WHY DO RESIDENT DOCTORS WANT TO SHUT DOWN THE HEALTH SYSTEM?

The National Association of Resident Doctors (NARD) recently issued a three-week strike notice that is expected to end on January 2, 2017.

In a press statement released by the National President Dr. John Onyebueze, NARD urged the Federal Government to urgently intervene in the lingering crises in the health sector to avert the impending strike.

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Footprints gathered that the doctors had shelved the planned strike three times in the past four months and were bent on going on strike from January 2.

But exactly what are the doctors agitating for?

Resident doctors want a uniform template for the Residency Programme, infrastructure for tertiary health facilities, proper grading of doctors and payment of outstanding salaries amongst other issues.

Speaking in Bayelsa, the National Public Relations Officer of NARD Dr. Agoeze Asinobi shed more light on the doctors’ demands.

“We don’t want strikes but we are going to have to resort to it again. The residency programme is fundamental to effective healthy care given the dearth of manpower as the country has less than 20 per cent of required experts.

“Each time the ultimatum expired we shift it in the hope that things will be made right within the time given but it is now obvious the Ministry officials are insincere.

“The issues we go on strike for are always the same and we are resolute to withdraw services come January 2 if our concerns are not addressed.

“One wonders if health ministry officials are sabotaging the efforts of President Buhari on purpose as their brazen and blatant disregard to the most basic institutional needs of the major workhorses of the health sector leaves a lot to be desired.

“Their attitude leaves one bewildered as sabotage appears to be the only logical explanation,” Asinobi said.

He noted that officials of the Federal Ministry of Health were playing politics with the lives of Nigerians as they were insensitive and disconnected from the realities the masses are facing in their daily lives.

Asinobi said that NARD frowned at the wastage in building new primary health centres rather than rehabilitating, equipping and staffing existing ones with requisite manpower.

The NARD spokesman explained that resident doctors had always embraced dialogue and discussions in finding lasting peace but regretted that their commitment to peace and industrial harmony was yet to be reciprocated.

He said that the present executives of NARD remain committed to end the myriad of incursions adversely affecting the welfare of resident doctors.

He appealed to the federal government to wade into the industrial dispute in the overall interest of the welfare of the citizenry.

Below, we present specific reasons why doctors are threatening to go on an indefinite nationwide industrial action, and why we feel their agitations are genuine, legal and worthwhile.

Since 2013 doctors have engaged and had agreements with government, last of which was the 14th July encounter with government stakeholders convened by the Honourable Speaker of the Federal House of Representatives, Yakubu Dogara. Stakeholders from the Federal Ministry of Health (FMOH), Federal Ministry of Labour & Employment (FMOL&E), National Salaries, Income & Wages Commission (NSIWC) and other parastatals were all in attendance. Like all previous meetings and agreements, the FMOH and other agencies of government reneged, thereby turning the goodwill of the Speaker into a political gymnick and charade for cheap political purposes.

It is important to note at this point that doctors are not in any way calling for action against Buhuri or the good people of Nigeria. Their actions are targetted at supporting the government of Buhari in his bid to do the right thing and weed out the cabal in the FMOH that has defiled all governments and are responsible for perpertuating crisis in the health sector since they always fed fat from such crisis. The doctors’ actions are targetted at defending and protecting the health system in Nigeria for the better, effective and efficient service of the medical needs of Nigerians.

The doctors’ demands are itemized as follows:

1) Quality, efficient, effective and uninterrupted medical services at the federal tertiary health institutions (FTHIs) through the full and immediate implimentation of the National Health Act which shall ensure universal health coverage, free medical treatment to children, pregnant women, elderly and medical emergencies through universal health insurance as well as the proper planning, funding and running of the health facilities including training of personnel;

2) Immediate renovation, rehabilitation, re-equiping and revamping of FTHI’s facilities and equipments which at the moment are in disrepair and are ill-equiped;

3) Release and implementation of the white paper on residency training which is the programme that provides the specialist manpower for tertiary and specialist medical services which are grossly in short supply in the country due to poor service/work conditions, poor remuneration, indequate training facilities/spaces and braindrain, all leading to oversea medical tourism with loss of huge capital to foreign countries;

4) Sponsorship of residency programme which contrary to claim, residency programme is not under any form of sponsorship from government and neither are the trainees. Resident doctors are employed as doctors and paid salaries for services rendered or work done, even though it forms part of their training. Beyond that, resident doctors also carry out research. They neither pay any school fees or tuition in residency programme, and government does not owe them any such obligation. The other aspect of in-service training sponsorship is part of duty tour allowance (DTA) payable to every staff for official duties. While other staff are paid duely their DTA, resident doctors are not paid as at when due leading to arrears accumulating up to 10 years in some institutions. Long after the resident doctor has finished the programme, he still does not get refund for the DTA he funded with his salary. Many a time, these official duties cost as much as 2 – 3 months of the doctors’ salaries thereby putting strain and stress on them amidst other responsibilities including financial obligations to their families, which they are supposed to resolve with the same meagre salaries. Not withstanding the oversea clinical attachment which is no longer sponsored by government.

4) ‘No work no pay’ policy viz-a-viz ‘work with no pay’: While government are at liberty to apply that rule, equity demands that if it is not universal, it should not be selective and if you are unable to pay for work done, then there is no moral justification to apply ‘no work, no pay’ as done to only striking doctors while sparing other striking workers in the health sector and other ministries. The institutions affected include: FMC-Owerri, FMC-Umuahia, FMC-Lokoja, ESUTH-Enugu, UPTH-Portharcourt, UBTH-Benin, FNPH-Uselu, FNPH-Aro, LUTH-Lagos, LAUTECH-Osogbo, FMC-Bida, FMC-Owo, JUTH-Jos, ABUTH-Zaria and FMC-Birnin Kebbi.

5) Salary arrears: While doctors share the pains of government over the recession and join hands with government to see that Nigeria comes out of recession, they request like every other citizen the immediate payment of their outstanding salaries ranging from percentages of salaries to outright no salaries, spanning from April to December and affecting almost all the  FTHs and STHs.

6) Implementations of July 14th 2016 agreement with government which for simplicity included:

i) circularization of entry level for house officers and medical officers which has suffered conspiracy from FMOH and NSIWC since December 2013;

ii) appropriate placement of newly employed doctors and correction of wrongful placement of previously employed doctors within the years of skipping by other health workers and in line with the 2013 judgement of the National Industrial Court of Nigeria (NICN) and HLB agreements and circulars that annuled CONHESS 10 and  CONMESS 2 from the salary structures of health workers and doctors while maintaining seniority and without tampering with our annual incremental steps;

iii) inclusion of resident doctors in the contributory pension scheme, deduction and remittance of our pensions including the counterpart funding from government to our PFAs in line with the Pension Remittance Act of 2014;

iv) universal and uniform residency training programme (RTP) through strict compliance by FTHIs and STHIs to the residency tenure template and the release of the white paper on RTP;

v) special bailout for STHIs through the state governments to enable them pay salaries to workers and upgrade hospital facilities and equipments;

vi) review of the case of all unduly sacked resident doctors, particularly in ABUTH (Zaria), JUTH (Jos) and FMC-Owo;

vii) review with a view to paying December 2015 salaries of doctors in FMC-Owerri who were locked out of duty by FMOH and became victims of the quagmire between FMOH and JOHESU;

viii) FMOH to visit centres unable to pay doctors’ salaries with their appropriate grade levels, compute and transmit the figures to the National Assembly (NASS) for consideration in the supplementary budget. Rather than implementing this simple agreement, the FMOH gave a directive to reverse skipping;

iX) nobody shall be victimized in any form for participating in the industrial dispute; and

x) suspension of doctors’ threat to withdraw services with the assurance that government would address the problems.

As it stands, government is yet to take decisive steps to address the lingering crisis in the health sector. The only communication from the FMOH is a letter in response to NARD’s communique and notice of strike which is incongruent with the realities on ground.

At this juncture, we weep for our dear country Nigeria. We join our doctors in mourning the death of healthcare delivery in Nigeria, while praying fervently for a revolution. So help us God!

 

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About Dr. Ken

Medical Doctor, Publisher, Editor, Novelist, Playwright, Visionary Poet, Activist, Blogger
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