DOCTORS’ STRIKE AND HEALTH MINISTRY’S THREATS.

AS usual, when faced with labour disputes, the federal government has not always acted reasonably or altruistically. Against the striking National Association of Resident Doctors (NARD) with which it has had a running battle for years, the government has oscillated between war-war and jaw-jaw. After months of dithering over how best to resolve the professional issues causing repeated misunderstanding between doctors and the federal government, the association interpreted government’s seeming indifference as a demonstration of lack of faith. It, therefore, decided to down tools beginning from Monday. Immediately, the Labour and Health ministries began a fresh and earnest round of negotiations to stave off the strike at a time of massive social and economic dislocations caused by the coronavirus plague.

On Tuesday, it was obvious that the doctors would not budge. As a result, the Health minister announced that he was directing health institutions to open a register for doctors to sign attendance in order to determine who should be get their salaries and allowances. The doctors called the bluff of the government and proceeded with the strike. They also threatened that if the government had still not met their demands in two weeks, doctors treating COVID-19 patients, but who are temporarily exempted from the strike, would automatically down tools. The government was livid.

By early June, according to some reports, over 800 health workers had tested positive for COVID-19. They are among frontline workers battling the disease. Yet, their April and May allowances and salaries had not been paid, and other incentives promised the doctors to enable them carry out their duties, such as life insurance and personal protective equipment, had also not been provided. It is remarkable that despite failing to live up to its side of the bargain, the government could still threaten the doctors with ‘no-work-no-pay’. Naturally, the doctors were unfazed, wondering what became of the payment due to them over the work they had earlier done.

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Last Friday, the government frantically announced that some N4.5bn had been released to pay the doctors. This is surprising. The government knew it was owing the doctors, but chose to blackmail them emotionally by insinuating that they were irresponsible to down tools at a time of medical emergency, even suggesting that Nigerian doctors were the only ones in the world to demonstrate that kind of indifference. But the government provided no proof that similar irresponsible conditions of unpaid salaries and allowances existed in any other country in the world. As hard as it is to endure the absence of doctors in hospitals at this time, the government surely had the larger blame for failing to discharge its obligations to doctors, other health workers and indirectly the public. It is shocking that the government could threaten to withhold salaries when it had not cleared the backlog of unpaid salaries, and even contemplated sacking intransigent doctors when it had no idea where to source and finance replacements.

A few issues spill over from the doctors’ strike. First, the government is obviously struggling with shortage of funds. For years, not only has the health sector been grossly underfunded, the government has given it little attention and priority. For the first time, public officials have found themselves grounded in Nigeria and forced to seek medical treatment at home. They had been used to flying out of the country for their health needs. But the result of years of neglect has led to the near collapse of Nigerian hospitals and the poor and epileptic payment of salaries and allowances to health workers. In short, no tradition or culture of giving doctors and other health workers their due was established.

Second, it is clear that the government has failed to prioritise the health sector, preferring instead to waste money on political schemes and structures, including foolish policies that do not directly impact on the health sector and well-being of citizens. The government must run their hospitals in such a way that salaries and allowances of health workers would be routine, devoid of labour disputes.

Third, the struggle to discharge its financial obligations to the health sector and other crucial sectors such as education and housing indicate how poorly the federal government is managing the country’s finances. A time of falling oil prices and global downturn indicate alarmingly that Nigeria is running out of time and options. It spends enormous sums, money it has problem generating, to sustain its bloated and unworkable political system. It needs to urgently restructure the system, curb wastes, and merge and rationalise governmental ministries and agencies in order to free money for the essential parts of the system.

There is no question that until the government and the country face reality by re-examining their dysfunctional system and redefining and rationalising the national superstructure, they will continue to struggle to meet their financial obligations. The education sector is heavily underfunded, the health sector is gasping for breath, and poverty is running rampant. If there is no significant and fundamental change soon, the country must expect further labour disputes to break out in the near future. It is unavoidable. And it will get to a point where the reluctance to grapple with this uncomfortable reality will lead to mass unrest. The needed changes must be made now while the initiative is not lost. For even after the NARD strike is resolved, the turmoil in the health sector will recur if no deep structural changes are made.