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The Minister of Health, Resident doctors and strikes

Minister and Perm Sec of FMOH

Since resumption of office, the Minister of Health has faced challenges of industrial disharmony in the health sector, largely inherited, all protracted and mostly on issues relating to the payment of doctors. Presently, a strike by the Nigerian Association of Resident Doctors has paralysed tertiary care centres across the country. This has left Professor Onyebuchi Chukwu in a difficult situation, unable to focus on the future of the precarious health sector in Nigeria, he is being forced to fire-fight his way out of these strikes. Complicating matters even more is the fact that Professor Chukwu was himself an ex-president of NARD.

Now things are really getting out of hand…with reports like these in several newspapers…..

PMnews reports that activities in General Hospitals in Lagos State have been paralysed due to the inability of the Lagos State Government to pay the federal wages its doctors are demanding for. 

Doctors’ strike paralyses LAUTECH, Ekiti govt hospitals

From a letter sent round by NARD in Lagos state recently, the key issues being demanded by the National Association of Resident Doctors can be summarised as follows. 

Reading between the lines suggests how deep our problems are. We have lost all confidence in our medical training. It is now the case that 50 years after independence, we conclude that a one year “overseas” attachment is critical for our training needs. There is apparently no shame felt or expressed in this statement. The demands by our senators has given credence to every demand for more wages in our country. The concept of federalism in our constitution and the right of state governments and their legislature to determine their wage structures is thrown to the winds whenever convenient….and “relativity”!…why is this so important? Is it important enough to abandon our patients to go on strike.

In the letter written by NARD, to which we are privy, not once is the patient mentioned. Not once are the state of our hospitals mentioned. No statement is made by NARD on what it is offering the Nigerian people. No commitment to serve. No commitment that when the saalaries are paid, that the work will be done. There is no empathy, no compassion – just fire and brimstone….

But then – our government has put us into this quagmire. After 50 years of independence I can bet that our Ministry of Health will join other Ministries in allocating millions of naira to celebratory books, seminars etc. What do we have to celebrate in our health sector. As with all these matters in our dear country, last week, our own Radio Nigeria reported that 2 committees have been inaugurated – one was a presidential committee and the other a ministerial committee.

1. A Presidential Committee to harmonize working relationships among health workers
 The 42 member committee (42!), headed by Justice Bello Abdullahi is to identify the root causes of disharmony among health workers, and professional groups in the sector, and to examine the negative impact of such problems on the healthcare delivery system. This is mandated to check the long standing rivalry and industrial disharmony existing among the professional groups in the sector.

2. A Ministerial Committee for the review of the residency programme in Nigeria.
The 11 member committee is mandated to review the residency programme in Nigeria including examine the proposed one year clinical attachment/training abroad for resident doctors.

The Lagos State Government has come out boldly to say that the package was worked out for federal doctors alone, and that the state government was not part of the agreement reached at the federal level therefore should not be forced to pay – I agree!

Commissioner for Health, Dr. Jide Idris, says that the Lagos State Government could not pay and would not be forced to do so. Idris stated that government would continue to support doctors who did not join the strike and had been working assiduously to meet the demands of the patient, saying that agitation of doctors in its hospitals for increment in salaries had become too frequent and worrisome, saying that they got increases in their salaries early this year. The state government has begun to employ the services of consultants to carry on the work of administering treatment to thousands of patients in the state’s public hospitals, which are generally inconsequential to meet the teeming needs of the people.

As doctors, we should be very careful not to lose the support of our patients, and we must be extremely careful not to use the power we have in society against the people we have sworn to serve. The “patient” must be central to our arguments and sacrosanct in our demands. We lose the patient we lose everything.

Granted, working conditions are difficult in many of our settings, and granted our Senators have lost all touch with reality by their demands, but must we follow them in this blind pursuit of self destruction.
Finally this issue of “relativity”. Are we really better than the nurses and pharmacists etc…think about it!

In all that has been written in the press and even in the letter circulated by NARD, Professor Chukwu is de
scribed as a man with uncommon integrity in his public and private life“. I could not agree more. We must give him the opportunity to build a better future for our health sector rather than spend the last 8 months of his tenure negotiating salaries.

Never doubt that a small group of thoughtful committed people can change the world; indeed it is the only thing that ever has…Margaret Mead

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