong to neither NMA nor JOHESU. I just firmly believe that this battle over supremacy between doctors, and other health workers started from somewhere, and asking health workers to accept a wrong status-quo and pretend that all is well will not improve the system.

Privatization LL affect doctors too. A lot of lab and pharmacy services can be easily automated and outsourced. It's no brainer. I advocate for across board privatization that will weed out deadwoods and rejig the health system.

CircleOfWilis:
my brother she is right....All over the world radiology is a specialty of medicine and surgery....

Radiographers carry out the procedure (xray, mri etc) while the radiologist interprets the result...only doctors who specialize in radiology are referred to as radiologist

Thank you.

I really appreciate.

careerwoman:


Yes it is, it's a paid job as well as a training.. the person I quoted used the entry level of intern pharmacists to compare the entry level of doctors which is the housemanship.. An intern pharmacist earns about 140-150k on an average..
The figures he posted were absolutely wrong..

140-150k .....abeg which hospital

Solababa91:


Please go check the meaning of hospital and run back here to edit what you posted up there. Hospital is meant for a patient, not for any Personnel. I do not know where you got your earlier assertion from. Just the way an Hospital cannot stand without a Medical Doctor is the same way it can't be a standard hospital without a Pharmacist (who will formulate, dispense or cross check or give prescriptions, or without a Physiotherapists (who diagnose, treats and rehabilitate patients as the case may be or a Med Lab Scientists that gives a Doctor a clearer picture of a differential diagnosis or a Nurse... etc. It is only that Nigeria health sector do not have boundaries in each job jurisdiction or clear cut description (or better still the laws are not bounding) if not a Doctor would not believe he can perform all the roles in the hospital and all other team members are irrelevant and should not be well remunerated. In saner climes, a doctor performing the role of a Nurse or vice versa would be jailed and same to all other professions too.

we are saying the same thing but it appears you are mixing up two independent variables.
I agree the hospital need a pharmacist, a lab scientist, a Nurse, a physiotherapist, etc to function.....but u should know that laboratory medicine is a branch of medicine & some doctors called pathologists specialize in that field....
Radiology is a branch of medicine, doctors who specialize in radiology are called radiologists...
Those specialists are by hierarchy suppose to be the head of the subspecialties they are in. That is how it should be.

An obstetrician(a doctor) can't head the department of surgery simply because he's a surgeon. in the same vain an opthalmologist can decide to head the department of medicine simply because he's a doctor.
MBBS is just a common ground on which they can relate at the same level. A pathologist by virtue of his training as a medical doctor & a lab clinician should head the lab... he has an all round training in laboratory medicine so should be the head
Pharmacy is not a branch of medicine neither is nursing that's y a doctor will not decide to specialize in those listed.

careerwoman:


Yes it is, it's a paid job as well as a training.. the person I quoted used the entry level of intern pharmacists to compare the entry level of doctors which is the housemanship.. An intern pharmacist earns about 140-150k on an average..
The figures he posted were absolutely wrong..

Abeg! wch hospital in Nigeria does an intern pharmacist earn above 140k, am patiently waiting...

Solababa91:


Are you also are aware Sir that all these other professionals in the health sector counterpart abroad do postgraduate studies but the selfish and what I do not know how to describe attitude of the conglomerate of Medical Doctors are blocking these opportunity in Nigeria? So that these all other health professionals do not get the opportunity to rise to the qualification to head an hospital? Common! you can only pretend not to be aware of this. I am a Physiotherapist if I have my cash today and I establish a Physiotherapy clinic/ hospital. I can establish a clinic and recruit a Medical Doctor, a nurse, a pharmacist or any other health care professional as far as I can pay him/her and he accepts the terms of agreement. I will run my clinic successfully without inviting a specific personnel somewhere because it is an administrative position, I have Medical Doctors as friends while I was in school and after school and there was no part of their curriculum that they were thought on how to run an hospital. Running an hospital is a inbuilt skill (leadership) that any professional in the health sector can do.

God bless you.
Heading a hospital is an administrative skill that can be carried out by any professional.
He that holds a man down holds himself.
That's a proverb that best fit the NMA

Solababa91:


Are you also are aware Sir that all these other professionals in the health sector counterpart abroad do postgraduate studies but the selfish and what I do not know how to describe attitude of the conglomerate of Medical Doctors are blocking these opportunity in Nigeria? So that these all other health professionals do not get the opportunity to rise to the qualification to head an hospital? Common! you can only pretend not to be aware of this. I am a Physiotherapist if I have my cash today and I establish a Physiotherapy clinic/ hospital. I can establish a clinic and recruit a Medical Doctor, a nurse, a pharmacist or any other health care professional as far as I can pay him/her and he accepts the terms of agreement. I will run my clinic successfully without inviting a specific personnel somewhere because it is an administrative position, I have Medical Doctors as friends while I was in school and after school and there was no part of their curriculum that they were thought on how to run an hospital. Running an hospital is a inbuilt skill (leadership) that any professional in the health sector can do.

The last time I checked pharmacy and the others have postgraduate studies, masters PhD, please correct me if am wrong. Even medical lab also have.
I definitely do not want any profession to be held back never but the issue here is let's not deviate from our original calling. Every aspect and branch or unit of the hospital is important and irreplaceable but some reason more important than the others and there is always heirachy in everything, if there is no heirachy there will always be confusion.
The cleaner is very important but not more important than the records, the record is important but not more important than the cashiers/accountants, the guys in pac are unique but are not more important than the radiographer,
The med lab is unique but you can't rule out the essential duties of a physiotherapist.
I can go on and on, Infact a surgeon is important but can we operate without our nurses or even the portal who will role the patient to theatre??
Even among doctors we are all indispensable but not equals, you can't say a community physician is as important in patient care to a physician or a surgeon,
Infact you can't say the work load of a neurosurgeon is same to that of a general surgeon.
Now we must have mutual respect for each other but we have to maintain our boundaries, do you think it's right for all the health workers to say they want to start doing residency?? You already have your career path,
Even if it's okay by you, in the USA they have nurse practitioner, despite this title doesn't mean they don't take instructions of patient management from doctors.
A nurse is a nurse while a doctor is a doctor. That's the case we are having here, people are not after going further in their fields they just want to challenge anything the doctor says.
I blame doctors for the cause of most things in the health sector, first the primary reason for most of JOHESU agitations is born out of anger that the doctors are not treating them with respect hence they want to be at par with them which I think Inst the way out, rather let's all agitate for mutual work place respect. Even among doctors bully and disrespect is worst, so it's not just a JOHESU stuff but JOHESU is handling this the wrong way.
Now if we have a consultant medical lab, what becomes the role of the consultant pathologist??
I agree with you that leadership wasn't taught in medical school back then but try and check back medical curriculum, management and leadership has been included in some parts of community medicine, however I don't think that's enough though to run an organization and I still wish that more strict criteria be used to determine the head.
But it's a pity that medical personnels like pharmacist, nurses, physiotherapist etc will join up with account and none medical professionals to demand for pay parity with doctors, if only pharmacist, etc are fighting I would understand but try and reason it how can you pay an account similar structure as a doctor just because he is in the hospital, hope you remember payment for job is about the technicalities you offer not just being in the job.

Amarabae:

Nursing is a different field from medicine,
When I or any nurse say that we know things in medicine except surgery does not mean that we know more than doctors but rather we are not novice in medical issues.
Knowledge comes not only by degree but by working experience too and by advancing in post graduate studies.
The problem is that you understand things literally and not logically.
What will make a graduate nurse or even a sound school of nursing nurse not to be able to treat her relative who is convulsing?
So if a child is convulsing and rushed to the a primary health care center where there are scarcity of doctors, the nurse on duty can't do anything?
What exactly do you think Nursing Science is?
I can see that you are dowing down the route of arrogance,
Are you aware that there are fellow colleagues who are in private practice managing patients?
Or you just want to comment.
The Lord resist the proud and uplift the humble,
Learn humbleness today.
.
.
Next time you want to quote me, please package your comment in a matured non insulting way,
Then I will reply.
Or don't bother mentioning.
Thanks.

insult kwa, u started it by shouting malaria and typhoid doctor, since then naim my mind drifted odd for u, even after a successful brainy surgery. not even an atom of kudos and encouragement.

that's y I doubted ure a trained nurse
I don't need to tell u the knowledge input those doctors carried to do that since u said u know medical facts.



kk, wen u said u know what a doctor know , u never made it clear ure just being sarcastic and logical, this is a public forum where u can be misinterpreted probably with respect to ur old post .


nawa o, I taught u really meant u know like a doctor aside surgery, coz even a claimed pharmD won't say that again wen I gave him simple clinical cases aside surgery, if u want screen shot of our discussion , I won't mind..


nevertheless..
u self don't insult doctors again,nobody will insult u..
if they make mistake, don't take it personal, if u most correct , be polite, except out of negligence..
they are human and not God/robot..just that it can b costly but let's be logical too, more likely a fresh graduate make cheap mistake...

oya na,
#shallom

Amarabae:

God bless you.
Heading a hospital is an administrative skill that can be carried out by any professional.
He that holds a man down holds himself.
That's a proverb that best fit the NMA

The reason u see things work in other countries is becos the people are wise, a nurse won't practice medicine. but in Nigeria, a med lab scientist is operating in full capacities of a doctor, he treats patients in his lab. Pharmacist practice medicine by virtue of their knowledge of drugs. Remember, these people do not know the pathological basis of disease that an exclusive of the doctor. For every disease, there are diagnostic protocols that should be followed.



This is the problem will face in Nigeria.
You want to Head the hospital so as to bastardize the system?? that's what JOHESU is clamoring for but it won't work.

Our Health Sector is ranked low because everyone is fighting eachother.We call "international best practice"when it fits our argument.
My suggestion/solution is this:
1.Every health profession should be autonomous,no professional should detect the pace of others.
2.Doctors should be the ones to Head most Directorates like Laboratory service,Radiological service.(With exception like pharmaceutical and Nursing services)
These Consultants/Doctors should work hand in hand with other professionals that are closely related to them inother to generate maximum positive result.Example;the Pathologist working closely with the MLSt to decide on the effective/right test to perform.
3.Health Adminstrators/Adminstrators should head our Teaching Hospitals/Medical Centres.When not possible,it should be OPEN to every Medical/Health professional.
4.Ministry of Health should be same as "3" above.
5.There should be a reasonable percentage of Relativity that should be agreed upon by all professional and also in relation to international practice.
6.Consultancy status should be given to Health professional that Deserve it especially Pharmacy,MLS,Radiography,Nursing and Physiotherapy.
but the requirements for consultancy status should not be Number of years spent"working"rather it should be rigourous Study,Reearch,Specialization e.t.c.In their various Postgraduate Colleges.
7.Health professionals should know that Doctors have the final say to any medication/treatment in the Hospital setting and also Doctors should not always dispute or discard any advice or suggestion from other health professional.

I think this is international best practice,once all these things are adhered to,then our health sector will have hope of improving.

Our health sector needs total overhaul

Amarabae:

God bless you.
Heading a hospital is an administrative skill that can be carried out by any professional.
He that holds a man down holds himself.
That's a proverb that best fit the NMA

I think nurses needs to look beyond employment from govt run hospitals and set up there own private clinic, its quite lucrative.

My personal health practitioner is a nurse, she worked with Absuth, after she retired she set up a clinic, and i can swear she was the best, they were lots of patients that she now normally referred them to hospital mainly if the case need delicate attention or surgery.

Nigeria is a big embarrassment in everything, its just a good idea if someone can set up a private investment on there own, if the fund is there.

Dething:
Doctors should not be the only ones heading the Units. Why will the doctors be the heads of all Federal Medical centres? You will see a small boy Doctor who left school barely 5 years ago will be controlling a senior matron Nurse who has been working for 30 year with Masters Degree in Nursing. Johesu is right on that! Being a doctor is by choice, many people did not want to be doctors from the outset of their lives, they wants to Medical scientist, pharmacist, Nurse, Radiologist, etc. Must everybody be doctor to head a unit?

Why are we acting like Doctors are super human? they simply chose to be! Others who chose other career have right to rule.

Is that not the same way a Newly graduated nurse directs the cleaners, some of whom are old enough to be her mother?

Dething:
Doctors should not be the only ones heading the Units. Why will the doctors be the heads of all Federal Medical centres? You will see a small boy Doctor who left school barely 5 years ago will be controlling a senior matron Nurse who has been working for 30 year with Masters Degree in Nursing. Johesu is right on that! Being a doctor is by choice, many people did not want to be doctors from the outset of their lives, they wants to Medical scientist, pharmacist, Nurse, Radiologist, etc. Must everybody be doctor to head a unit?

Why are we acting like Doctors are super human? they simply chose to be! Others who chose other career have right to rule.

Before they made the choice of not being a doctor dont they know that doctors head hospitals and head medical teams...why make a choice not to be a doctor and now turned back to reap age long leadership associated with doctors

Privatize the whole system or let the status quo stay.

PaChukwudi44:


you know that will never happen.I am not a medical doctor but it would be grossly unfair to suggest Doctors should earn same thing as lab scientists or nurses.It is even laughable to suggest.Go on strike from now until 2028 it wont happen.It takes a lot to become a medical Doctor.If there are to nearn the same thing peope would rather chose to become lab scientists or nurses than to go through the rigours that it takes to become a medical Doctor.

GOD Bless you for this

Disparity in salary is why crisis in health sector cannot be resolved —JOHESU Chairman




The Chairman of the Joint Health Sector Unions (JOHESU) and National President of the Medical and Health Workers Union of Nigeria (MHWUN), Comrade Joy Josiah Biobelemoye, speaks with SOJI-EZE FAGBEMI, on the perennial crisis in health sector, the on-going nationwide strike by the workers and why the crisis cannot be resolved except President Buhari intervenes.

There is a court injunction calling on your members to end the strike and go back to work while you continue negotiation. What is your reaction to this development?

I don’t know of any court injunction. I have not received one, neither my legal department has reported to me that they had a notice and so they are going to court. So, I am not aware.

 

What if it happened and you got the notice, how will you handle it, bearing the fact that there are many court judgements in favour of JOHESU against the government which have not been implemented?

That is one of the reasons I doubt if any court will even give such a reward to the Federal Ministry of Health, Federal Ministry of Labour or their proxies; because this very courts have given their rulings; between eight to nine rulings they have disrespected. So, I am not too sure they have the moral right to even go to court to approach the court, but if they have gone through the proxy, I believe the court would not even grant it because they have disobeyed the same court.

 

There is this issues generating argument between the NMA and JOHESU, that if your member as a graduate get into service like say on grade level eight, and he spent seven to eight years to get to level 12, and a fresh medical graduate enters same service directly at level 12, the NMA is still insisting that the basic salary of a fresh graduate Doctor who enters at grade level 12 must be higher than your member who has spent seven years gathering experience to get to that grade level. Is this the fact and can that be justified?

Certainly it cannot be justified. Service wide, people of equal grades in any sector earn equal basic value. What makes the difference is the peculiar allowances. For instance, if someone enters as a clerical officer, passes his promotion and confirmation exams and gets moving until he has additional qualifications, moves to executive cadre and gets to grade level 12, his own basic will be the same as any others who enters at grade level 12. Or like Architects, engineers and lawyers, if that man  gets to level nine, no separate basic is provided or produced for them because a junior cadre person has grown to level nine.

Now, if that is not possible, we are talking of graduates, two groups of graduates where some are trained for eight years, the doctors are trained for eight years, and the others are trained for between six and eight years under JOHESU. Nurses are trained for seven years, which is post NYSC. They are trained five years academic, one year internship and one year youth service. Doctors are trained six years academic, one year houseman-ship and one year youth service.  Optometric within JOHESU are trained for eight years too, six years academic, like doctors, one year internship and one year youth service.

Even these ones that are trained for equal years with the doctors are still not entering service at grade level 12. They are entering at grade level 10 which is CONHESS 9 and their salary is not equal to that of Doctor who just enters service even after they get promoted to level 12 after three years in service. For Nurses who enter at level eight, after nine years they get promoted to level 12, their salary is still lower than a fresh doctor who is employed today.

So, we begin to ask, what is the parity, giving this explanation in terms of figures. Let us take the upper limit, a doctor who is on CONMESS 7, which is the apex of their service progression goes home with N704,000 be

fore the adjustment; whereas on our own side, someone on CONHESS 15 which is the apex was going home with N476, 000. Is there any parity there? No. Now, on their own part, when they have adjusted, they are taking about N1million and they are saying we should still remain at N476,000. Even with our own adjustment, ours will take N670, 000.

The Optometric who was trained for eight years will take close to N700,000. So, the doctors and these other officers have difference of about N300,000. Is that parity? That is not parity. If an architect, a lawyer who enters service at grade level 9; and executive officers who gets promoted after eight years to grade level nine are placed on the same basic salary, do you call that parity? Salary differential is not measured by basic salary only. It is measured by allowances, total emoluments. So, if you are taking total emolument of N500,000, and I am taking total emolument of N300,000, that makes our difference. In civil service, differential is determined by the next highest N1.

So, if you get promoted to the next grade, you are earning N100,000 and if the step above where you are earning the N100,000 is N101,000, that is your benefit; not to talk of a situation where you have above N100,000, N200,000 and N300,000 above and you are still claiming of parity. There is no parity. It is designed to mislead Nigerians so that Nigerians will say our struggle is not justified, and so turn the strike action against JOHESU, mislead Nigerians that the strike is not legitimate and not for genuine reasons. So, they will use that to boost their quest.

What is their quest?

It is simply to arm-twist the President to approve privatization of public health institutions. That is the main thing. Again, they know that when they create this avoidable situation of strike action, they believe that they have nothing to lose. When they force us, like we endure six months before we embarked on this strike now, after given them 66 days to avert the strike that they refused; and we went into this strike, their moribund private clinics will now thrive. So, it is a way of creating a situation to boost the business of their colleagues, because people would be forced to go there. That is why we have always been mindful. This thing started 2014, we signed an agreement last year, 30 September, and within the same month doctors signed the agreement with the government. Within 16 days, they implemented for doctors, coming to our own, they have not implemented, saying that there is no money.

The same people that says there is no money are now providing huge sums of money, over billions, about N2 billion to implement skipping illegally. The court clearly said it was ruled for us, the Salaries, Income and Wages Commission clearly said that skipping is for us only, doctors were not part of it. But the Federal Ministry of Health is owned by the doctors. The Minister is a doctor, Minister of State a doctor and in the recent past, the permanent secretary was a medical doctor. They decide to do everything the way they want, whether it is right or wrong. If it is for the doctors there would be money, if is for the other health workers and professionals, the money will not be there. It is a deliberate way of creating chaos in the system to support their call for privatisation so that they can enslave Nigerians.

 

A government agency, came up with a circular that the skipping is not meant for the doctors, why is the ministry paying the doctors, why those who went to court and got the judgement were not paid?

That is what we are saying until the ministry is properly manned. If the minister is a doctor, at least the minister of state should be from the other group that makes 95 per cent of the health  delivery system. Also we are saying that we should revert back to the success days of Nigeria health system where West African countries were coming to Nigeria.

The health tourism was inward in those days. What happened was because h

ospitals were not headed by the medical doctors, but by hospital administrators. Doctors also come to do their professional things, the nurses and others. Everybody concentrated on what to do. But giving hospitals into the hands of people that do not have the capacity to manage health services, people that are full of pride, ego to manage hospitals, that is why from then, when Late Olikoye Ransome Kuti made that mistake, the indices of health started nose-diving. We headed South until when a non-Doctor, Eyitayo Lambo was appointed minister of health, that period, the indices started traveling North again. But has he left and the doctors took over, they have started heading deep-deep South until perhaps the depth will be so much that we will not be able to salvage ourselves.

 

How do you think this perennial crisis can be resolved?

The strike issue, the major problem behind non resolution of this issue is that the people who are there to conciliate are all interested parties. The minister of health is a doctor; the minister of Labour is a medical doctor too. Between the two, one is fair but then, when they get back to the house, it must be the doctors’ family again. So, the only way we can really get justice is if President Muhammadu Buhari intervenes himself. I say this with all seriousness because history is about to repeat itself.

The same way in 2014, President Jonathan was not well briefed by the then minister and he was told different things. But close to the elections, he was touched to come in and he came in to the matter. It was when he intervened he got to know the truth of the matter. But then, it was too late to assuage the hanger, he pleaded because of the elections please, and that after the elections he will treat the matter; but it was too late to assuage the hanger of the health workers.

The JOHESU family is a big family, we are not insignificant. JOHESU family is over one million membership, the five registered trade unions and the professional health care associations; the Assembly of Health Care Professionals. We are over a million, and only with our spouses take us to two millions, with our children, you can imagine. So, I hope the President will not let it to go too late.

 

Are you in support of independent people or body, beside those in the ministries of health and Labour, to come in and resolve this issue?

Fine, if the President comes in and constitutes a body, like the other time, the Secretary to the Government of the Federation was involved. If the President can come into the matter, first he should speak with the JOHESU family, so that he will hear things first hand. After that, that will guide him properly to appoint those people and give the appropriate terms of reference to quickly resolve the issue.

This issue would have been resolved, we provided all the factors, simplified factors to resolve this issue, to avert the strike, but because of their interest, they wanted the strike to go on, hence, they refused to take to our advice. For instance, we told them the Salary, Incomes and Wages Commission has calculated N22 billion. This is per annum, breaking it into 12, it is N1.8 billion per month. N1.8 billion can easily be gotten, source like two months of it, pay it into our members account, then we can have time so that the ultimatum will be suspended and we can have time may be you need two, three months to find way of including it in the budget. They refused. We also asked them, 12 days to the 66 days ultimatum we have given; please can you bring the structure. You cannot get a financial implication without a structure, give us that structure you used, give it to us, let us take it to our members and see if it will assuage their hanger, they refused to give to us. That would have been a resource to also avert the strike action. We went to the National Assembly when we gave the first 21 days to see how National Assembly can intervene to find early solution; the same doctors wrote to Nat

ional Assembly that they should not attend to us.

The Senate President, after approving a meeting with us, the morning of the meeting, the House of Reps said the Speaker can no longer meet with us. To be fair to him, he set up the House Committee on Health to meet with us. But for the Senate, that day we were meeting with House of Reps was the day we got the cancellation letter that the Senate President is not going to meet with us. So, we made the efforts to avert this strike action, but they did not. To show that there was a serious insincerity at ensuring averting this strike action, the minister sent a memo requesting that for harmony of the health sector, I recommend N22 billion, and they gave us that document which we used in showing to our members to remain calm for the long period. That memo was raised in December, but it will surprise you to know that the minister went to defend the budget of the ministry in February but did not include that N22 billion. So, can you see that there was deceit, dishonesty in finding solution to this problem?

Do you mean that it is the salary, wages and income commission that came up with that amount in the first place?

The N22 billion yes.

1.The Govt should privatise the health sector let doctor open hospiyal,pharmacist open pharmacy,nurse open nursing home,lab scsit open lab then lets see who is superior.
2.let govt equate basic salary for doctors,and nurses and cleaners and judge and generals since no one is superior to the other.
3.since medicine na by choice let nobody study medicine since its just like the rest.
i rest my case.

transformed:
Before they made the choice of not being a doctor dont they know that doctors head hospitals and head medical teams...why make a choice not to be a doctor and now turned back to reap age long leadership associated with doctors

where is it in the Law that doctors should solely head an hospital.

Nothing for instance says a Medical Doctor has to Head a Hospital!
You can put a person with strong Management and Finance background. Just be sure to put in a Medical Director (Not Chief Medical Director) Under him/her to provide the Medical Decision Making Direction.
I will give you an example, the CEO of Mediclinic Middle East, Mr. David Hadley is a Straight up MBA Medical Administrator. Not a Doctor;
But profitably leads the biggest Hospital chains in the Middle East! When it comes to Medical decision, he allows the Doctors take the lead. But he busy himself with looking at the financial and administrative aspect of things.
That way he is able to give all the resources needed by the Doctors to care for the patient, and to assure its done in such confines as to assure that the organization is financially solvent and making money for its investors.
Nigeria wants to have top rate Healthcare but
a) We don't want to Fund it. b) we put in untrained Medical Doctors to Administer the effort.
There has to be a paradigm shift.

Who need all these battalion of staffers in the hospitals sef... Split the system, all of this professionals can stay independently...let Nurse aids, Nurses and Doctors continue to rival each other. What is a pharmacist doing inside hospitals when you can pick up your drugs at Walgreen, CVS, GSK etc. Outsource power supply and security to private contractors, there are private lab operators and radiologist at best they can be allowed to work inside hospital facility as an independent entity. Finance and admin staffs have nothing to do with health, theirs will be to busy with documentation, PR, balance account and audit

PRESS CONFERENCE DELIVERED BY THE CHAIRMAN OF NIGERIAN MEDICAL ASSOCIATION (NMA), FCT CHAPTER, DR. CHIEDOZIE JUDE ACHONWA TO STATE THE POSITION OF THE NMA WITH RESPECT TO THE ONGOING STRIKE ACTION BY JOHESU AT THE CONFERENCE HALL OF FEDERAL MEDICAL CENTRE, ABUJA ON TUESDAY,22ND MAY 2018.
Protocol
It is no longer news that JOHESU has been on strike for over a month now over sundry demands which include among others equal pay with medical doctors, headship of our public hospitals. Since the strike commenced, the Nigerian Medical Association (NMA) FCT has been following up on matters arising from it. We would ordinarily have ignored JOHESU as it concerns her ongoing strike but we are at the moment constrained to respond and put the record straight to debunk JOHESU’s deliberate peddling of falsehood, twist of facts, misinformation and manufacture of non-existent figures just to hoodwink and get the sympathy of the innocent and unsuspecting public who may tend to believe their propaganda if we keep quiet. While unionism and activism is encouraged, it must not be carried to the extreme with the delusion that the system can always be brought to its knees for unreasonable, baseless and reckless demands to be acceded to. The NMA wishes to state clearly that the ongoing JOHESU strike is essentially against medical doctors in particular, and the peace-loving Nigerians in general. The unnecessary strike, we must let Nigerians know, is centered on quest for equal pay with Medical doctors as well as leadership (clinical governance) contestation in our hospitals.
Naturally when a sick person visits the Hospital, it is to see a medical doctor to get cured of his/her ailment. In getting the patient cured, several other factors come into play between the doctor and the patient. It is within these factors that the allied healthcare professionals play their supportive roles. It must however, be emphasized that these support staff only act upon the instruction or directive of the doctor. This is the standard practice world over, and is the concept of governance in clinical practice which Nigeria cannot be an exception. Apart from the fact that the training of a medical doctor is all encompassing (it covers all the fields of other healthcare professionals in addition to the core patient care and management), it is the doctor that is held accountable should anything go wrong in the overall management of the patient. Nigerians can therefore, be the judge as to who qualifies to be the leader of the health team.
While NMA appreciates the supporting roles being played by members of allied healthcare professionals and considers them important stakeholders in the health team, it is, however, in the best interest of this country for everyone to stay within their roles as team players. Nigerians need to understand that the Hospital is structured in such a way that every treatment/instruction must be directed from the medical doctor. No patient receives anything in the Hospital unless the doctor says so. The reason is not far-fetched. It is in the best interest of the patient so that he/she is not mishandled. The outcome is better imagined when a doctor gives instruction on patient’s management and the other healthcare workers also give separate and possibly conflicting directives on the same patient. It is akin to the proverb ‘’too many cooks spoil the broth’’. The unwarranted leadership contest in the health sector by JOHESU in recent years has led to several untold hardships on our patients with attendant avoidable loss of lives in some of our public health institutions. Comparison of Nigeria health indices between the remote past and recently shows that we fared better in the former when there was orderliness, strict observance of roles, and obedience of doctors’ command with respect to patient care. Questions must be asked while this unfortunate scenario doesn’t play out in private or public-private Hospitals. The answer is obvious; everybody knows his/her boundary and must conform to laid down rules and organogram.
Concerning the quest by JOHESU to earn equal pay with doctors, it must be reiterated that NMA has never been against any wage or salary increase or adjustment for health workers. Rather, NMA has, in her numerous engagements, severally advocated for wage or salary increase for all Nigerian workers. It must be emphasized that what JOHESU is asking for is not necessarily increment in salary per se, but equal pay as doctors. They want government to pay them exactly the same amount as paid to doctors. Is a court clerk paid the same wage as a judge, or an air hostess as a pilot? The answer is definitely NO. It should be expected, therefore, that NMA will never allow JOHESU to use subterfuge and backdoor approach to become doctors. The universities are out there with clearly spelt-out guidelines for anyone who wishes to study Medicine and Dentistry. We wish to encourage JOHESU to take advantage of that rather than employing this back door approach to become ‘’doctors’’.
The concept of wage relativity is used in wage management to ensure that only equal job of equal value attract equal pay. This was succinctly and clearly stated in the judgement of National Industrial Court of Nigeria in 2006 and affirmed by same in 2013 in matters involving JOHESU. Relativity exists between the salaries of healthcare workers in the hospitals and their counterparts in other agencies and parastatals of government. Engineers, administrators and accountants in hospitals (members of JOHESU) earn between 2 to 3 times the salaries of their counterparts in the core public service. Whether this is deserved is not the question, but for the purpose of this conference, is it not contradictory, deceitful and ironical that the same healthcare workers who on one hand accepted an advantaged salary over their counterparts outside the health sector on same levels and steps will turn around to reject salary difference with the doctor who does a superior and different job from them?
Historical trend of salary award/adjustment and relativity:
Pre-independence to 1974: Practitioners of Medicine and Dentistry (medical and dental practitioners) were grouped in Senior Service Scale A which was the apex for remunerating public officers. The relativity between the salaries of medical doctors and graduates of other health sector was 1:1.58 at the entry point and 1:1.65 at the terminal point
1975: Udoji committee eroded the relativity in the health sector, and the ratio dropped to 1:1.27 at the entry point and 1:1.07 at the terminal. The NMA protested which led to the setting up of the Justice Atanda Fatai-Williams presidential committee to look into the complaints in 1990.
1991: Due to the findings of that committee, circular 1, 1991 containing two separate salary structures in the health sector was released. This was following the approval of the memorandum by the Federal Executive Council at its 11th meeting in 1990. It was an attempt to correct the distorted relativity. These were:
Medical System Scale (MSS) for consultants and below
Medical System Super Scale (MSSS) for consultants Special Grades I and II.
(A and B were contained in a single circular).
Health System Scale (RUSS/HSS) for other health care workers.
The relativity at the entry point was 1:1.28 and 1:1.2521 at the terminal.
1993: The 45% award on salaries for public officers in 1992 was implemented on the 8th of February 1993 for doctors to restore the relativity between MSS/MSSS and other salary structures.
However, on the 9th of February 1993, a 15% award was applied to other salaries through circular CND.26/S.5/Vol.IV/380 without corresponding application to MSS/MSSS. This brought down the relativity at the entry point to 1:1.1 and 1:1.94 at the terminal.
1995: The industrial arbitration panel award of professional allowances eroded the relativity. Consequently, NARD/NMA demanded for the restoration of 1:3.33 ratio prior to the award. In response government did a comparative analysis of salary/wages worldwide and found a relativity range of 1:2 to 1:2.7. Government eventually signed an agreement with NARD on a relativity of 1:2.5
1998: The Federal government carried out harmonization of salaries. The MSS/MSSS were harmonized into HATISS for doctors in tertiary institutions and HAPSS for those in regular public service. The NMA and NARD protested to the Federal Government on what they called ‘’drop in salary’’ for those who were paid HATISS. The Association rejected the HATISS structure and asked government to pay her members with HAPSS pending a possible correction of the error they observed in HATISS. This was approved by government.
NARD complained of a distortion in relativity as a result of the harmonization of salaries. The National Salaries, Income and Wages Commission(NSIWC) did half-hearted correction of the observed errors in the conversion of MSS/MSSS into the HATISS structure. These corrections were rejected citing inadequate address of the relativity problem observed. The relativity at the entry point was 1:1.2, at all other grades it dropped to 1:1
2001: The relativity of 1:2.5 (4:2:1.7) for call duty allowance was sustained.
2006 and 2013: JOHESU went to court to seek pay parity with Doctors at the NICN but that wasn’t granted.
2014: The NMA persistent protest led to the setting up of the Alhaji GoniAji presidential committee to look into her complaints in 2013. Consequently, the Federal government signed an agreement with the NMA on relativity at each grade level with CONHESS as the reference. A circular on the correction was issued on the 3rd of January, 2014. Relativity was 1:1.2 to 1:1.5
In all it dropped from 1.58 to 1.2 for fresh doctors, and from 1.65 to 1.5 for consultant Special Grade 1 and or a Professor of Medicine on full appointment in a Hospital.
We wish to, at this juncture, remind the government that NMA will not accept any attempt to further distort or erode the existing relativity as agreed and signed in the collective bargaining agreement of 2014. It is important to note that this agreement was reached with a lot of comprise and sacrifice already on the part of Nigerian doctors. It is worthy of note that members at the recently held NMA ADM unanimously resolved to utilize every means legitimate to forestall any attempt to disregard or breach the said agreement. It must be placed on record that NMA has put before government issues that border on universal health coverage, improvement of health facilities and equipment as well as issues regarding conditions of service. It is our hope that government, while engaging in dialogue on these matters with a view to making progress, will not precipitate another crisis by bowing and acceding to pressure from JOHESU.
Doctors in the FCT have been going about their legitimate duties in all public health facilities. They have had to go extra miles to cover for the absence of the allied health professionals in order to ensure service delivery to patients. Management of our public health institutions have been visited and encouraged to create an enabling environment for doctors to carry out their duties and we are very much satisfied with their cooperation. We wish to seize this opportunity to call on patients who may have mistakenly fallen for the propaganda of JOHESU that the entire health institutions have been locked down by their strike to visit and access care from our Hospitals.
We urge the allied health professionals to be reasonable in their demands, suspend their strike, return back to work to join the doctors to continue the good work for the benefit of the masses.
Dr. Chiedozie Jude Achonwa Dr. Abdullahi Nasiru
Chairman, NMA-FCT Secretary, NMA-FCT

1. All public servants deserve salary increment: doctors, nurses, pharmacist, lab techs, teachers, police, soldiers etc.

2. For the lingering health sector crisis the following should be bore in mind
I) Is the training of a doctor, nurse, pharmist, lab technician, record officers the same?
II) Who spend more time in the hospital?
III) Using universal standards, is there anywhere in the world that all health care workers(doctors, pharmacists, nurses, etc) are started on same salary scale/ level?

3) In the military that I know of there are 'ranks" and "files". Is such application in the health sector? Should a doctor earn same entry level salary with a health record officer or a health assistant, just because they belong to Johesu?

4) Can the role of a medical doctor be substituted for?
5) can the role of a nurse be substituted for?
6) can the role of a pharmacists be substituted for?
7)can the role of a physiotherapist be substituted for?
Does years of experience/ service automatically confers the title of a Chief nursing officer?
9) Does the years of experience automatically confers the title of a consultant?
10) Will an old matron with over 30 years of experience automatically become a physician? same way, will a cathechist with 30 years of service automatically become a Priest?
11) In an oil company, even the gatemen( those that won't allow you pass to submit your IT letter) is important, does that make him want to start on same salary scale with those in process/maintenance? Or want to head the oil facility?
13) Who is the head the heath team? In the same way, who does the patient have in mind to see when he goes to any health facility?
14) why do other Healthcare workers want to bear the name "doctor"? Even a male nurse wants to be addressed by patients as a "doctor".
15) A brief history of nursing that I know was to take care of the sick and render assistance to the doctors. When them do they want to shy away from the role of assisting the doctors? Most of them call themselves "scientific nurses" and as such are too big to assist the doctors.
16) Are they specialty facility for each health care team? If yes, do they spend same number of years in specialty schools? If no, who then would be more abreast with patients' management?
17) All healthcare unit have their unique role to play. If the role isn't suitable for you, kindly reverse. I have seen a 45 years old nurse go back to medical school just because he didn't like to serve surgical instruments during surgery.
18) now let's fall back to the real Nigerian hospital situation. If you have been there before, do the pharmist play any additional role other than take case notes from patients and dispense prescriptions?
Why do we see most old matrons sitting and ordering the young nurses around?
Why are doctors always busy? Why don't we see consultants sitting and ordering the junior ones around?
Why must you have a number of years of service before becoming a chief nurse officer? yet I see young consultants everywhere?

CASE SCENERIO:
A 35 year old woman was rushed into the hospital with a ruptured ectopic pregnancy, she likely to die if who is not available?
a) nurse
b) pharmacist
c) doctor
d) lab scientist
e) physiotherapist.



PLEASE NOTE, I AM NOT A HEALTHCARE PROVIDER.

slimany:



where is it in the Law that doctors should solely head an hospital.

A doctor should lead a clinical team I believe everybody will agree with that. If it is the leadership of the hospitals that is causing wahala, let them privatize everything and stop wasting government paying 30 staffers operating a generator/diesel. No hospital manager will be willing to pay a pharmacist instead they will set up a pharmacy independent of the hospitals.

Gliding:


Is that not the same way a Newly graduated nurse directs the cleaners, some of whom are old enough to be her mother?

So a nurse is to a cleaner, what a doctor is to a nurse? U don't understand that their is difference between skilled and unskilled worker ni.