Doctors have again resolved to embark on indefinite withdrawal of services without further notice if by October 1, 2009, the Medical Salary Structure (MSS) is not restored for Medical and Dental Practitioners in Nigeria.
IT was a crisis, government for once, deployed all it had to avert. Again, it has to do with honouring an agreement reached between the doctors and all tiers of government over improved pay package and working tools.
Through out last week, the spectre of disrupted services hung over public hospitals in the country as the Health Minister, Prof. Babatunde Osotimehein and officials of the ministry battled to starve off what could have led to needless deaths in the nation's healthcare sector.
But on Saturday, leaders of the Nigerian Medical Association (NMA) took a landmark decision to shelve its planned strike action for Monday. The doctors, however, said they would undoubtedly go on strike by October 1 if the agreement were not ratified by the end of September as promised.
The Minister who has been in talks with the NMA on this issue for about four weeks deployed all the weapons in his arsenal to ensure that the strike was nipped in the bud.
Besides meeting with all the stakeholders, the minister enlisted the support of the Senate President, Speaker of the House of Representatives, the Sultan of Sokoto and the President of the Christian Association of Nigeria.
In the Minister's letter to the personalities, he reiterated his often stated fact that there is no disagreement between the doctors and the government, arguing that the only outstanding issue is the implementation of the agreed package. He promised that government is already working assiduously towards achieving the set goals and that all the relevant circulars are released in time.
The Minister also undertook visits to the Senate and the House Committee on Health to brief them on the situation of things, which led the Committees into mediating on the issue.
The efforts of the Minister got to a crescendo when he led the Association's Executives and the Chairmen of the State Chapters to the Presidential Villa in Abuja on Friday to meet with Vice President Goodluck Ebele Jonathan where the "final peace" was brokered with the assurances by the presidency that the agreed package would be faithfully implemented.
Apparently not carried by the assurances, some of the doctors insisted on going ahead with the strike as they said that the association had given government enough time to implement the agreement, which has been on the drawing board for 11 years.
But it took the intervention of elders of the association to calm frayed nerves. Consequently, they resolved at their Saturday meeting to give government another chance.
NMA National President, Dr. Prosper Igboeli, told The Guardian in a telephone interview after a press conference yesterday: "This new course of action was based on solid assurances from the highest level of government as arranged by the leadership of the Federal Ministry of Health. After due consideration of appeals from the presidency, the Federal Ministries of Health and Labour and other respected groups, it was agreed by doctors to give benefit of the doubt and shelve the planned strike that would have started tomorrow (Monday)."
According to the communiqu� signed by Igboeli; and the National Secretary, Dr. Kenneth Jonathan Okoro, it stated: "After due consideration of appeals from the presidency, the Federal Ministry of Health, the Federal Ministry of Labour, the Committee on Health in the Senate and House of Representatives as well as well-meaning Nigerians, and taking particular cognizance of the fact that ordinary Nigerians who did not contribute to the ruin in our health system will be most affected by the horrible consequences of a withdrawal of services by doctors in Nigeria, NEC (National Executive Council) resolved to give the government the 'last chance' to avert this action by fulfilling the pledge by the Honorable Minister of Health, re-affirmed by the Vice President of Nigeria, to resolve the dispute with the NMA by circularizing and implementing a Medical Salary Structure (MSS) on or before September 30, 2009. This is without prejudice to a health salary structure for other health professionals, which was actually introduced alongside MSS in 1991 and was implemented up till 1998.
"This is a demonstration of the maturity, goodwill and patriotism of NMA and Nigerian doctors as well as the fact that it is government's insensitivity that ultimately leads to reluctant withdrawal of services by doctors.
"NEC also resolved that if by October 1, 2009, the MSS is not restored for medical and dental practitioners in Nigeria, all doctors in Nigeria will embark on indefinite withdrawal of services without further notice."
The planned strike action, which had been on the cards since May when the Association had its Annual General Meeting in Abeokuta is in reaction to the non-implementation of the MSS, which the doctors had been pushing for since 1998.
Health Minister, Osotimehin, in a reaction to the decision of the doctors to listen to government, described it as patriotic. He said: "Given the sensitive nature of the industry and the severe consequences of a strike action on the vast majority of Nigerians, we cannot but give it to them that they have done well. We will do our best to ensure that the commitment that the government has made at the highest level is brought to practical reality. The doctors will never have cause to go on strike on this issue again because all that is necessary to be done would have been done by then to bring this agreement into effect."
Osotimehin extended a hand of fellowship to the NMA and other professionals within the health sector, saying, "we can only succeed when we work together and cooperate. It is only when we work together that we can turn around our ailing health sector."
The Guardian learnt that although the Salaries and Wages Commission (SWC) has finished the computation of medical doctors in government hospitals and the financial implication of meeting their demands, the commission is still working on that of other health workers.
It was learnt that the SWC will have to finish that of the other health workers before the document is sent to the Secretary to the Federal Government (SFG) for onward delivery to the President and the Federal Executive Council (FEC) for their accent, before it is presented to the National Assembly for approval.
Although, government has accepted in principle to release the enabling circular for the new salary scale for doctors, government is concerned about the ripple effects it would trigger off in the usually restive health sector.
"This issue portends grave danger to the health sector," declared Dr Godswill Okara, first Vice President, Association of Medical Laboratory Scientists of Nigeria (AMLSN).
The association in a letter sent to the Health Minister, yesterday, and signed by the President, Mr Rubainu Mannason and Okara stated: "MLSN does not believe that it is proper, justifiable and acceptable to single out one profession in a multi-professional industry like the health sector".
"A call for salary increment by doctors is actually a call for salary increase by the health sector. We wholly support this call and request. Attending to this call unilaterally in favour of doctors will further destroy the needed fraternity in the health care service delivery," they said.
"Government must address the issues holistically. Singling out one group in an industry is not only unhealthy; it is also an unreasonable denial of the team nature and professional pluralism that characterise the industry - in this case the health industry,"
"AMLSN is also of the opinion that certificate should not be used as the sole criteria for remuneration. Relative values of professional inputs into collective services rendered, quantum of work done, quality of service rendered and intellectualism brought to bear at work should all contribute to what remuneration each group and subgroups should get,"
"AMLSN suggests that, with some minor adjustment, the job evaluation in the health sector conducted jointly by Office of Head of Service, Salaries and Wages Commission, Ministry of Labour and Productivity, should be used as the frame work and basis of remuneration in the health sector," they added.
They suggested a small stakeholders group meeting to fine-tune final matters of content and value to salary increase in the health sector staff remuneration.
Similarly, pharmacists and nurses are kicking against the move to revert to the new salary scale for doctors, which was the brainchild of the late former Health Minister, Prof. Olikoye Ransome-Kuti,as "discriminatory".
Pharmaceutical Society of Nigeria (PSN), Lagos branch in a statement said: "The politics of wages and salaries in organized Labour has not attained equilibrium since 1991 when the MSS was introduced by the Ibrahim Babangida government. The discriminatory wages for doctors in the 90's triggered agitation for exclusive wages for university lecturers, teachers in public schools (TSS) and indeed other group of workers. In reality, no group of worker would want to be left on a general scale".
The Chairman, PSN, Lagos Chapter, A. Lanre Familusi, who articulated their views stated: "Government must therefore see beyond the games which the incumbent Health Minister and his NMA colleagues are playing, if it must avoid the vicious cycle of industrial disharmony which discriminatory salary wages will bring."
The statement reads: "Entry-points for each cadre of worker will however differ based on whether or not they have professional training and specialist or post-graduate qualification. Other appraisal mechanisms will include duration of training and other work related hazards. The details of this should be immediately worked out by a Presidential Committee inculcating membership from the Office of Head of Service, Salaries and Wages Commission, Federal Civil Service Commission and Establishment Office. This exercise should be made thorough and comprehensive to address all pending and potential sources of industrial unrest once and for all in Nigeria.
"Doctors have argued that the major imperatives why they must have MSS include the prevailing economic meltdown and the brain-drain syndrome in the health sector. It should be a matter of common sense that the economically inclined problems affect all workers in Nigeria and not only those in healthcare," he added.
When government introduced the Consolidated Salary Structure, it subsumed other salary structures in existence then, including the Medical Salary Structure.
The salary structure effectively abolished some sensitive allowances in the health sector, forcing doctors to kick against it. For instance, the Call Duty allowance that formed the buck of doctor's remuneration was pegged at eight hourly, with the maximum of 40 hours a week. This, the doctors protested, reduced their take home pay and the relativity with other health professionals, which they were enjoying. Other health professionals did not share that view.
But when the Salaries and Wages Commission, Ministry of labour and Productivity and the Office of the Head of Service came out with a new allowance frame work, after job evaluation exercise which included job content and the period of training, the relativity with other health professionals further narrowed. Expectedly, doctors rejected the proposal as the basis for remuneration.
Okara said; "Independently trained professionals came out a more scientific basis for determining allowance, which doctors rejected while all the other health professional wholly adopted. In fact the evaluation opened to everyone that the bloated margin of differences between the doctors and other health professionals was not realistic"
These, as well as the proposal for the Office of Surgeon General are the main contentious issues which government has to resolve in the next two months.
By Ben Ukwuoma and Chukwuma Muanya
IT was a crisis, government for once, deployed all it had to avert. Again, it has to do with honouring an agreement reached between the doctors and all tiers of government over improved pay package and working tools.
Through out last week, the spectre of disrupted services hung over public hospitals in the country as the Health Minister, Prof. Babatunde Osotimehein and officials of the ministry battled to starve off what could have led to needless deaths in the nation's healthcare sector.
But on Saturday, leaders of the Nigerian Medical Association (NMA) took a landmark decision to shelve its planned strike action for Monday. The doctors, however, said they would undoubtedly go on strike by October 1 if the agreement were not ratified by the end of September as promised.
The Minister who has been in talks with the NMA on this issue for about four weeks deployed all the weapons in his arsenal to ensure that the strike was nipped in the bud.
Besides meeting with all the stakeholders, the minister enlisted the support of the Senate President, Speaker of the House of Representatives, the Sultan of Sokoto and the President of the Christian Association of Nigeria.
In the Minister's letter to the personalities, he reiterated his often stated fact that there is no disagreement between the doctors and the government, arguing that the only outstanding issue is the implementation of the agreed package. He promised that government is already working assiduously towards achieving the set goals and that all the relevant circulars are released in time.
The Minister also undertook visits to the Senate and the House Committee on Health to brief them on the situation of things, which led the Committees into mediating on the issue.
The efforts of the Minister got to a crescendo when he led the Association's Executives and the Chairmen of the State Chapters to the Presidential Villa in Abuja on Friday to meet with Vice President Goodluck Ebele Jonathan where the "final peace" was brokered with the assurances by the presidency that the agreed package would be faithfully implemented.
Apparently not carried by the assurances, some of the doctors insisted on going ahead with the strike as they said that the association had given government enough time to implement the agreement, which has been on the drawing board for 11 years.
But it took the intervention of elders of the association to calm frayed nerves. Consequently, they resolved at their Saturday meeting to give government another chance.
NMA National President, Dr. Prosper Igboeli, told The Guardian in a telephone interview after a press conference yesterday: "This new course of action was based on solid assurances from the highest level of government as arranged by the leadership of the Federal Ministry of Health. After due consideration of appeals from the presidency, the Federal Ministries of Health and Labour and other respected groups, it was agreed by doctors to give benefit of the doubt and shelve the planned strike that would have started tomorrow (Monday)."
"This is a demonstration of the maturity, goodwill and patriotism of NMA and Nigerian doctors as well as the fact that it is government's insensitivity that ultimately leads to reluctant withdrawal of services by doctors.
"NEC also resolved that if by October 1, 2009, the MSS is not restored for medical and dental practitioners in Nigeria, all doctors in Nigeria will embark on indefinite withdrawal of services without further notice."
The planned strike action, which had been on the cards since May when the Association had its Annual General Meeting in Abeokuta is in reaction to the non-implementation of the MSS, which the doctors had been pushing for since 1998.
Health Minister, Osotimehin, in a reaction to the decision of the doctors to listen to government, described it as patriotic. He said: "Given the sensitive nature of the industry and the severe consequences of a strike action on the vast majority of Nigerians, we cannot but give it to them that they have done well. We will do our best to ensure that the commitment that the government has made at the highest level is brought to practical reality. The doctors will never have cause to go on strike on this issue again because all that is necessary to be done would have been done by then to bring this agreement into effect."
Osotimehin extended a hand of fellowship to the NMA and other professionals within the health sector, saying, "we can only succeed when we work together and cooperate. It is only when we work together that we can turn around our ailing health sector."
The Guardian learnt that although the Salaries and Wages Commission (SWC) has finished the computation of medical doctors in government hospitals and the financial implication of meeting their demands, the commission is still working on that of other health workers.
It was learnt that the SWC will have to finish that of the other health workers before the document is sent to the Secretary to the Federal Government (SFG) for onward delivery to the President and the Federal Executive Council (FEC) for their accent, before it is presented to the National Assembly for approval.
Although, government has accepted in principle to release the enabling circular for the new salary scale for doctors, government is concerned about the ripple effects it would trigger off in the usually restive health sector.
"This issue portends grave danger to the health sector," declared Dr Godswill Okara, first Vice President, Association of Medical Laboratory Scientists of Nigeria (AMLSN).
The association in a letter sent to the Health Minister, yesterday, and signed by the President, Mr Rubainu Mannason and Okara stated: "MLSN does not believe that it is proper, justifiable and acceptable to single out one profession in a multi-professional industry like the health sector".
"A call for salary increment by doctors is actually a call for salary increase by the health sector. We wholly support this call and request. Attending to this call unilaterally in favour of doctors will further destroy the needed fraternity in the health care service delivery," they said.
"Government must address the issues holistically. Singling out one group in an industry is not only unhealthy; it is also an unreasonable denial of the team nature and professional pluralism that characterise the industry - in this case the health industry,"
"AMLSN is also of the opinion that certificate should not be used as the sole criteria for remuneration. Relative values of professional inputs into collective services rendered, quantum of work done, quality of service rendered and intellectualism brought to bear at work should all contribute to what remuneration each group and subgroups should get,"
"AMLSN suggests that, with some minor adjustment, the job evaluation in the health sector conducted jointly by Office of Head of Service, Salaries and Wages Commission, Ministry of Labour and Productivity, should be used as the frame work and basis of remuneration in the health sector," they added.
They suggested a small stakeholders group meeting to fine-tune final matters of content and value to salary increase in the health sector staff remuneration.
Similarly, pharmacists and nurses are kicking against the move to revert to the new salary scale for doctors, which was the brainchild of the late former Health Minister, Prof. Olikoye Ransome-Kuti,as "discriminatory".
Pharmaceutical Society of Nigeria (PSN), Lagos branch in a statement said: "The politics of wages and salaries in organized Labour has not attained equilibrium since 1991 when the MSS was introduced by the Ibrahim Babangida government. The discriminatory wages for doctors in the 90's triggered agitation for exclusive wages for university lecturers, teachers in public schools (TSS) and indeed other group of workers. In reality, no group of worker would want to be left on a general scale".
The Chairman, PSN, Lagos Chapter, A. Lanre Familusi, who articulated their views stated: "Government must therefore see beyond the games which the incumbent Health Minister and his NMA colleagues are playing, if it must avoid the vicious cycle of industrial disharmony which discriminatory salary wages will bring."
The statement reads: "Entry-points for each cadre of worker will however differ based on whether or not they have professional training and specialist or post-graduate qualification. Other appraisal mechanisms will include duration of training and other work related hazards. The details of this should be immediately worked out by a Presidential Committee inculcating membership from the Office of Head of Service, Salaries and Wages Commission, Federal Civil Service Commission and Establishment Office. This exercise should be made thorough and comprehensive to address all pending and potential sources of industrial unrest once and for all in Nigeria.
"Doctors have argued that the major imperatives why they must have MSS include the prevailing economic meltdown and the brain-drain syndrome in the health sector. It should be a matter of common sense that the economically inclined problems affect all workers in Nigeria and not only those in healthcare," he added.
When government introduced the Consolidated Salary Structure, it subsumed other salary structures in existence then, including the Medical Salary Structure.
The salary structure effectively abolished some sensitive allowances in the health sector, forcing doctors to kick against it. For instance, the Call Duty allowance that formed the buck of doctor's remuneration was pegged at eight hourly, with the maximum of 40 hours a week. This, the doctors protested, reduced their take home pay and the relativity with other health professionals, which they were enjoying. Other health professionals did not share that view.
But when the Salaries and Wages Commission, Ministry of labour and Productivity and the Office of the Head of Service came out with a new allowance frame work, after job evaluation exercise which included job content and the period of training, the relativity with other health professionals further narrowed. Expectedly, doctors rejected the proposal as the basis for remuneration.
Okara said; "Independently trained professionals came out a more scientific basis for determining allowance, which doctors rejected while all the other health professional wholly adopted. In fact the evaluation opened to everyone that the bloated margin of differences between the doctors and other health professionals was not realistic"
These, as well as the proposal for the Office of Surgeon General are the main contentious issues which government has to resolve in the next two months.
By Ben Ukwuoma and Chukwuma Muanya
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