I naturally dislike arrogance. It is cancerous. Anyone who
develops little pieces of arrogance in himself should be on
the watch out! Otherwise those “cancerous arrogant cells”
will mutate and overcome the “moral health system” of
the person.
I perceived such “arrogant taste” in an article written by Dr
Paul John titled “Another ultimatum from JOHESU?” I was
deeply sad within me. It is really shameful that Dr Paul
John, who is a medical doctor, belonged to this noble
profession by descending so low to “swim in the ocean of
arrogance” which negates the true principles of the
medical profession.
I am an administrative officer in one of the federal medical
centers in Nigeria. I never really understood this
“infighting” that characterized the health sector. I have to
admit this by humility. However, when I was given the
privilege to become recruited into the federal civil service
system few years ago, I came to witness, on a ‘first-hand’
basis what is truly happening in the Nigerian health sector,
regarding the battle between NMA and JOHESU. In fact
permit me to state that from what I saw and from the
available literature I came across, “my eyes were opened”.
Another ultimatum from JOHESU? By Dr Paul John Part 1
Often times, we have heard the saying, “what is good for
the goose should be equally good for the gander”; some
have rephrased this to be “what is good for the goose and
the gander is good cheese”. One of the fictional characters
in George Orwell’s “Animal Farm”, held that “all animals
are equal but some are more equal than the others”, after
stating initially that “all animals are equal”. We also have
heard that “Napoleon is always right”. This in a nutshell
captures the battle of working relationship, harmony,
remuneration between NMA and JOHESU. We have a
situation in Nigerian health sector that “though all animals
are equal”, “some animals” (the doctors) are more equal
that the “other animals” (physiotherapists, nurses,
pharmacists and other health workers, clinical and non-
clinical). What is good for the “goose” (the doctors) is no
longer good for the “gander” (non-doctors). The “goose”,
having taking its own salacious full of the cheese, “with
resounding cries of yummy-yummy”, have declared that
the cheese is not good for the health of the “gander”!
There is an Igbo proverb, “agbara rawa nsi, efosia ya ihe
ejiri mara ya. Arusi rawa nsi, agwa ya osisi ejiri pia ya”. Dr
Paul made some assertions in that article of his, which at
best ought to be ignored. However, I felt I had a burden to
issue this reply to him and to whatever “school of thought”
which he represents.
There was an interesting assertion that Dr Paul made. I
would quote him thus, “If you want to become something
in life, you must follow the due process. The current
director general of World Health Organisation, Dr Margaret
Chan, wanted to be in her current post and when she
realized that the post was and is still an exclusive
preserve of medical doctors, she simply applied to study
medicine despite the fact that she had had a degree in
Home Economics and for the fact that she was already
practising as a Home Economics teacher . In my class we
had many people that were studying medicine either as
second or third degrees. The most annoying aspect of the
whole stuff is that these medical insurgents will quote
international best practices which I am sure they don't
really understand the meaning”. I would like to remind Dr
Paul that Jim Yong Kim the present head of the World
Bank is a medical doctor, not even an economist.
When the post was vacant couple of years ago, our own
Okonjo-Iweala (whose pedigree has never been questioned
in the field of economics and finance management, tested
and trusted as a world class economist) indicated her
interest alongside Jose Antonio Ocampo (another reputable
economist from Brazil). Of all the candidates, Okonjo-
Iweala possessed the most formidable credential to head
the World Bank. However, the medical doctor was chosen.
He has been heading the World Bank and no one has ever
come out to attack or criticize his administration. And he
has been performing well. Someone would wonder, what is
a medical doctor doing as the head of World Bank? But he
has been delivering. That’s’ the truth. So Dr. Paul should
not be selective in his instances that he easily brandished
in his arrogant article.
Is it a criminal offence if a nurse, or a physiotherapist or a
pharmacist becomes the chief medical director of a
hospital? If it is a criminal offence, then the world bank
executives would not have appointed a medical doctor to
head that pristine financial institution, a medical doctor
who is not a professional economist”! They would have put
Okonjo-Iweala there. But the World Bank has not collapsed.
Most of our revered Nollywood actors and actresses never
read Theatre Arts. Most of our revered musicians did not
study music as a profession. But they are doing very well,
making Nigerian movies and music cross the shores of
Nigeria and Africa.
In fact, is it not a sign of contradiction, that these Nigerian
doctors clamoring that they are the only ones worthy to
head a health institution, has no form of knowledge in
hospital administration. In the United States, doctors have
no business in hospital administration. Of course there are
professional health administrators. I know of one Institute
of health administration somewhere in Cross Rivers. Why
would the doctors not allow a career, professional health
administrator to run the teaching hospitals, federal medical
centers and other health institutions in Nigeria as Chief
Medical Directors? I am saying all this so that an objective
mind somewhere would see the point I am trying to make.
In fact, what I suggest we should have in Nigeria is “Chief
Administrative Director” (CAD), not “Chief Medical
Director” (CMD) as we have it today.
That reminds me. I pray that the head of service will read
this piece. From what I have read from the Public Service
Rule, the entry point of staff in the civil service is Grade
level 7-10. But from what we have seen today, the doctors
have succeeded in making their entry point to be grade
level 13! Let me explain further.
Another ultimatum from JOHESU? By Dr Paul John Part 2
The normal grade level in the civil service here in Nigeria
is GL 1-6 for junior staff and GL 7- 17 for senior staff. Now
in the health sector, there are two salary schemes:
CONMESS and CONHESS. These two salary schemes were
approved around 2009 by His Excellency Alhaji Umaru
Musa Yar’Adua, former Nigerian president (may he
continue to rest in peace). The Medical Doctors in the
Nigerian are on CONMESS, while other medical personnel
(physiotherapists, nurses, pharmacist and other clinical
staff) and every other person working in the Health Sector
were placed under the CONHESS structure. I would want
my reader to take a look at these schemes in the chart
below:
NORMAL GRADE LEVEL CONMESS (FOR DOCTORS)
Grade Level 10 CONMESS 01 (house officer/youth corps
Doctor)
Grade Level 12 CONMESS 02 (Registrar/Medical Officer)
Grade Level 13 CONMESS 03 (Senior Registrar Senior
Registrar II/Senior Medical Officer Grade 2)
Grade level 14 CONMESS 04 (Senior Registrar Grade 1/
Senior Medical Officer Grade 1)
Grade Level 15 CONMESS 05 (Consultant/Principal Medical
officer Grade 2)
Grade Level 16 CONMESS 06 (Consultant Special Grade 2/
Principal Medical Officer Grade 1)
Grade Level 17 CONMESS 07 (Consultant Special Grade 1/
Chief Medical Officer)
NORMAL GRADE LEVEL CONHESS (FOR OTHER CLINICAL
STAFF AND HEALTH WORKERS)
Grade Level 8 CONHESS 7 -- INTERNS / NYSC
Grade Level 9 CONHESS 8 X -Officer 1
Grade Level 10 CONHESS 9 Senior X-Officer
Grade Level 12 CONHESS 11 Principal X- Officer
Grade Level 13 CONHESS 12 Assistant Chief X-Officer
Grade Level 14 CONHESS 13 Chief X-Officer
Grade Level 15 CONHESS 14 Assistant/ Deputy Director X-
Officer
Grade Level 17 CONHESS 15 Director X-Officer