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Nairaland Forum / Nairaland / General / Health / Drop A Suggestion On How To Solve The NMA Vs Johesu Issue? (30275 Views)
NMA Threatens To Embark On Strike If FG Yield To The Demands Of JOHESU / Strike: "JOHESU is Selfish, They don't know what they want" must read!! / Federal Health Workers Under The Umbrella Of JOHESU Embark On Indefinite Trike (2) (3) (4)
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Re: Drop A Suggestion On How To Solve The NMA Vs Johesu Issue? by chukel(m): 6:12pm On May 22, 2018 |
For those looking for international best practices. 1 Like
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Re: Drop A Suggestion On How To Solve The NMA Vs Johesu Issue? by Nobody: 6:16pm On May 22, 2018 |
slimany:That us very close to what exist in Nigeria government hospitals the only difference is the hospital administrator. |
Re: Drop A Suggestion On How To Solve The NMA Vs Johesu Issue? by sogodihno: 6:20pm On May 22, 2018 |
transformed: So, because it's age long mean it's correct? or how do we continue doing something that's obviously not correct just because we have started doing them since time memorial. |
Re: Drop A Suggestion On How To Solve The NMA Vs Johesu Issue? by capitalzero: 6:38pm On May 22, 2018 |
1.Privatization of tertiary hospitals is a way forward. BUTH, ABUTH, Eko hospital etc are owned by private individuals but no strike or agitation. 2.Compulsory health insurance or subsidy for healthcare services. 3. Adopt healthcare model of a developing nation with good health care indices 2 Likes |
Re: Drop A Suggestion On How To Solve The NMA Vs Johesu Issue? by drI: 6:42pm On May 22, 2018 |
yefasolution: My dear, have you received medical care in these saner climes, if yes you will understand that there is a marked difference between the doctor and others. Generally everyone is important and respected, but clearly the doctor is the headbof the pack. He hives others and every other person follows. By the way, a new specialist doctor is paid much more than any nurse in the US irrespective of his or her number of years of practice or expertise. And strangely, in the US, the specialist nurses do much more, they even get to see patients and give prescriptions unlike our nurses here who do much less. |
Re: Drop A Suggestion On How To Solve The NMA Vs Johesu Issue? by MIKOLOWISKA: 6:51pm On May 22, 2018 |
amaham:universal insurance will never make it affordable |
Re: Drop A Suggestion On How To Solve The NMA Vs Johesu Issue? by cutedharmee: 6:55pm On May 22, 2018 |
Teecomm:Did u say MD will do d work of nurses? I bet u they cant |
Re: Drop A Suggestion On How To Solve The NMA Vs Johesu Issue? by aieo(m): 6:56pm On May 22, 2018 |
dokyOloye:the diagnosis you make, is it not based on what the med lab scientist gives to you? who cannot recognise and diagnose symptoms of minor cases we see everyday. my point is the complex decisions the doctors make are based on other professionals |
Re: Drop A Suggestion On How To Solve The NMA Vs Johesu Issue? by drI: 6:59pm On May 22, 2018 |
xreal: You are the one that need to get your fact right. Radiologists are medical doctors who have gone through 5 yrs further training, called residency and are now specialists.radiographers on the other hand are bsc graduates who studied radiography. 1 Like |
Re: Drop A Suggestion On How To Solve The NMA Vs Johesu Issue? by aieo(m): 7:00pm On May 22, 2018 |
ultron12345:Give us an instance sir |
Re: Drop A Suggestion On How To Solve The NMA Vs Johesu Issue? by ocelot2006(m): 7:01pm On May 22, 2018 |
Dething: Young 2nd Lieutenants fresh from the Academy lead grizzly veteran Sargents. That's because there's a heirachy/structure in place. If you don't like it, go get a JAMB form and get an MBBS degree. |
Re: Drop A Suggestion On How To Solve The NMA Vs Johesu Issue? by sogodihno: 7:06pm On May 22, 2018 |
rottentomatoes:. See what this doctor is saying, they are not asking for equal pay for christ sake or sentiment and arrogant has deafen your ear too. How is proposed 190k for a pharmacist for example equal to the 260k of a doctor at the same grade level, and their's also one allowance which is 4% of doctors salary and 2% of of pharmacist salary, how does 4% of 260k equal to 2% of proposed 190k. How is this salary + allowance equal? my people. Again, how is (260k+ 4% of 260)equal to (190k + 2% of 190) at the same grade level? A doctor should please answer me. This strike will not end soon. |
Re: Drop A Suggestion On How To Solve The NMA Vs Johesu Issue? by chara019: 7:12pm On May 22, 2018 |
Teecomm:I hope MDS would be able to perform bed pan rounds? with their ego that was how one proud doctor remove thermometer from patient armpit,put it in the mouth say he wants accurate reading. No cleaning whatsoever just stop all this doctor claiming high position talks,and face reality and truth. we all need each other. |
Re: Drop A Suggestion On How To Solve The NMA Vs Johesu Issue? by drI: 7:12pm On May 22, 2018 |
kolmart: Strangely a patient can go to the hospital, see a doctor, get fully treated and leave without the other health workers. Not because they are unimportant but because the doctor has been trained to do everything other health workers can do and much more. For instance the teaching hospitals are operational and functioning fully while JOHESU have been on strike. We are even carrying out major surgeries without JOHESU. What else is required to prove my point? 2 Likes |
Re: Drop A Suggestion On How To Solve The NMA Vs Johesu Issue? by drI: 7:15pm On May 22, 2018 |
Angelfrost: kolmart: Strangely a patient can go to the hospital, see a doctor, get fully treated and leave without the other health workers. Not because they are unimportant but because the doctor has been trained to do everything other health workers can do and much more. For instance the teaching hospitals are operational and functioning fully while JOHESU have been on strike. We are even carrying out major surgeries without JOHESU. What else is required to prove my point? |
Re: Drop A Suggestion On How To Solve The NMA Vs Johesu Issue? by drI: 7:23pm On May 22, 2018 |
chara019: My dear, I have been carrying the bed pans oh and sincerely its not rocket science. Infact I have been very satisfied with my patient management cos I do everything myself. I am sure the vital signs charted are right. Maybe because I am a perfectionist it suits me well. Again, the patient load is low so it works well for me, I cant say about when they become more. |
Re: Drop A Suggestion On How To Solve The NMA Vs Johesu Issue? by Deniceone: 7:23pm On May 22, 2018 |
careerwoman:Entry level differs from internship(housemanship?). Dr! |
Re: Drop A Suggestion On How To Solve The NMA Vs Johesu Issue? by DrStealth(m): 7:25pm On May 22, 2018 |
xreal:Brother, radiologists are doctors You're talking about radiographers 2 Likes |
Re: Drop A Suggestion On How To Solve The NMA Vs Johesu Issue? by xreal: 7:30pm On May 22, 2018 |
drI: Oh. Not again. This matter has been trashed long ago. Don't distract my attention. Nigeria must WIN this match. |
Re: Drop A Suggestion On How To Solve The NMA Vs Johesu Issue? by WesleyPepper: 7:41pm On May 22, 2018 |
xreal:Listen to correction. Radiologists are specialist doctors. |
Re: Drop A Suggestion On How To Solve The NMA Vs Johesu Issue? by Teecomm(m): 7:41pm On May 22, 2018 |
chara019: Are you now saying a Nurse can't make the same mistake They claim high positions cos of their years of studies....I will still that again For example You can't compare me as Doc that spent 7years studying with a nurse that spent 5years in school now....I had to spend an additional years to know what a Nurse doesn't know......you can't consider us as the same now Another example We finished university and we were given BSc...you went ahead to further and you obtain your MSc....So you think we are both the same |
Re: Drop A Suggestion On How To Solve The NMA Vs Johesu Issue? by Deniceone: 7:42pm On May 22, 2018 |
Areaboyfriend:With all the drs surrounding patients in our hospitals, people still die! Some na Dr kill dem self. LOL |
Re: Drop A Suggestion On How To Solve The NMA Vs Johesu Issue? by Cmanforall: 7:42pm On May 22, 2018 |
Dething:It is myopic to base the leadership role of an individual on age. 1 Like |
Re: Drop A Suggestion On How To Solve The NMA Vs Johesu Issue? by xreal: 8:01pm On May 22, 2018 |
WesleyPepper: Is Nigeria leading the match? |
Re: Drop A Suggestion On How To Solve The NMA Vs Johesu Issue? by Gliding(m): 8:18pm On May 22, 2018 |
sogodihno: Have you considered how long it takes a pharmacy technician to catch up with a newly employ pharmacist? Essentially, I think the basis of your argument is flawed. You referred to a newly employed doctor telling a nurse what to do as a demeaning thing. The doctor owns the patient and he is expected to take charge. Telling someone what you want then to do should not be viewed as demeaning. Perhaps you expect such decisions to be based on negotiations with the other health workers. |
Re: Drop A Suggestion On How To Solve The NMA Vs Johesu Issue? by donald197: 8:20pm On May 22, 2018 |
A better analysis and solutions to the current crisis by Dr Ibrahim Toli. Enjoy it. Never ending health crisis GL 1 GL 2. CONHESS 1 GL 3. CONHESS 2 GL 4. CONHESS 3 GL 5 CONHESS 4 GL 6 CONHESS 5 GL 7. CONHESS 6 GL 8 CONHESS 7 GL 9 CONHESS 8 GL10 CONHESS 9 CONMESS 1 GL12 CONHESS 10 CONMESS 2 GL13 CONHESS 11 CONMESS 3 GL14 CONHESS 12 CONMESS 4 GL15 CONHESS 13 CONMESS 5 GL16 CONHESS 14 CONMESS 6 GL17 CONHESS 15 CONMESS 7 For the benefits of those asking us what is really happening currently in the tertiary health sector. The conflict centres around MONEY and LEADERSHIP positions which in turn is link to money. Other confounders are gross indiscipline, ego, lack of job description, failure of supervision and conflict of interest. As a whole, it is a systemic failure needing urgent, radical and wholistic repair to prevent complete collapse. There are currently two salary structures in the public tertiary hospitals in Nigeria. They are called CONMESS for medical doctors and CONHESS for all other hospital workers including those in the administration and accounts. CONMESS was born on 29/09/2009 via the circular SWC/S/04/S.410/220 while the CONHESS was born on 08/12/2009 through the circular SWC/S/04/S.410/Vol.II/349 of National Salary Income and Wages Commission (NSIWC) respectively. Both the two salary structures are consolidated and derived from the traditional grade level (GL) system as shown above. Note that there is no GL 11 in the traditional grading system for all civil servants which is taken care of in both CONMESS and CONHESS, hence the APPARENT lack of level skipping in them. The States and local government councils are still using the traditional grading system and pay less than the FG. To my knowledge only Yobe State has just started paying health workers exactly as the FG! I will be using the traditional grade level system for ease of understanding. Very very few people including those in the Accountant General of the Federation's office easily comprehend the interrelationship of the 3 salary scales. Between 1998-2013, doctors and any other hospital worker of equivalent level had identical basic salary while between 2009-2013 they had identical basic salary, hazard and teaching allowances. The differences were in call allowances where doctors earned higher and specialist allowance to medical consultants or specialists on GL 15-17 only. Note that doctors on GL 15-17 that are not specialists are not PAYED specialist allowance. In 2014 relativity was restored where the basic salary of doctors became 20-50% higher than equivalent levels of other hospital workers from GL 13-17 only. There had always been differential pay relativity between doctors and other health workers from 1960 to 1998 at various ratios. In the years 1998-2013 that was when relativity was lost. When it was restored in 2014, the conflict resolution compromise was to forgo 25 years of arrears. After graduation from medical school, a doctor practices for 12 consecutive months under supervision of a specialist or a very senior doctor of no less than GL 15 before given licence to practice independently. These group of doctors are called house officers. Pharmacists, degree nurses and medical lab scientist have similar program and they are called interns. They are employed at GL 10 for doctors and GL 9 for the other 3 until around 2013-2014 except for degree nurses that started internship around 2016-2017. Both earn salary for one year only because of the services they offered, but they are not regular staff and hence not the entry points in to civil service. The entry points (post NYSC) for doctors in to civil service were GL 12, pharmacists GL 10, medical laboratory scientists GL 10, degree nurses GL 9 and non degree nurses GL 8 in the tertiary public hospitals. In contrast entry point for degree holders in other ministries is GL 8. In 2013 the National Industrial Court of Nigeria (NICN) passed a judgement for skipping of GL 12 for health workers on CONHESS ie any other hospital worker except doctors. So the entry point of pharmacists, medical lab scientists (and degree nurses around 2017-2018) still remains GL 10 with skipping of GL 12 around 2013-2014. In view of this, the entry point of doctors now shifted to GL 13 between 2016-2017. Other health workers are variously employed at GL 8-9. Medical doctors can pursue their post graduate studies through Residency Training Program (RTP) or traditional postgraduate degrees of MSc and PhD otherwise they join the public service like any other degree holder. Doctors that join the RTP in tertiary and teaching hospitals are called Resident doctors. They gain entry only after passing an exam with a pass rate of 35-45% and average waiting time of 2-4 years. They are doctors under training to become specialists. They are temporary staffs throughout the training and get promoted only after passing exams, 2-4 years after starting the program in the first stage and 3-5 years in the second stage. This is a privilege enjoyed by 15-25% per exam. The specialist exams are conducted twice a year in Ibadan and Lagos. Other health workers including specialist medical doctors are permanently employed in the hospital. The latter are also University lecturers for teaching, research and supervision of undergraduate and postgraduate students including non doctors. Medical doctors with first degree in the University are employed as Lecturer II similar to PhD holders while every other degree holders are employed as Graduate Assistants, in the military doctors occupy the rank of equivalent of army Lieutenant and 2nd lieutenant in others, DSP and ASP in police, in Custom and Immigration same, SIO1 and SIO2 in DSS respectively. The other aspect is that of leadership. a) At present both the substantive and State ministers are medical doctors (prerogative of Mr President). b) The following are departments in the Federal Ministry of Health (FMOH), ii, iii and iv are headed by medical doctors http://www.health.gov.ng/index.php/department/84-departments. i) Department of Procurement with two divisions; capital and recurrent. ii) Department of Family Health with five divisions; Child Health, Gender adolescent school and elderly care, Health promotion, Nutrition and Reproductive Health. iii) Department of Health Planning Research and Statistics. iv) Department of Public Health with eight divisions; Non-communicable diseases, Neglected Tropical diseases, Occupational health and safety, Port health services, National Tuberclosis and Leprosy Control Programme, National Malaria elimination programme, HIV AIDS and Epidemiology services. v) Department of Finance and Accounts. vi) Department of Human resources. vii) Department of Food and drug services. c) The following are agencies under FMOH http://www.health.gov.ng/index.php/department/79-the-ministry. Agencies i, iii and iv are headed by medical doctors. i) National Primary Health Care Development Agency (NPHCDA). ii) National Agency for Food & Drugs Administration and Control (NAFDAC). iii) National Health Insurance Scheme (NHIS). iv) National Institute of Medical Research (NIMR). d) All the chief executives of tertiary hospitals are specialist medical doctors (Act of the National Assembly). There are 13 Federal Specialty Hospitals, 21 Federal Medical Centres and 22 Federal Teaching Hospitals http://www.health.gov.ng/index.php/department/83-parastatals. e) The following are directorates in the tertiary hospitals i) Director of Clinical Services and Training/Chairman Medical Advisory Committee headed by specialist medical doctor. There are divisions like 2 deputies headed by specialist medical doctors, (deputy) director nursing headed by a nurse, (deputy) director pharmacy headed by a pharmacist. ii) Director of Administration headed by an administrator with divisions that include establishments, account and supply, audit, expenditure, works, nutrition, kitchen, laundry, security, etc. f) Headship of clinical departments, clinical and training laboratories in the tertiary hospitals for teaching, training and research of undergraduate and postgraduate students. They are all headed by specialist medical doctors/unversity lecturers and in the laboratories they are also called Pathologists with units headed by optometrists, radiographers, medical scientists, technicians etc. In my opinion the solutions to the unending crisis in the health sector are mainly, 1. Implementation of the Presidential Committee of Experts on Inter-Professional Relationship in the Public Health Sector report by Yayale Ahmed committee submitted to FG on 19/12/2014. 2. Invitation of "foreign" experts like PricewaterhouseCoopers and Agenda for Change for proper job evaluation and placement. 3. Consideration for law amendments and the movement of all tertiary hospitals under affiliated universities. They also have their issues, but they seem to be relatively more stable. There is high academic loss in the current setting. 4. Strengthen and make wholistic coverage the National Health Insurance Scheme (NHIS), and then privatise all tertiary hospitals. Both LGA, States and FG shall concentrate in primary and secondary health care services especially the former. In my limited opinion, this is the best long term solution to our low quality health care services in Nigeria. There shall also be active support for purely private investments in health. The investors will decide who heads or leads who, what, which and how. 5. Positions of leadership in the FMOH, parastatals and its agencies can be tackle by the FG as it deems fit. You can correct me where I erred. May God forgive my mistakes. Aknowledgement: Dr N.L. Orhue, my friends in other climes. ibrahim Toli doctoli@gmail.com 2 Likes |
Re: Drop A Suggestion On How To Solve The NMA Vs Johesu Issue? by Nobody: 8:21pm On May 22, 2018 |
tsquaure:It's like you've been leaving in the moon...If they didn't educate you well enough in medical school you should have read on your own that there are levels of care and of course they diagnose, prescribe and manage patients at their area of competence. They can recognise when there's danger and when there's a need for referal. You claim international best practices while closing your eyes to independent non medical prescribers in those climes. The world is changing and we're evolving with it. NMA hasn't seen anything yet cos we're getting to the era where there'll be independent non medical prescribes even in the hospital. That's our end goal. |
Re: Drop A Suggestion On How To Solve The NMA Vs Johesu Issue? by jaychubi: 8:32pm On May 22, 2018 |
Doctors have always been better treated in civil service dts y every intelligent science student wants to read medicine. Juhesu shld be forced to resume or they shld be fired n their jobs advertised nonsense. Do u kw how poorly lecturers are paid yet ASUU are not complaining. Entry level doctor earning 260k dts d salary of a lecturer with 9 years post PhD teaching experience. |
Re: Drop A Suggestion On How To Solve The NMA Vs Johesu Issue? by Areaboyfriend(m): 8:39pm On May 22, 2018 |
chukel:So what is johesu clamoring for? Wanting same pay |
Re: Drop A Suggestion On How To Solve The NMA Vs Johesu Issue? by Areaboyfriend(m): 8:49pm On May 22, 2018 |
Deniceone:Nurses, doctors, pharmacists, lab scientists all make mistakes. But answer the question(maybe in your mind). 1 Like |
Re: Drop A Suggestion On How To Solve The NMA Vs Johesu Issue? by Areaboyfriend(m): 9:21pm On May 22, 2018 |
Even the best US hospitals are managed by physicians. https://www.sciencedaily.com/releases/2011/07/110706104808.htm |
Re: Drop A Suggestion On How To Solve The NMA Vs Johesu Issue? by georgebruno(m): 9:42pm On May 22, 2018 |
chukel:Stop deceiving the people. The figures in the column for doctors are for specialists and not entry level doctors. Entry level doctors earn just a little higher than what is obtainable for other health professions. I'm beginning to wonder if part of the training in medical school involves a special course in telling of lies. 4 Likes 1 Share |
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