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Parity, Equity Or Slavery: The Dilemma of the Nigerian Health Sector Wage System. By Aniey Obot. The Nigerian health sector has been tumultuous for some times now. It is either members of the Nigerian medical association (NMA) are downing tools using its affiliate, the national association of resident doctors (NARD) as her war horse or the members of the joint health sector unions (JOHESU) are on strike paralyzing health services in the country. Presently, health services in the country have been paralyzed for over three weeks now due to the ongoing strike by members of JOHESU, comprising all health workers aside medical practitioners. One of the reasons JOHESU, which is a marriage of necessity and convenience of all the registered trade unions in the Nigerian health sector, is on strike, is the wage system in the sector. They are pushing for an equitable and fair wage system, describing the present wage system as a sort of slavery. The NMA which is the umbrella body for all medical and dental practitioners in the country, is seriously pressurizing the government not to grant JOHESU’s demand because according to her, JOHESU is asking for pay parity with doctors. According to NMA, this is against international best practices. This was echoed by the ministers for health and labour who incidentally are members of the NMA. Parity, Equity and Slavery! These words have been on the front burner of discussions within the sector. NMA is rejecting parity, JOHESU is denouncing slavery and asking for Equity. To understand the discussion, these words must be defined. We take the definitions from dictionary.com. Parity is defined as the state or condition of being equal, especially as regards status or pay. Equity is defined as the quality of being fair and impartial. Slavery is defined as a condition of having to work very hard without proper remuneration or appreciation. The story of the wage system in the Nigerian health sector is a very long and complex one. To avoid boredom, I will concentrate on the evolution of the present salary structures in the sector namely CONMESS and CONHESS. In 2009, the federal government approved CONMESS for medical and dental practitioners alias medical doctors and CONHESS for other professionals and workers in the sector. These salary structures are gauged against the popular grade levels in the civil service. The basic tenets for these salary structures are that, every worker on the same grade level should earn the same basic salary and common allowances now called consolidated salary. Peculiar allowances should be paid to different professional groups as approved. Different professions have different entry level according to their years of training and the work they do. Any future adjustment must be done on both tables. These they say is to maintain an equitable pay relativity (this is a topic for another day). The NMA and JOHESU where actually unhappy with the new salary structures, because of the pay gap. NMA claimed it was too narrow, and JOHESU claimed it was too wide, they accepted the salary structures and forged ahead. Surprisingly, in 2014, against the tenets of the 2009 agreement, the federal government approved an upward adjustment of CONMESS to the satisfaction of NMA without an equivalent upward adjustment CONHESS. The real bone of contention here is the issue of pay gap between the medical doctors and other health professionals. To appreciate the cries of JOHESU, an analysis of the wage system in the Nigerian health sector is necessary. For the analysis, a nurse will be used to represent an average health professional. If a post NYSC medical doctor without any postgraduate certification or experience and a double qualified nurse (a registered nurse who has a post graduate training as a midwife) are employed the same day into the federal civil service, the doctor will get employed into the service on CONMESS 3 which is Grade level 13, while the nurse gets employed in the service on CONHESS 7, which is Grade level 8. At the end of the month, the salary of the nurse will be less than 30% that of the doctor. The nurse will need to work for about 15 years to get to grade level 13 which is the entry level for a post NYSC medical doctor. After these 15 years, the nurse’s salary is still less than the salary of a newly employed doctor. To earn the same as a newly employed medical doctor, the nurse will have to work for about 21 years, assuming the nurse passes all the promotion interviews! During the course of their services to Nigeria, both of them may be given in service specialist training. On successful completion of such trainings, the medical doctor will be promoted to grade level 15 and called a consultant. With this new position comes a new allowance called specialist allowance, while the nurse will be posted to the area of need of the newly acquired skill without any promotion or specialist allowance. The nurse will keep on working waiting for her next promotion interview before he/she can enjoy any promotion if he/she passes the interview. One of the reasons JOHESU is on strike is to narrow this pay gap and maintain the 2009 relativity, all they are asking for is for people on the grade level to earn the same consolidated pay (basic salary plus general allowances) whether you are a doctor or a nurse. Earning the same consolidated pay is not the same thing as earning the same salary if you are on the same grade level, each professional or group of professionals earn allowances peculiar to them. Remember it takes a nurse about 15 years to be on the same level with a newly employed doctor. JOHESU is simply saying let an average health professional after spending 15 years in the service earn the same consolidated pay with a newly employed doctor. This does not make the health professional earn the same with the newly employed doctor, as the doctor’s other allowances especially call duty allowance is far more than that of the health professional (for those who earn it).Thus, even after spending 15 years to get to the same level as a newly employed doctor, the average health professional will not even earn as much as a newly employed doctor when the demands of JOHESU are met. It is so surprising that the NMA and both ministers of health and labour are calling this demand of JOHESU an attempt to achieve pay parity with the doctors. It is evident that they either don’t understand the meaning of pay parity or they don’t understand the relationship between the two salary structures in our health sector. I will not want to believe that they are mischievous, as only mischievous people will go on national television and dish out what they know are lies to win sympathy from the public. Now the onus is on the public to judge if JOHESU’s description of their ordeal in the hands of our health managers as slavery, and their demands for an equitable, fair and just wage system in the health sector is tantamount to requesting for pay parity with doctors! |
A NON JOHESU PERSON WROTE THIS!!!! As a seasoned public servant, my heart bleeds whenever I read what you young ones with no experience come to social media to post. I am not a member of JOHESU but look at this objectively, a fresh medical officer enters the public service at grade level (GL)12 while pharmacist and lab sci enter on GL 10, nurse on GL 8....how can these salaries be the same? doctor's call duty allowance is 4% of his basic salary while pharmacist's call duty is 2% of his basic salary...now how can 4% of GL 12 be same with 2% of GL 10? Nurses collect shift duty allowance, how can a meagre shift duty allowance of GL 8 be the same with 4% of GL 12? A medical officer who enters on GL 12 as resident and becomes a fellow after 4 or 6yrs is upgraded to GL 15 ..it takes a pharmacist minimum of 12 yrs to get to GL 15 and nurse minimum of 18 yrs to get to GL 15. NMA is really not helping the Nigerian health sector. ![]() Copied |
MrEgghead: |
MY RESPONSE TO THE ENEMY OF JOHESU 1. What is the meaning of the word `medical´ when it is used to refer to a group of profesional? 2. Are Physicians (they are being called ``doctors´´ which is an honorary title. Only PhD holder is fit to be called a `doctor´) not Health Workers? 3. Who do they refer to as ``non-medical professionals´´? Nurses, Pharmacists, Medical Laboratory Scientists or Physiotherapists? 4. Who is fit to head health sector? Physicians have been heading health sector but it is still a shame that Nigeria Health Care Delivery is ranked one of the lowest. 5. Who should determine the wages or salary? Government or Physicians? 6. What profesional courses are needed to be qualified as a ``medical profesional´ that Nurses, Medical Lab Scientists, Physiotherapists and Pharmacists have not ben exposed to during their undergraduate and post-graduate programs? 7. Can any health professional work in isolation? If No, how should each be paid? Based on input/output or grandiose salary scale? Physicians are not the head of other professional workers. We are all equal contributors to the health care delivery. To think otherwise is a Delusion of Grandiosis. WE ARE YET TO GET IT RIGHT IN THIS COUNTRY AS CITIZENS. PUBLIC SHOULD BE WELL INFORMED THAT PHYSICIANS ARE NOT THE HEAD OF ANY OTHER MEDICAL PROFESSIONAL (Nurses, Medical Lab Scientists, Physiotherapists and Pharmacists,Radiographers). Their position is purely ARROGATORY. |
The only period in the history of labour unrest and agitations in Nigeria with some relative peace was when Prof. Eyitayo Lambo (Health Economist & Administrator) was the Minister of Health. He was able to administer the health sector from the view of an Economist Administrator with a balanced approach to issues as it affects each health care profession within the health sector. However, prior to that period especially when Prof Olikoye Ransom-Kuti was minister for almost eight years under the Gen Babangida "Maradona" junta, the health sector witnessed a systematic consistent decimation and degrading of other health workers while deliberately elevating and empowering doctors as "special superior" species in total violation of the existing rules and regulations of the civil service as obtainable in the health sector then. Various circulars were released and released until doctors became the Alpha and Omega of the health sector sidelining all other health professionals into a box. The consequences of this atrocities is the downward decline in the health indices of Nigerians because the sector was poorly managed by doctors till date. Doctors are not trained in college to manage human resources and financial resources but patients who are medically sick or ill. Management of Sick persons is different from the management of Humans as resources. A look at all the Health parastatals and agencies headed by doctors today manifests decay and a shift from the intended act establishing such agencies. From NHIS to Primary Healthcare development Authorities to Teaching hospitals and Federal medical centre to National Blood Technicial Services to Expanded Programme on Immunizations to NAFDAC (during Dr Paul Orhii) tenure. They are simply poor managers who approach issues from egoistic point rather from administrative point. My submission is this. It took other health professionals to almost two decades to come together under one body as JOHESU to fight the ROT and favoritism of doctors in the health sector. It is obvious now that the present minister does not even understand the difference between EQUITY AND EQUALITY even as a Professor. The end of JOHESU strike when the goal of equity in emoluments and other issues should not be the end of health workers struggle. JOHESU as a body should impress it upon the Federal government and the Legislature that the head of the any Health institution is not a medical qualification but a pure Administrative position as Health Administrator which is NOT a medical position. That the present situation of doctors running the health facilities without adequate prerequisite management and administrative skills and knowledge has never helped the health sector in Nigeria UPTIL Date. A Health administrator (Non-medical) CEO will manage the health sector judiciously and fairly without placing one professional above another as it is now. Prof Albert Einstein said "All Professions are equal and non is superior or inferior to another.. |
THE NIGERIA HEALTH SECTOR: A MIRROR OF THE ANIMAL FARM Current events in the Nigeria’s federal ministry of health have taken my mind back to the George Orwell’s classic novel “Animal Farm”. The animals ganged up to removed the evil human who in their own wisdom they saw as cruel and abusive only to enthrone the pigs as their leaders. Well, one particular pig, Napoleon, hid nine puppies until they grew and then began to terrorize, maim and kill any animal that questions its authority with these dogs. In the end, the animals ended up in a worse situation than before and the pigs grew fatter at the expense of the labour of the other animals, eggs went missing, milk went missing and animals also went missing, end of story. It is significant to note that the health care system of this our great country has nosedived over the decade in the hands of the leaders of this sector. The system seems to be crawling and struggling while a select few are squeezing the milk of the sector, collecting enormous salaries and attending international conferences, while the vast majority of the workers in that same ministry continue to wallow in pains of poor remuneration and limited opportunities. However, whenever questions are raised to determine the main cause of anomaly and suggestions are made to bring sanity back into the sector we are reminded of how important Doctors are and how they must continue to be in charge. (All animals are equal, but some animals are more equal than others are). When agitations continue, they begin to play the card of international best practice, which is carefully painted to favour the oppressor and continue to bind the oppressed. The system has been designed to fail. Whenever any suggestion or idea comes up that seems to challenge the status quo but has the potential to improve the sector, the ones in charge who sees these suggestions as a threat to their rulership begin to kick against it and start quoting international best practice. This to me is an insult to this great country because it suggests that we are not capable of thinking of lasting solutions to our problems ourselves, so we have to copy. The persistent write-ups and press releases by the Nigeria Medical Association (NMA) and Medical and Dental Consultants Association of Nigeria (MDCAN) has continued to fill me with dismay, it begs the question. “What are you afraid of? What effect does a better payment for others have on yours? If other health workers are better paid, is it not a motivation for them to work better and improve our health care delivery? What do you have to gain from destroying others, are you not indirectly destroying yourself? The federal government must be aware that the ministry of health and all hospitals do not need a doctor, medical scientist, pharmacist or any health professional to head it because their allegiance will be to the profession they belong and this will be to the detriment of that sector and other health workers. We need a public administrator who has no alliance with any health professional. Who understands administrations and can bring balance and equity to the system. Who will ensure medical laboratories are well equipped and our pharmacies are well stocked. Whose concern will not be how to destroy other health workers to ensure they do not challenge his authority but how to develop them professionally. Who understands that the hospital is a multifaceted organization that needs to be handled by someone who judge in fairness. Until we get the leadership right, the sector will still be in a mess, the minister will continue to deny agreements, the NMA and MDCAN will continue to manipulate the federal government and our people will continue to suffer under a failed health sector leadership. ![]() |
God bless him for this kind gesture but he shud av bought flat screen desktop for them rather than laptops cause the teaching staff can easily turns the lappy into their personal use. |
[quote author=frankpro27 post=67019310]Innoson is far above Dino. Dnt compare both pls. Let dem touch innoson Nd let's see how it will end.[/quot Igbo cum chest beater don start their usual gragra threat o rather than doing d needful.. ![]() |
So this one too wan start the blame game like our bubu here .I hope Liberians Neva enter one chance oo ;DSo this one too wan start the blame game like our bubu here .I hope Liberians Neva enter one chance oo |
Eleribu omale jatijati in Bello,posterity will Neva forgive u for this ur servility and frivolity. ![]() |
princechurchill:No u are wrong ,its never possible for a big natural breast like her own to stand firm except its a cosmetics one. ![]() |
Donpresh95:Kogi ke, I doubt d demons called can try dt .Kogi ppl especially d igbiras and igala are very very wicked in their own right ,Fulani's dare not misbehave dere ![]() |
momodub:Is that a training or punishment? .How do u expect a saner person to undergo such barbaric tortures to behaved sanely in d society; I wonder why Nigerian Army cannot take a clue from d military training of other saner climes. ![]() |
morikee:Yeah ,its bcuz she is no more a naija official but a global official. |
[quote author=daftpikin post=64055766]Leave the guy. He should just add PhD so he would be a general [/quote ![]() |
Babalawos: |
May d Lord forgives me but I must be real wit myself ;I felt so so elated wen I saw d headline.Its instructive to note dt no one under d sun has d monopoly of violence, its high tym we southerner respond to d wanton killings by d demonic herdmens thru d same measure . Enough is enough...... |
Okoyeeboz:E pain am gan ni, Nigerians and their oversabi.Why crying more than d bereaved?,If the genuine members who regularly paid their tithes with resultant blessing are not complaining ;wats ur own ooooo ![]() |
goldbim:You mean her destiny helper or other room helper? |
Vblossom:Thank you for d enlightenment ,I hope d ducks wud rily put aside their overbloated ego and do d needful.Eat and let others eat too ........Its so so appalling DT in dis insane climes like ours ,an house officer is earning twice of what a pharmacist supretendient ,a chief matron or a chief Medical Laboratory Scientist wit years in service is earning in public hospital yet they are Neva satisfy but wud do everything to be d clog in d wheel of other health professionals. Even d students odawise called resident doctors wit d privilege of be d only professional sponsor by d govt among d health professionals would readily go on strike wit flimsy excuses yet d govt wit alacrity wud alwaz accede to their demands but cry wolf when a duly registered labour union under d law like JOHESU embark on legitimate strikes to express their grievances. |
Scholar212:Gbam,God bless u for dis . |
If dis is true ,ur friend shud kill his mother asap.Iranu oshii ![]() |
rentAcock:NwaAmaikpe wannabe spotted ,d earlier u leave dt NwaAmaikpic path and follow a good path like dt of d impressive Explorer,d beta for u. ![]() |
rentAcock:NwaAmaikpe wannabe spotted ,d earlier u leave dt NwaAmaikpic path and follow a good path like dt of d impressive Explorer,d beta for u. ![]() |
magoo10:E pain am seriously : ![]() |
Its quite saddened wit d huge loss ,dts d reason its said dt d innocents often have a share in d calamity dt befalls d guilty ones.British island has alwaz been a safe haven for d looters and oda shady elements all over d world especially naija my beloved country. ![]() |
DTS cool but no be nollyword star Saheed Balogun be dis in d second to d last pics in |
Candidly ur story get k-leg as we dey talk am in our local parlance ;how is possible to av dated a girl for good 9 years yet ur parents or family members were nt aware or acquainted wit such girl.Anyway let me comical here,ur mum could av rejected ur fiancee at first meeting cuz ur fiancee might be ur mum senior in their witchcraft coven hence she won't want her child to be entrap. ![]() |
Wow,dts cheering .Now i know dt karma is really alluring and very sweet. ![]() |
LoveDecay:Gbam!,u really nail it well though d truth is alwaz bitter .Have alwaz told my ibo friends anytym we are discussing naija politics dt its would be more a possibility for a camel to pass thru d needle than an ibo presidency to be actualize in naija wit their hateful and distrust mentality over oda tribes. |
LoveDecay: |
fpeter:Hmmm,i sight u #TeamKorean# ![]() |
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.maybe she has other means of income .