NIGERIAN MEDICAL ASSOCIATION
National officers’ committee
press release,
Wednesday 9TH march, 2016.

IMPENDING DISASTER AND COLLAPSE OF GOVERNMENT HOSPITALS AND THE PUBLIC HEALTH SECTOR IN NIGERIA: A CALL FOR IMMEDIATE ACTION AGAINST EXISTING AND EMERGING ABSURDITIES IN THE NATION’S HEALTH SECTOR
For almost two decades now, the nation’s health sector has been unduly traumatized and continually subjected to crippling upheavals by persons who have insisted on redefining the time hallowed and universally accepted meaning of Medicine and the Medical Profession. They have been aided by the acquiescence or collusion of some persons entrusted with power and authority to perform certain roles in the system, to foist a state of frozen conflict on the healthcare delivery system of Nigeria to the detriment of the public. Their main motivation seems to be the misguided belief that decimating the medical profession and “equalizing” medical practitioners with other health workers and professionals, will lead to the fulfilment of their ambitions to also lead the health team. They have used a combination of contrived misapplication of government policy and establishment circulars and misuse of legislations to cause unimaginable divisions, segmentation, acrimony, mischief, indiscipline and other vices in the healthcare system with attendant but avoidable injuries and deaths to unsuspecting and hapless members of the public.
The Nigerian Medical Association (NMA) is highly appalled by the state of affairs in the healthcare delivery system which has been reinforced by the recent ruling of National Industrial Court. An ill-informed ruling as a result of a poor understanding of the meaning of Medicine, its ramifications and appendages, the role and rights of practitioners of Medicine and their relationship with allied healthcare professionals for the purpose of maintaining members of the public in a state of health.
Surprisingly, everybody in the health care setting have argued for a direct and unfettered access to the patient, against the standard health system practice, all in the name of autonomy. This has culminated into a voracious appetite for positions, extra roles and responsibilities cursed with a spirit of get-it-at-any cost mentality, industrial acrimony and senseless strikes became the order of the day. For NMA and her members, ethical principles were inadvertently compromised in efforts to attempt to restore normalcy to the system. Those who were in positions to take actions did little to stabilize the system or to halt the decent to anarchy. Decisions and agreements were reached based mainly on emotions, fear, half-truths, disregard for quality and excellence, ignorance and total disregard for international best practices as the authorities became impotent in the face of the looming threats and blackmail by these forces at moments of decisions, and literarily handed over their mandates to unions and professional associations.
Frivolous courses and programmes with no relevance to hospital and indeed the health care industry were quickly developed, and accredited by institutions that could have first verified their usefulness to the system. In some others, the duration of training have been elongated as a way of measuring up to medical training with no added value to actual job requirement and the government compelled to commit scarce resources to funding such. The middle level manpower critical to the needs of a developing and cash strapped country like ours have been virtually eliminated even with all the hues and cries of alleviating the acute shortage of healthcare expertise among our rural poor populations. The financial burden on government became unnecessarily and excessively increased with no added value commensurate with the extra expenditures. Resources that could have been deployed in improving infrastructure/facilities to facilitate further relevant/needed training and provide commodities and consumables to guarantee better healthcare for the citizenry were used to service largely redundant and over bloated bureaucracy without the people seeing commensurate improvement in efficiency and promptness of services rendered.
The legislative process appeared to have been hijacked. Legislations were passed without fully exercising the rigorous legislative scrutiny necessary to ensure that law making remains all about entrenching order, good governance, peace, discipline and standards in the society and not to cause chaos. Arising from the seeming hijack, conflicting laws were passed against expert advice thus creating absurdities, and attempting to reverse nature and its sequence of order and hierarchy. If these absurdities were allowed to stand, it would only create undesirable and unintended disastrous consequences to both individual health seeker and the public. Public interests have been seriously compromised in favour of corruption and ego promotion. Patriotism and conscience to promote decency and preserve the sanctity of a noble profession like medicine have been thrown overboard to deliberately or inadvertently destroy the healthcare system, thus accelerating the descent into anarchy.
Under our watch judicial pronouncements that rather than annul inordinate desires, moderate insatiable appetites and quench greed and jealousy by seeking out these absurdities further escalated the conflagration in the guise of interpreting the letters of the extant laws and not their spirit. Deep rooted enmity of a lifetime and for future generations has been created among a group of people who work and live together as a team because of these interpretations that pacified only the crying baby without asking for the reason for the lamentation. Chief Medical Directors and Medical Directors (C/MDs) were and are still being compelled to do things that further waste scarce public finances even when they know such actions complicate the system of service delivery and add no value to the system, just to please individuals and groups. Yes, when the fire of the attacks gets too hot on the ministry, it is transferred to the management of the hospitals. Confusion held sway.
Many well-trained and highly-skilled Nigerian doctors and dentists have left the shores of this country over the years because of suffocating, unhealthy, antagonistic, unproductive and acrimonious work environment in the public health sector. Else, how can one explain the situation where a professor of haematology is barred from performing tests and exercise quality assurance programs and activities in the haematology laboratory by a judicial pronouncement. Can a science laboratory technologist bar a professor of chemistry from conducting his researches and overseeing the operations of a chemistry lab? But in medicine, a consultant plastic surgeon was prevented from reviewing the wound of a patient in the ward he operated on earlier because a “consultant” nurse had given order that the wound must not be opened. Can the Nigerian sick people survive under this state of anarchy? Who would be the loser? Our experts who couldn’t stand this seeming primitive jungle-like scramble for relevance and roles are now sojourning in other countries and performing excellently well to the shame and pain of their motherland. Privileged Nigerians and other impoverished citizens sell their life savings and even family landed resources and embark on medical tourism only for them to discover that that famed world class surgeon or other medical experts are Nigerians. Asked why they are not coming back home to save their people, they will respond- the Nigerian factor, the system that has put the world on its end. For how long would this continue?
The NMA is deeply concerned for our dear and beloved country; concerned for the dead and those who die daily from these senseless pursuits for positions, role and equality. We are concerned that unless decisive actions are taken NOW to allow international best practices to take root and prime position in our approach to patient care many more avoidable deaths are in the offing, as a result of the miscarriage of unionism, impunity, ignorance and lawlessness in our