Under the aegis of the Association of Resident Doctors (ARD), medical doctors in Federal Medical Center, Lokoja on Friday complied with the directive of their parent body National Association of Resident Doctors (NARD) by wearing black coats and bands to register their displeasure in the way and manner Nigeria’s health system is being handled.
NARD had directed its members to carry out peaceful protests by wearing black ward coats and conducting rallies at the expiration of the initial ultimatum given to the Federal Government (FG) on January 2.
Recall that NARD had on December 19 given FG up to Jan. 2 to implement the National Health Act 2014 and address lingering issues beleaguering the health sector, especially as it affects resident doctors.
The ARD President of FMC-Lokoja, Dr. Kennedy Obohwemu, said his members are part and parcel of NARD, and as such duty bound to comply with the national directive.
Kennedy said, “With due respect to constituted authority in the Federal Ministry of Health, our actions today have become necessary considering the protracted saga and unfathomable quagmire resident doctors across the country find themselves.
“Apart from the fact that we are following instructions from our national body, we believe it is time to take the bull by the horn and address these persistent problems once and for all.
“Let the whole world know what resident doctors are going through. Our patients deserve the best of healthcare delivery. We cannot do that when we the healthcare providers are not in the right frame of mind.
“The medical profession is going through the toughest of times in recent years. Our black jackets and black bands symbolize the death of our healthcare delivery system. We ask for a resurrection, a revamping of the system, such that the average Nigerian can confidently access quality healthcare at affordable rates.”
Kennedy lamented the pitiable state of Nigeria’s health system, citing the need for FG to urgently intervene and prevent massive exodus of doctors to the outside world, seeking greener pastures.
“More doctors are preparing to leave the shores of our land,” he warned. “Let’s not get it twisted. We are committed to our jobs. But we are limited by infrastructural decay in the health system, dearth of specialised skills caused by lack of training, poor funding of our health institutions and lack of political will to get things done. At the end of the day, it’s the poor masses that suffer.
“Let it be noted that no one – absolutely no one – is immune to the deleterious consequences of the neglect of the health sector. The same hospital one fails to equip today may be the closest hospital that could save one’s life tomorrow.”
Kennedy said that NARD demands are not outrageous. He noted that these issues have been neglected for far too long, thus placing the future of the medical profession in jeopardy.
“We need a uniform template for the residency training programme,” he said. “The structural framework for the programme must be clearly spelt out in a consistent unbiased manner, and applied universally.
“Since enactment in 2014, the National Health Act is yet to be implemented. This legal document provides a framework for the regulation, development and management of a health system and sets standards for rendering health services in Nigeria. The Act ensures that patients are given the best of healthcare delivery with availability of health infrastructure, while ensuring that the rights of health care personnel are protected.”
Details of the doctors’ demands are contained in a document made available to newsmen. Highlights of the demands include:
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.