₦airaland Forum

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The strike embarked upon by the joint health sector Union is festering. While uptake had been initially minimal, concrete information has it that plans are on to include state and local government health workers.
Implications

There is unlikely to be meaningful work done in government owned hospitals which usually provide cheaper and quality services to the public. While doctors will continue to attend to patients in the out patient clinics, admission and specialized care such as surgeries will be a challenge.
Access to hospital equipment also remains an issue with various departments locking up government property and ensuring no work done. The government looses revenue as striking workers still get paid.

Issues at stake
JOHESU consists allied professionals (pharmacists, nurses, lab scientists, physiotherapist and radiographers) and other workers such as medical records personnel, health assistants, technicians, hospital engineers and security staff among others. Interestingly Bachelor degree holding nurses have opted out of the strike and claim not to be JOHESU members.

Headship: Allied professionals contest sole headship of government hospitals by doctors. Nigerian public hospitals run a system where one man has the final say. That position had been considered reserved for doctors until recently.
Consultancy status: Allied professional are leaning heavily on government to recognize members as specialists in their respective fields. This is not unconnected with the heads-up tussle as the Constitution says only medically qualified personnel, interpreted as consultant should head the hospital.
Other issues are in respect of salary upgrade, increment in retirement age and reconstitution of the boards of government hospitals to include more members.
Challenges
Unclear goal: JOHESU is yet to provide written guidelines on how specialists will be produced. Will it be as a result of advancement in the Civil service ladder or following postgraduate degrees? NMA has a clear advantage here with established residency programs approved by law and recognized internationally or at least in West Africa.

JOHESU is also yet to provide a clear blueprint on how specialists will work in line with extant laws guiding the health sector. This has fueled a fear of the unknown especially among doctors. Even as health care is team work, someone still has to take responsibility. Which consultant will have the final say on patient care? To what extent will these specialists be legally exposed?
Dwindling oil fortunes: With falling oil prices government is unlikely to make decisions supporting wage increases in a much watched segment of the Civil service. While it approved such for federal doctors numbering less than 10000, it will be reluctant to do same for hundreds of thousands of other health workers.

NMA may be maintaining silence but there is no doubt the association is eagerly watching developments in this space. The fact that that it embarked on a a prolonged and much criticized strike some months ago clearly showed that all gloves are off when it comes to battling the system to a standstill.

Possible Solutions

Government has largely adopted a divide and conquer strategy, pitting one side against the other. While this seems to have worked in the short term the method is backfiring with both sides clearly the wiser.

A more pragmatic approach will be collective bargaining involving all members. Orthodox health care is not native to Nigeria and a number of countries are implementing it more successfully. Such working systems can be adopted as models via consensus with some modifications to suit the Nigerian sphere. These models will form the frame work for relativity in salaries, clinical and administrative functions and insurance among others.

So while specialist pharmacists exist in Canada for instance, what are their roles via a vis public hospitals. What training do they undergo? If their roles there are limited to nursing homes and care for the elderly it shows some form of regulation. What of consultant nurses? Is there room for specialists to thrive in the private sector where their services as experts are not limited to hospitals.

This lingering health sector crises requires a once and for all solution. Failure to do this will result in an endless cycle of strikes where half solutions proferred to strikes by one group forms the basis for another strike by opposing faction. This will effectively cripple the public health sector. Unless of course that is what the government wants.

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Dr Nwanji Ify writes at www.naijaclinic.com

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Thank you chief

ozo13:
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NMA is watching or NMA is hoping it won't work out for JOHESU? Because of being already rendered toothless by FG during their last strike.. Mumus

adeoladrg:
NMA is watching or NMA is hoping it won't work out for JOHESU? Because of being already rendered toothless by FG during their last strike.. Mumus

It is clear you still buy the divide and conquer strategy of the federal government. Notice that govt had activated no work no pay. So lets see what happens after a month of no pay. This is exactly why govt is delaying negotiations. It is always better to do business with hungry people. The cane that was used to flog the first wife is always available to do same for the new one.

As usual the govt is waiting till next month. Dec 5 I hear. When Johesu members fail to recieve alerts in their respective bank accounts then the tempo of discussions will change. Even doctors as well paid as we imagine they are could not hold out for more than 7weeks. Lets see what becomes of cleaners, records officers and actually everybody who is dependent on monthly salaries. And we know the govt is in no hurry. And it usually has public support when it comes to dealing with health workers.

In other news, visit www.naijaclinic.com for timely health information that could save your life!

naijaclinic:
It is clear you still buy the divide and conquer strategy of the federal government. Notice that govt had activated no work no pay. So lets see what happens after a month of no pay. This is exactly why govt is delaying negotiations. It is always better to do business with hungry people. The cane that was used to flog the first wife is always available to do same for the new one.

Well, this is very true!