₦airaland Forum

Joenz: Nigerian greedy and unthinking physicians on the brink!Yesterday u canvassed for total privatization,today its PPP,what exactly do you want?or more appropriately,when exactly will you stop blaming others for what your greed,selfishness and delisional self-importance has led you?For your info.,all such schemes will be firmly resisted n fought to a standstill.if privatzation is d new magic wand for the health sector,it is to b total i.e all depts!Conversely,u want PPP?it has to start from d consulting room,down to d theatre n all other depts shikena.Anything short of dis is an open invitation to anarchy(borrowng d words of NMA).I wonder wen u guys will stop thing that d hospital was made solely for u,hence,every other pesrons n groups thr must b brought to subjection n servitude n I wondey why NMA has been foisted with leadership liabilities for so long,aint thr decent members that can pilot d fast-becoming hopeless association?Sigh!make I stop here for now,oya,attack me.

PPP is already operational in hospitals in some states. Some eastern state teachin hospitals already Hv PPP , in the west, a very good example of PPP is the lagos state university teaching hospital laboratory ( it is called BT diagnostics) the pharmacy in LASUTH is also under PPP , the state of the art ICU is under PPP ,the new renal centre recently opened in gbagada local government is under public private partnership (PPP)!!!!

sogodihno: Dz NMA pple sef. yesterday u were saying privatisation today u are saying PPP. (PPP ko PSP ni). u guys dont even know wat u want. if there's any privatization then it must be total privatisation of evry department in d hospital.
Anyway let's watch how dz season film go end.

it wouldn't matter if it turns out to be partial or total privatization. It would interest u to know that privatization of clinics and theatre services would benefit the doctors and nurses more because they would b paid per there input.. Remember wat they offer are services not products like the lab or the pharmacy

ottizz: Unfortunately, you are not following my logic.

there should be a CEO of a university too who could b anyone from NASU. Even the court bailiff too should b appointed justice of the Supreme Court and even attorney general. Mtscheeeeew

ottizz: Unfortunately, you are not following my logic.

because ur submission is actually devoid of logic

Without doubt PPP is the way to go

allycat: Zeuss, are you really a fellow? Because if you are one I will fine you for trying to confuse me with submento bregmatic diameter and stuff? On a serious note did you finish from Uniport, because I did soooooo many years ago. I'm ancient

LOL ... No I didn't finish from uniport. I did all my trainings in Ife(OAU)

drered: That's your excuse? What happened to global best practise doctors clamour for and using what attains in developed countries as a framework? Only when it suits doctors yeah? But quoting relatively and remuneration from UK/US hospitals is no problem at all..

no one is quoting relativity or renumeration from UK/US . Relativity and renumeration is common sense. I personally Hv workers that work for me in a telecommunication firm, they are paid based on their academic qualification , responsibilities and output. I can't remember copying that...it's just common sense !

ebner70: Once upon a time, a magistrate asked for assistants to be employed in a
bid to make his services more efficient. After some time, they got so
good in their specific tasks, they felt
indispensable and proficient enough to do all the magistrate did. They
began to agitate to bear the titles "Esquire" and "SAN". They began to
blackmail a weak government seeking re-election.
They went on strike and locked up the courts to prevent the magistrate
from working (knowing that left alone, the magistrate could still see
cases).
These assistants also went to the media and began to mislead the
public. The government
without proper consultation or consideration of "international best
practices" agreed to the
demands of these assistants due to their large number (and monetary
influence?).
So the magistrate went on strike and left them to attend to cases.
Haba, Magistrate! Why should you have gone on strike? Here's the
reason why:An analysis of JOHESU:
Nurses: Most nurses always wanted to be nurses. They love their
profession and work closely with doctors despite the often overbearing
attitudes of
these doctors. They appear not to be too keen on this JOHESU fight as
they lack the inferiority complex displayed by other members. Within
their ranks is a battle between the traditional
Registered Nurses and the university trained B.Sc Nurses. This may
contribute to their disinterest. A lot of them are married to doctors, have
dated doctors or have doctors as children.
PS: "Doctor" refers to a medical doctor who has sworn the Hippocratic
oath or a similar oath and carries a licence to practice Medicine.
Pharmacists:
These professionals are university trained. Unfortunately, in the
government sector, their
role appears to have been largely limited to procuring, stocking and
dispensing of medications. Their occasional attempts to involve
themselves in patient care is often tainted by the mutual suspicion
between them and the clinician (doctor) directly responsible for the
patients.The Pharm.D (Doctor of Pharmacy) programme is currently the standard
in the USA but is under some controversy in Nigeria as other university
academics (excluding medical doctors) are unhappy by what appears to
be a shortcut to a Ph.D equivalent.
Some pharmacists want(ed) to be medical doctors. In some pharmacies,
they are already masquerading as doctors.
Some are quite satisfied being what they always dreamt of.
Optometrists:
These are trained in the University to measure refractive errors and
prescribe lenses (glasses). In addition, they receive clinical training in
management of simple eye disorders.
Ophthalmologists (medical doctors specializing in eye disorders) are
inadequate in number and are
more focussed on eye diseases. Optometrists provide valuable services
as primary care providers and even ophthalmologists go to them
for glasses...but...
They are not doctors in the medical sense. Some universities run 6 year
courses and award O.D. (Doctor of Optometry).
However, when it comes to major eye disease and eye surgery, only the
ophthalmologistis licensed to treat.
Optometrists are doing well financially based on their private practices.They are not key militants in the JOHESU saga.
Physiotherapists:
These relatively new and few entrants into Nigeria's health sector are
University-trained to carry out physical rehabilitation of patients. Some
also run private gyms.
Depending on their training institution, they receive bachelor's or
"doctorate" degrees. Most of them will confess to have chosen to read
Medicine
initially. Like the general public, most of them were not aware of their
current profession when they got university admission.
Their association is rapidly becoming one of the more militant JOHESU
affiliates.
Medical Laboratory Scientists (Technologists?)
These are the arrow-heads of JOHESU. As a group, they have the free
time, the resources and the lack of professionalismand empathy for
suffering patients needed to start this controversy.
These staff are usually not university trained as their programmes are
run by accredited teaching hospitals. They obtain memberships and
fellowships of the institutes of Laboratory Science (or Technology)
allowing them to work in Pathology laboratories.Virtually all of these folks had the ambition of being medical doctors but
could not meet the requirements.
In better countries than Nigeria, laboratories are headed by research
scientists (in research institutes) and by consultant pathologists (in
hospitals). Research scientists are typically Ph.D holders while
consultant pathologists are medical doctors with postgraduate
specializationsin Pathology.
In Nigeria, they are quick to claim they do all the work in the
laboratories of government hospitals.
In their private practices, most masquerade as doctors, prescribing
antibiotics and other drugs after spurious "Typhoid" tests.
Having grown wings, they fired the first salvo by declaring their right to
perform accreditation for all labs in Nigeria including side-labs in private
hospitals.
The next issue was preventing resident doctors in training from
accessing the labs to carry out procedures (yet they claim they do all
the work).
It got to the point, doctors were physically harassed by laboratory
scientists and hounded by the Police and SSS on the instigation of these
technologists. Luckily, most security agencies quickly washed their hands
off this matter.Interestingly, when JOHESU members (or their family) get ill, they never
go to their fellow JOHESU members for care or advice! They always look
privately for the same doctor they insult publicly. And the doctors still
treat them specially "as colleagues".
This JOHESU problem appears to be a problem of the teaching
hospitals. State-owned hospitals and private/institutional centres would
not condone this needless rabble-rousing and jostling for primacy.
Nigerians shouldn't permit persons without direct involvement in patient-
care add to the many problems already facing our healthcare system.
Nigeria is not the only country running a teaching hospital system. Let's
look at the successful models in other countries and make things work.
That way, all these unnecessary crises in our health system will end.

was having a glass of vodka while I read ur post. Though ur post is so so true but ur presentation was so hilarious I almost aspirated.lol

ottizz: A physician is trained to manage patients but not trained to manage a health-system. In fact many physicians are bad managers, not because they are not smart, but because they are not cost-benefit smart. In fact a lot of hospitals in the mid-west of the US has nurses as their COO. This is why a lot of MDs are now going for their MBAs, simply because they were not adequately prepared for management positions in medical school. This current conundrum can be rectified by the government if an office of CEO is created while also retaining the CMD. Chief medical director in its current form is a misnomer. CMD should not be the person in charge of the medical center but rather the person that is responsible for management of the physicians and patients. And this position should only be reserved to the physicians. CMD should be on the same level as the Chief nursing officer (CNO), who is responsible for the management of nurses. Management of the medical center should be reserved to the CEO and COO, and should be based on their experience in hospital management rather than how well one knows the human physiology and anatomy. Anyone, therefore, can be the CEO if qualified.

to follow ur logic, no seasoned professor should become a vice chancellor as long as he/she is not from the department of management and accounting. Infact some NASU members who are themselves graduates shld be more eligible

[quote author=joker5180]" doctor of medical lab science" is next, I think they are still 'googling' to find out if it is been offered in UK or US[/quote that was so funny , I almost aspirated

He talked about privatizing the clinical outpatient department . No big deal. I can bet u medical doctors won't have any problem with that.meanwhile,The pharmacy department ,physiotherapy, laboratory departments are even much easier to privatize.I say let's privatize ALL

jideolubiyi: REVISITING THE NMA STRIKE - MY CANDID OPINION

I feel compelled to write on this subject because of its seriousness and the dearth of objective analyses in this forum. It is an emotive subject for both the NMA and JOHESU, and I can understand why punches fly around, but the parties must rise above petty and emotional considerations if we are to find a way forward.

The NMA has a list of 24 demands but I will limit myself to the most contentious ones. At this stage, it is probably best that I introduce myself. I am medical doctor of Nigerian heritage practising in the UK.

WHO SHOULD HEAD THE HOSPITAL
There is no contention – the medical doctor is the head of the clinical team. He/she leads the ward rounds, clinics, surgical operations, multidisciplinary meetings etc because the ultimate responsibility for patient care rests in his/her hands. The headship of the hospital is a different matter. This is an administrative role and needs not be occupied by a medical doctor. This job is better in the hands of people who have administrative or business management skills. This is the case in countries like the UK, Canada and the US, which heavily influence our health system. Therefore, it is difficult to reason with the NMA why this job should be the exclusive right of medical doctors.

NON-MEDICAL CONSULTANTS
The doctor-patient ratio in Nigeria is abysmally low and very unsafe. In my view, the role of non-medical professionals such as nurses, physiotherapists, pharmacists etc needs to expand to cope with the demands on doctors. It is important that this is done in a safe way by providing the appropriate level of training for these individuals. This is the case in countries such as the UK, Canada and the US where consultant nurses, pharmacists etc have existed for a few decades now. I do not see any problem with non-medical consultants as long as these individuals are appropriately trained and can practise competently, safely and within an agreed framework. If this arrangement enhances patient care, then where is the problem with it? Pursuing this demand is tantamount to the NMA obstructing the professional development of JOHESU members, and I don’t think this is helpful to anybody.

HAZARD ALLOWANCE
The types of hazard and the level to which healthcare workers are exposed vary considerably and depend on the type of job they do. Psychiatrists are hardly exposed to body fluids and their risks for contracting diseases like HIV and hepatitis are much lesser than a theatre scrub nurse. The risk of physical assault by a patient is higher for a psychiatrist than for a surgeon. And because psychiatry nurses spend more time with the patients, their risk of assault is arguably higher than the consultant psychiatrists. The people who work in radiology departments e.g. radiologists, radiographers, nurses, porters and so on have greater exposure to radioactive materials than everyone else in the hospital.

The health hazard allowance is a pittance – it needs to increase. However, I think it is important to get an independent risk assessor for impartial advice.

MISCELLANEOUS
I have read far too many emotional arguments on the subject of this NMA strike and very little of an objective discourse. It is important that I draw your attention to a few of these.

What has become obvious is the lack of understanding of the concept of teamwork. There is a pervasive notion among doctors that the other healthcare workers are there to serve them. JOHESU members think that doctors have become too conceited for their own good and are determined to put them in their “places”. The most important person in the hospital is the patient – not the doctor, nurse, pharmacist or laboratory scientist. Every team member is important and must be respected, including the people who do the least clinical jobs like cleaning; I don’t imagine that any hospital will remain open for long if its cleaners went on strike and dirt was allowed to accumulate to the point where it constitutes a health risk.

I have heard so many anecdotal accounts of nurses not joining doctors on ward rounds or pharmacists altering prescriptions without first discussing these with the prescribing doctors or laboratory scientist slapping doctors; and these accounts are being given as reasons why doctors must continue to head hospitals. These are disciplinary matters, which should be managed according to existing procedures. These excuses are emotional and should not be used to block the professional development of others.

Another recurrent theme in these debates is the abuse of junior doctors by both medical and non-medical staff, which appears to be endemic. There is a consistent account of junior doctors being asked to do other people’s jobs such as collecting blood from blood banks, taking samples to laboratories etc. In extreme cases, these doctors are asked to undertake non-clinical tasks by more senior doctors. This is simply unacceptable! I think it is fair to place the blame for this at the hands of consultants who are responsible to the junior doctors. But this in itself is not a good argument for blocking JOHESU members from becoming consultants in their specialties or for stopping them from heading hospitals if they have the right qualifications.

I am concerned that the NMA is losing public sympathy. Increasingly, I hear people describe doctors as selfish and heartless. This is very sad and rather unfortunate. They say doctors do not have any motivation to end the strike because patients are forced to pay exorbitant fees to them in their private hospitals. Those who cannot afford these fees are left to suffer or die. If the NMA has made any efforts to carry the public along, these do not appear to have been effective (yet).

CONCLUSION
To conclude, the current strategy (i.e., recurrent strikes) is not working. Over the last decade or two, the NMA and JOHESU have taken turns to go on strikes. Perhaps, it is time to sit both parties and resolve these contentious issues once and for all. It’s pointless for the government to enter into agreements with one party knowing fully well that the other party will ask for a near-reversal of those agreements.

It has become imperative to incorporate Ethics, Teamwork and Communications into undergraduate curricula.

Disciplinary procedures are there for a reason. They must be followed when necessary.

Although I practise abroad, I should point out that this strike affects me too. My family and friends all live in Nigeria. And who says I am not planning to come home to practise?

Lastly, let us be mindful of our own mortality – most of us will be ill someday. When this happens the only thing that will matter to us is to be looked after by caring and competent health-workers regardless of their individual specialisation. We can create that environment if we forget our individual egos and work as a team." -- Ijabla Raymond MD

mr "Dr" how could u be practicing in the UK and expect ur view on health issues in Nigeria to make much sense. Have u ever heard of the word "peculiarity"??

Martin0001: Mutual respect is lacking in Nigerian hospitals. Just like you noted, everybody in the system is important and should be accorded due respect and at same time hoping that that same person reciprocates it. We cant all be doctors or nurses or pharmacists or Optometrists or radiographers etc but we all exist because of the patient. I agree with you, it is high time government brings every profession in the health sector to the same table for a discussion on how all these bickerings should be resolved and chart a way forward for our ailing health system and sector. If these continue, patients will suffer and the sector is further being destroyed.

there is no point bringing anyone to any table. Nigerians are very indisciplined. People are usually not proud of their original role in public hospitals. They all want to play the role of another person"s profession. SOLUTION Very simple OUTSOURCE most departments or PRIVATIZE the hospital completely...simple !

YourHealthlabs: Although this is an old thread but i'll like to educate Dr enabulele a.k.a Vibro cholere is gram positive..

There are Consultant Biomedical Scientists in the U.K. Medical laboratory Scientists are known as Biomedical Scientists in the U.K with the same job description. In Austrialia they are Consultant Medical Scientists, in the U.S Consultant Clinical laboratory Scientists.

Enabulele wants to head the Scientist the Laboratory but he went on erroneously calling Vibro cholera a gram positive organism in a national newspaper and misleading ignorant Nigerians. A mistake an Intern Scientist can never make.

I called a junior resident yesterday to remind me the value of the submentobregmatic diameter, meanwhile I am a fellow of both d west african and the national post graduate college of surgeon...... Did Dr enebulele tell u that he is not fallible Is there any human u Hv met that is not fallible Oh I remember ur intern scientist !

joshuapharm: Pls Mr laalamed, whenever u're mentioning professions for unnecessary consultancy conferment, pls do not mention Pharmacy again.. As we av consultant pharmacists all over the world..

A "nurse consultant" is one that assist a firm on legal matters that bothers on health HE/SHE DOES NOT WORK IN AN HOSPITAL . A "consultant pharmacist" is a pharmacist that is employed to work and assist with medications in the old people"s home NOT IN AN HOSPITAL !!!!!!!!

Read ur own post carefully and you will see that nigerian health system is disjointed.
An optometrist is a primary health care giver like u rightly pointed out. So I wonder why they are bein posted to secondary and tertiary health institutions where we already Hv the opthalmologist ( a specialist medical Doctor)who is trained to manage complicated eye conditions.only to find the optometrist competing for consulting rooms and patient wt the opthalmologist!! Optometrist are supose to be at the primary health centres then refer difficult cases to the secondary or tertiary hospital to be seen by opthalmologist

Ecosol: Very well said. The blue print for consultancy is very much in place already infact there are consultant pharmacists in some teaching hospitals and Fmc already and they attain this status through rigorous tutulage, research and exam certification by the West African post graduate college of pharmacists. But the hospital management hav refused to recognise dem let NMA and JOHESU drop sentiments and iron thins out through dialogue its the only way to avert all this bickering.

am sick of this consultancy thing . The way u even talked about hospital consultancy put me in no doubt that u know only but little about an hospital consultancy. The west african post graduate college of pharmacist u cited( mind u it used to be called west african pharmaceutical federation until 1997. The reason 4 d change of name ? Well u know d answer..lol )Meanwhile all the Franco fone countries that Ofcourse makes up a considerable percentage of the west african sub region pulled out of it because they didn't REALY see it's use afterall PHD in pharmacy is still obtainable in universities. Well irrespective of whatever name u call a post graduate college , it would interest u to know that it still doesn't automatically bestow upon anyone d title of a CONSULTANT!! I will xplain further, as an example,the west african college of surgeon would bestow upon u a FELLOW when u graduate therefore u automatically become a a SPECIALIST in ur chosen field but NOT A CONSULTANT. Ones u become a fellow of a post graduate college,u wil b disengaged from the hospital I.e u become unemployed. Then u may reapply to the same institution or another. If the hospital or any other organisation sees a need for ur service then they will CONSULT you. Therefore u bcome a CONSULTANT in that hospital or organisation . So let these ur pharmacist and nursing fellows u talked about agree to b disengaged from service first and then wait for the ministry of health to determine if this their "specialties" is indeed needed by the hospitals ...then they would b consulted and automatically bcome a CONSULTANT....very simple !!!!

Ecosol: Very well said. The blue print for consultancy is very much in place already infact there are consultant pharmacists in some teaching hospitals and Fmc already and they attain this status through rigorous tutulage, research and exam certification by the West African post graduate college of pharmacists. But the hospital management hav refused to recognise dem let NMA and JOHESU drop sentiments and iron thins out through dialogue its the only way to avert all this bickering.

A "nurse consultant" is one that assist a firm on legal matters that bothers on health HE/SHE DOES NOT WORK IN AN HOSPITAL . A "consultant pharmacist" is a pharmacist that is employed to work and assist with medications in the old people"s home NOT IN AN HOSPITAL !!!!!!!!

Government and the hospital board should make it a criminal offence for anyone wishing to go on strike and then lock up government facilities and take the keys home during that his/ her strike period

Favourtony: We are simply agitating for our CONHESS. "E mere nwata ka emere ibe ya, obi ga-adi ya mma". Thank u

no one says u have no right to agitate for whatever. But just make sure u guys don't lock hospitals" properties and take the keys home. Just go home and leave the government properties alone. The keys to the theatre, the offices, the record rooms are not ur father"s property

otokx: It is alleged that doctors went away with the patients folder in UPTH so the nurses and others could not administer care.

My colleague who had just been operated by doctors had to be discharged home. When next you doctors are going on strike do well and leave the folders - it is also public property.

WITHOUT DOUBT u are a blatant LIER

prettyprettywow: Na wa o. Imagine Obembe "we have medical and non-medical workers. Medical workers are Drs while non-medical are allied health workers" If the word "medical refers to Drs alone, I wonder why we have "medical"lab scientists, Medical rehab, medical image scientists.

medically qualified doctor
medically qualified doctor Physician. In the UK, the term doctor is more widely used and understood to mean physician; medically qualified may be added to doctor to confirm that the person in question is a medical doctor and not a degree holder in an unrelated, non-medical field.
Segen's Medical Dictionary. © 2012 Farlex, Inc. All rights reserved.

sogodihno: I av to disagree on one point sir: Medical is not restricted to doctors, because if it's restricted to doctors, den d word "medical doctor" will b tautology. Tanks

medical
adj.adjective
Of or relating to the study or practice of medicine.
Requiring treatment by medicine.
n.noun
A thorough physical examination.
Source: Houghton Mifflin
Google is ur friend

allycat: Some of the demands surprised me. Did some of these people know the brief of the Commitee they were to face before they appeared. What does a Commitee on inter Professional relations have to do with HND/BSC dichotomy or making programmes degree programmes so that groups will now be respected. Or how do people who say they are primary eye care people demand to consult in tertiary centres. It appears the role of teaching hospitals and general hospital is unknown to these groups. Tertiary hospitals are not supposed to be primary health care centres they are not where people should go for uncomplicated cases like straight forward malaria or normal deliveries. It is because everyone wants the best healthcare and want to be seen by specialist that you have even the simplest cases running to a general or teaching hospital. The Primary eye care specialist should be fighting to be posted to primary health centres not fighting for seats with ophthalmologist who are by their designation providers of secondary and tertiary eye health. The teaching hospitals are set up to train medical personnel so that is where medical students and postgraduate students in gynecology learn to take deliveries.
Or is it people asking for internship and residency for their professional groups. Doctors fashioned out how they believed doctors could be trained hundreds of years ago. They decided the that after didactic lessons and clinical training a fresh doctor still needed to work under supervision for one year before getting a full license, likewise that medical postgraduate training could not be done in a classroom but as an apprenticeship. Thus residency and house job evolved. So now because people believe residents and house officers are "enjoying" they suddenly want Yayale to declare these programmes into existence.
It's obvious the beef is that doctors are enjoying too much so we to want what they have. I didn't see anything that they asked for that had to do with patient care rather it was all about what doctors were getting.sorry I am being unfair the health records group wanted electronic health records, how does that tie in with inter professional retaliations.

i hope yayale himself gets to read this ur beautiful piece

Hmm

aluunoble: My dear friend, dnt mind that fellow. Maybe he's one of them (the we-no-go-gree faction of NMA).

So, this information to him might be deemed unsavoury! Am not taken aback by the disputation and query of the veracity of the source of this info. Pls save ur breath for it's a known fact that a good number of Docs are not so comfortable with some ill demands of NMA. They have no option than proceed in the industrial action so as not to be tagged saboteurs!

pls visit this link. http://www.medicalworldnigeria.com/ and then if u still believe it was only "4" demands they indeed spent d whole of their time in abj to iron out then pls do me a favour by not responding to my post

prettyprettywow: http://dailyindependentnig.com/2014/07/strike-division-among-doctors-threatens-nma/

The source may be a joke sha, but it is just a report, it mustn't be true

yea the source is a joke

prettyprettywow: Abuja — The strike embarked upon by the dental and medical practitioners under the aegis of the Nigerian Medical Association (NMA) has successfully placed a sharp division among doctors in the country.

The division became evident and more pronounced at the delegate meeting of the NMA held on Saturday in Abuja, with some doctors threatening to break from the NMA and form their own separate body.

The meeting which was scheduled to start by 8 am and end by 10am could not start until 9am. It however lasted for over 12 hours.

Anxious journalists spent the whole day waiting for the outcome of the meeting. They were however disappointed when late in the evening, it was learnt that the NMA could not resolve its internal issues and hence the delegates voted that the strike should continue.

A reliable source at the meeting, who confided in Daily Independent in Abuja, said the meeting did not agree to call off the strike, because the NMA officials refused to table to the entire delegates the 24-points demands it gave the Federal Government for assessment at the meeting.

Instead, the source said the NMA officials only tabled three points to the delegates for discussion resulting in a heated argument and sharp division among the doctors. This also led other delegate to accuse the NMA officials for having ulterior motives for embarking on the strike.

The source who pleaded anonymity said: "The meeting could not arrive at a tangible conclusion on the strike because the delegates demanded that the 24-point demand be placed on the table for assessment (to decide whether or not to) call-off the strike, but the officials only presented three points.

"This did not go down well to the delegates. Most of the doctors are eager to call off the strike.

"The meeting was aimed at assessing the impact of the strike and also looking at the effort of the government in meeting the 24-points demands. We wanted to see if the government has really tried in meeting some of the demands, then we call off the strike and continue with negotiation.

"Most doctors are worried that innocent people are suffering while others are dying. Again, the issue of Ebola has come up. Therefore most of the doctors are eager to go back to work so as to save people from dying unnecessarily.

"There is division among the doctors. Majority of the doctors said if the officials cannot bring to the table the 24-points demand for discussion, then there is no way the strike could be suspended."

On the way forward, the source said: "Until when the delegates agree on the status of the 24-points demands given to the federal government before they can vote for the strike to be called off."
http://allafrica.com/stories/201407280055.html

Your source is a joke...THERE ARE NO DIVISION IN NMA

aluunoble: Sir, in as much as I appreciate the import of resident docs, which I hv always known remains indisputable just as other health care providers, the point am making is that Resident docs shuld the privatisation recently clamoured for holds sware will be 100 per cent submisive to their employer. Do u think u residnt docs will be receiving up to #250k per month for a start in all d private teaching hosp?

Moreso, who will be responsible for the oversea residency training which is one of the demands of NARD under the aegis of NMA shuld it be granted?

Concerning ur assertion of Res Docs teaching medical stdnts, pls I want to knw if they dnt receive teaching allowance to justify their impartation of knwledge?

Hmmm I wonder what effect ur strike had the last time u guyz embarked on strike that ostensibly didn't yield any fruit. It only created leeway for ur ogas to wake up from slumber to do dia wrk, thereby justifying their bogus pay.

Anyway, I wish Nigerian health system luck!

I am not a resident doctor.

aluunoble: Sir, in as much as I appreciate the import of resident docs, which I hv always known remains indisputable just as other health care providers, the point am making is that Resident docs shuld the privatisation recently clamoured for holds sware will be 100 per cent submisive to their employer. Do u think u residnt docs will be receiving up to #250k per month for a start in all d private teaching hosp?

Moreso, who will be responsible for the oversea residency training which is one of the demands of NARD under the aegis of NMA shuld it be granted?

Concerning ur assertion of Res Docs teaching medical stdnts, pls I want to knw if they dnt receive teaching allowance to justify their impartation of knwledge?

Hmmm I wonder what effect ur strike had the last time u guyz embarked on strike that ostensibly didn't yield any fruit. It only created leeway for ur ogas to wake up from slumber to do dia wrk, thereby justifying their bogus pay.

Anyway, I wish Nigerian health system luck!

friend, if a private or public hospital wants to be competitive in the market it would definitely b wiling to sponsor its drs for oversee training to acquire special skills. As an example wouldn't u prefer to b operated in an hospitl renowned for carrying out minimally invasive surgeries?? Even other health workers would b sent for further training as long as the private hospitl management is convinced of the importance of doin such. . Another advantage of privatization is that worker"s duties and limitation would be well defined. Whoever is deemed not useful would b let off. If u a medical doctor is addressed as a nurse , pharmacist, lab scientist, or optometrist and u do not correct and introduce urself to the patient concerning who you REALY are and ur ROLE in the health team then u will b sacked and VICE VERZA... If u understand what I mean!!!

aluunoble: @ Oduduwaboy; dnt u think National Association of Resident Doctors (NARD) will be worst hit in the privatisation theory? Imagine if Oga Seun (by the grace of God) buys over LUTH from FG, will he pay a resident doc over #250,000 to use his facility (Seun Teaching Hospital, SETH) for training while the resident doc is flexing muscle with him, embarking on incessant strikes and threatening Seun Osewa his employer?

The reverse will be d case, Oga Seun will rather demand for school fee (u go fear private Uni)........otherwise u knw na *baning*!!!!!!!

there seem to b somtn about medical doctors residency progammmes that some pple don't seem to understand. Resident doctors are the power house of a teaching hospital. 1. They are already doctors 2. While runin their residency programmes,they treat /operate patients. In other word they sought out the primary reason y a patient came to the hospital in the first place 3. They also teach medical students 4. It would also interest u to note that some private hospitals in Nigeria are already offering residency training programmes and they pay d drs. 5.Medical residency and teaching hospital = symbiosis 6.Hv u ever asked urself y tertiary hospitals paralyses each time resident drs (not even NMA this time ) go on strike

Summary Of The Yayale Ahmeds Presidential Committee On Inter-Professional Relationship In The Public Sector: Interactive Session With Stakeholders

SUMMARY OF THE YAYALE AHMED'S PRESIDENTIAL COMMITTEE ON INTER-PROFESSIONAL RELATIONSHIP IN THE PUBLIC SECTOR: INTERACTIVE SESSION WITH STAKEHOLDERS.

Meeting started with silent prayer by all the attendees at exactly 11am.

Introduction of all participants and the associations they represent was done.

ASSOCIATIONS IN ATTENDANCE:
1. Association of Medical Laboratory Scientist of Nigeria (AMLSN).
2. Association of Pathologist of Nigeria (APN).
3. Association of Private Radio diagnostic and Imaging Directors.
4. Association of Radiographers of Nigeria (ARN).
5. Committee of Heads of Pharmacy in Nigeria Health Institutions.
6. Environmental Health Officers Association of Nigeria (EHOAN).
7. Guild of Medical Laboratory Directors.
8. Health Information Managers Association of Nigeria (HIMAN).
9. Joint Health Sector Union (JOHESU).
10. Medical and Dental Consultants' Association of Nigeria (MDCAN).
11. Medical and Health Workers Union of Nigeria (MHWUN)
12. National Association of Community Health Practitioners of Nigeria.
13. National Association of Government General Medical and Dental Practitioners (NAGGMDP).
14. National Association of Nigerian Nurses and Midwives (NANNM).
15. Nigerian Dental Association (NDA).
16. Nigerian Dental Therapists Association (NDTA).
17. Nigerian Medical Association (NMA).
18. Nigerian Optometrists Association (NOA)
19. Nigerian Society of Physiotherapy (NSP)
20. Nigerian Union of Allied of Health Professionals (NUAHP)
21. Pharmaceutical Society of Nigeria (PSN).
22. Senior Staff Association of University Teaching Hospitals (SSAUTH)

REGULATORY BODIES IN ATTENDANCE;
1. Dental Technologists Registration Board of Nigeria (DTRBN).
2. Dental Therapist Registration Board of Nigeria.
3. Environmental Health Officers Registration Council of Nigeria.
4. Health Records Officers Registration Board (HRORB).
5. Institute of health Services Administration of Nigeria (IHSAN).
6. Medical and Dental Council of Nigeria (MDCN).
7.Medical Laboratory Science Council of Nigeria (MLSCN).
8. Medical Rehabilitation Therapist Board (MRTB).
9. Nigerian Institute of Science Laboratory Technology (NISLT).
10. Nursing and Midwifery Council of Nigeria (NMCN).
11. Optometrist and Dispensing Optician Registration Board of Nigeria.
12. Pharmacist Council of Nigeria (PCN).
13. Radiographers Registration Board of Nigeria (RRBN).
14. West Africa Health Examination Board (WAHEB).
15. Community Health Practitioners Registration Board of Nigeria.
16. Institute of Public Analysts of Nigeria.

The Chairman, Alh. Yayale Ahmed welcomed everybody and stated that, he hoped the committee would find a lasting solution to the disharmony among the stakeholders in the health sector. He promised the committee would do a thorough and perfect job and be an unbiased umpire. Not the headship of the organisation that matters but raising a team to deliver the best for our patients in line with the best practices across the globe. He prayed, this would be the last face off and disharmony in the health sector.
He further stated that all memoranda submitted by each association and regulatory bodies were carefully gone through so all we needed to do was for each association to present what should be solutions and the way forward.

Each association was given 7mins to make her presentation and 2mins to conclude.

AMLSN;
Accused ASSOPON of not changing from the old practice, which gives room for anachy in our laboratories.

APN;
Demanded for an Organogram which should have a Pathologist as the undisputed head of the team in accordance with MDCN Act.

Assoc. of Radiographers of Nigeria(ARN);
Accused the Radiologists of not issuing reports on time, which they claimed is largely due to maladministration of the head of the department of radiology.
Their prayers are;
1. Radiographers to be allowed to scan the patients as this is now done in the advanced countries.
2. Radiographers should be allowed to report their films.

Committee of Heads of Pharmacy in Nigeria Health Institutions;
They alleged;
1. Repression from Doctors.
2. Their fellowship not backed by any circular, so they want the fellowship to be recognised in the scheme of service and remunerated accordingly.
3. There's stagnation in their carrier progression which should be corrected.

Environmental Health Officers Association;
1. Functions are streamlined in the ministry
2. They want a directorate of environmental officers in the ministry.
3. Recruitment of more environmentalists.
4. From the Ministry of Health, ministry of preventive health should be carved out so as to resolve role conflict that is in existence presently.
5. Adequate and sustainable budgetary allocation.
6. Department of environment should be captured in the 3 tiers of Govt.

Guild of Med. Laboratory Directors;
1. Their colleagues in the public sector are repressed.
2. The infighting among stakeholders should stop.
3. Employment of Auxiliary technologists should be discouraged.
4. Allow independent observers to inspect laboratories both within and outside the hospitals.
5. Respect the rule of law.

Health Information Managers Association of Nigeria:
1. They alleged complete neglect.
2. Not allowed to rise to the peak of their profession.
3. Exclusion from decision making in our hospitals.
4. Hippocracy of the managers of our hospitals.
Prayers;
1. Record officers to be drafted to all departments in the hospital eg NHIS, A&E etc.
2. Records dept to be operated electronically
3. A curriculum should be developed for them within the university system in Nigeria.

JOHESU:
1. NMA is not a registered labour union, it's a professional association operating as a labour union.
2. The extant Labour laws in Nigeria as well as International Labour Organisation laws should be adhered strictly to by the Govt.
3. JOHESU under it has 5 registered unions hence can negotiate with the Govt.
4. Clinical services in our hospitals can be headed by doctors but the head of health care services should be left open for any qualified health managers.
5. They desire equity, fairness and justice in the health sector.

MDCAN;
1. Medicine should be practiced according to international best practices.
2. All areas in the health sector has a doctor consultant in that field so creating a non doctor consultants will bring chaos and anarchy in such department and who will take the ultimate responsibility of patient care?
3. The laws regulating medical practice in Nigeria need to be amended.
4. Surgeon General of the federation or Chief Medical of health office should be resuscitated.

MHWUN:
1. The headship of our institutions should not be the exclusive right of doctors, every other professional in the health sector should be able to apply for the post or in the alternative a professional administrator to manage our health system.
2. Doctors dominate all the directorates in the ministry of health.
3. Salary relativity should be equitable, they want a single salary structure in the health sector.
4. Entry points for all graduates in the health sector to be level 9.
5. Advocated a health summit.

NAGGMDP;
1. Medicine is an act with a team work hence we need a leader in that team who is a doctor.
2. Appropriate regulations from all regulatory bodies should be sought after.
3. Indiscipline and insubordination should be tackled frontally.
4. Each professional should know his/her limits
5. Respect team work and leader.
6. Office of the Chief Medical of Health or Surgeon-general should be resuscitated.
7. Relativity as it is practised world over should be maintained in our health sector.
8. Conflicting laws governing health care delivery in Nigeria should be abrogated.

NANNM;
1. Training, skill acquisition, and service delivery have moved up.
2. Nurses are not seen and recognised as a professionals
3. They want intenship program for graduate nurses.
4. Fellows of postgraduate nursing college should be recognised as consultants.
5. Incursions of doctors into their profession eg. midwives are no longer allowed to take deliveries in teaching hospitals, Nurses no longer do wound dressing on the ward.
6. Doctors as the head of the team that they claim to be must carry everybody along.
7. Other professionals in the health sector must be allowed to head the hospitals.
8. Doctors should see others as colleagues and not look down on them.
9. All laws should be harmonised

Nigeria Dental Therapist Association;
1. Nigerian university should be allowed to train them in other words, they want to start getting BSc degree.
2. It's a branch of Dentistry but they are not allowed to do their job because of hierarchy in the system.
3. Disparity in the call duty allowances between them and the Dentists is too wide. 1.2 to 7.5%.
4. There's no provision for their freshers to do internship which they want government to make provisions for.

NMA:
1. Medical practice is about patient care therefore, adherence to core professionalism, job description and definition in accordance with international best practices should be our focus.
2. Adherence to principles of relativity in line with training, levels of responsibilities etc, should be strictly observed.
3. Appropriate no-skewed job evaluation facing the reality, as against 2008 evaluation report that NMA refused to sign because of the fraud detected in it.
4. Total avoidance of nomenclature and designations alien to medical practice.

Nigerian Optometrists Association;
1. This profession is supposed to be responsible for primary eye care in our society, but they are not allowed to do so by the ophthalmologists.
2. There's rivalry between them and the ophthalmologists
3. Optometrists are relegated to doing refraction alone, they are not allowed to consult at the OPD.
Prayers;
1. Full recognition and participatory roles in the care of the eye.
2. They should be given full opportunity to consult at the OPD.
3. Department of optometry to be created and stand alone in our hospitals.
4. Scheme of service to be created for them.

Nigeria Society of Physiotherapists;
1. There are certified consultants and specialists among them who should be allowed to practice to their full potentials.
2. Support JOHESU's submissions.
Prayers;
1. In full support of relativity but should be paid according to training and skills.
2. Directorate of physiotherapy should be created.
3. Clinical residency program should be started in physiotherapy.
4. There should be carrier progression without repression or suppression

Nigerian Union of Allied Health Professionals;
1. Appointing doctors both as Hon. Minister of Health and Minister of State for health is no longer acceptable to them, henceforth, for peace to reign doctor should occupy 1 while any other health professional occupy the 2nd.
2. Entry point for all degree interns should be level 8 step 1, pharmacist, 8 step 2, and doctors, 9 step 2, thereafter, all allowances should be fixed for all, abolishing salary dichotomy we are experiencing in the health sector.
3. Directorate for all health departments.
4. In the composition of the management team, instead of about 8 doctors representing themselves and other health professionals, the distribution should be spread out.
5. There shouldn't be a perpetual leader in the health management team although in the clinical setting this can be. In each department, other professionals there must be allowed to head, eg. Radiology, pathology etc.
6. Headship of the hospitals should be left open to all.
7. Registered trade unions should be recognised in the hospitals and be represented in committees and especially, in the National Council on Health.
8. We don't need a Surgeon General.
9. No particular section should lay claims to be the head of all.

PSN;
1. A Pharmacist is an indispensable link in the care of patients.
2. The role of pharmacist should be well defined in Nigeria.
3. No single health profession can provide the health needs of a patient.
4. A pharmacist is a 7man professional viz; a pharmacist, decision maker, leader, teacher, community leader etc.

SSAUTH;
1. There's shortage of staffs in our hospitals.
2.NMA and NARD are not registered trade unions so, they are not qualified to call for strike.
3. Direct employee of the hospital should be the CEO and not doctors as it is obtainable now.
4. Support creation of more directorates for other professionals.
5. The pronouncement made by NMA that some units should be concessioned or outsourced was unethical.
6. They want only one salary structure in the health sector.
7. Justice Gussau committee report of 2008 should be implemented to the letter.

Dental Technologists Registration Board;
1. Discrimination between HND and BSc holders should be looked into.

Dental Therapists Registration Board;
1. They want degree for Dental Therapists so as to earn respect from other professionals.
They repeated virtually all what the association presented.

Environmental Health Officers Registration Council of Nigeria;
1. Pure preventive health should be looked into instead of concentrating on curative medicine.
2. BSc degree for her members so as to enter into the management cadre.

Health Records Officers Registration Board;
1. To abolish the dichotomy between the HND and BSc holders.
2. To make it as a law that, all hospitals in Nigeria be it public or private should employ a record officer.
3. Record keeping in Nigeria must change from analog to computer.

Institute of Health Services Administration of Nigeria;
1. The leadership tussle should be looked into.
2. Proper structure for team work.
3. Reorganise Ministry of Health.

MDCN;
1. Improvement in funding the health sector.
2. The conflict between the MDCN Act and MSN Act must be corrected.
3. Team work and harmony in the health sector should not be disrupted.

MLSCN;
1. Claimed there's no conflicts in the MDCN and MLSCN Acts.
2. Hospitals to be headed by administrators.
3. Signing what you did not perform is tantamount to fraud so asking pathologists to append their signatures on the results of tests performed by medical laboratory scientists is no longer acceptable to them and this should stop.

Medical Rehabilitation Therapists Board;
1. Internship for their fresh graduates should be approved.
2. More higher institutions of learning should be compelled to offer the course.
3. Postgraduate training for them to be embraced.
4. Discrimination against them should be looked into.

Nigerian Institute of Science laboratory Technology;
1. We are all guilty of the mess we put ourselves in the health sector.
2. There's no reason for the infighting.
3. Discrimination cuts across and not limited to one group an claimed by all.
4. Call duty allowance should be extended to them.

NMCN;
1. The nurses constitute the largest workforce in the health sector.
2. It is the only profession having 24 hrs contact with the patients.
3. The shift allowance for nurses should be improved upon.
4. Government should look into method of salary negotiations.
5. The issue of skipping for nurses must stay.
6. Midwives should be allowed to palpate pregnant women and take deliveries in our tertiary institutions.
7. Internship for their graduates should be allowed.
8. More Nurses should be appointed into the boards of our health institutions just as we have Doctors in all the boards.

Optometrist and Dispensing Opticians Registration Board;
1. Creation of the department of optometry in the public service.
2.members should undergo internship compulsorily with adequate provision made for that purpose.
3. Review scheme of service to cater for their consultants.

PCN;
1. Government should compel all hospitals in Nigeria both public and private to employ the services of a pharmacist.
2. The activities of pharmacy technicians and patent medicine vendors should be looked into and properly regulated.
3. Government should improve on the funding of the council.
4. The council is opposed to the office of Surgeon-general as been requested for by NMA unless if the office is left open for other health professionals eg. Pharmacists, Nurses etc to aspire to occupy the office.

Radiographers Registration Board of Nigeria;
1. Increase in funding and proper monitoring.

Institute of Public Analysts of Nigeria
1. Proper integration into preventive health.

After all the presentations, the Chairman, appreciated all the stakeholders present, he asked, 'do you all believe that if there are no patients there can't be hospitals?' which we all answered in the affirmative, he further asked that in total honesty ' who do we think patients come to see in the hospitals?' There was murmuring. He reassured us that the committee would be unbias and that arrangements have been concluded for members of the committee to visit advanced countries to look and study their health systems and come out with recommendations in line with international best practices and put an end to recurrent altercations, indiscipline, insubordination and industrial disharmony in health sector.

Meeting was brought to a close at 5.10pm with silent closing prayer from everybody.