Amidst complaints of cash crunch by the federal government, JOHESU, comprising all health workers, has threatened to embark on an indefinite strike to press home their demands. Will this ever end? KEHINDE OSASONA asks in this report.
Bone of contention
Incessant industrial actions embarked upon by workers in the nation’s public hospitals may have become an accepted norm if recent information pertaining to an impending strike is anything to go by.
Apart from doctors and dentists, if the union make real its threat, some of the health workers who will down tools in the nation’s 20 teaching hospitals, 22 federal medical centres, and 13 specialist hospitals as well pharmacists, medical laboratory scientists, nurses, radiographers, dietitians, therapists, health record and information management workers.
Some of the affected health workers who operate under different associations and unions are the Association of Nigeria Nurses and Midwives (NANNM), Association of Medical Scientists Laboratory of Scientists of Nigeria (AMLSN), Assembly of Healthcare Professional Associations, Joint Health Sector Unions (JOHESU), Medical and Health Workers Union of Nigeria (MHWUN), Pharmaceutical Society of Nigeria (PSN), Nigeria Union of Allied Health Care Professionals (NUAHP) among others.
The letter
While issuing a 15-day fresh strike ultimatum in respect of its grievances recently, the Joint Health Sector Unions and Assembly of Healthcare Professional Associations (JOHESU) cited the government inconsistencies to adjust the Consolidated Health Salary Structure for health workers,
The union also accused the government of shifting from their agreed terms and rules of engagement relating to non-discrimination in the determination of the wages and benefit packages of health workers.
In a letter addressed to the Federal Ministry of Health and signed by the National Secretary, Matthew Ajorotu, the union stated with dismay the recent communication from the Federal Ministry of Health (FMoH), saying it attempted to sabotage the laudable report of the Technical Committee on the Adjustment of CONHESS as was done for CONMESS, by claiming its implementation would distort existing CONMESS relativity with CONHESS.
Other demands
While highlighting their demands, the unions called on the federal government to consolidate on Health Salary Structure as agreed in terms of settlement of September, 2017, which had lingered since 2014.
They also urged the government to pay a peculiar allowance to health workers “under the aegis of JOHESU/AHP” as well as an immediate and unconditional implementation of the Consultant Cadre circular of pharmacists in all federal health Institutions.
Other demands include, “payment of all withheld salaries of our members in Federal Medical Center in Owerri, Jos University Teaching Hospital, Lagos University Teaching Hospital and their withheld April and May 2018 Salaries; speedy adjustment of retirement age from 60 – 65 years and the exclusion of some health workers in the payment of new hazard allowance as well as payment of COVID-19 allowance balance.”
While demanding a negotiation of the peculiar allowance, the unions added that “the planned 25% review on CONHESS will only widen the existing relativity with CONMESS to our disadvantage while also distorting albeit significantly the supposed edge over general salary scales in public service.”
The letter read further that, “If the federal government does not stick to tenets of due process spelt in our rules of engagement since the commencement of negotiations on the Adjustment of CONHESS as was done for CONMESS and the other lingering demands as highlighted above within the 15 day window, it would be clear that it is the federal government that should be held responsible for the fall-outs of a possible strike.”
However, with few days to the fresh 15-day ultimatum handed down by the health workers, no government official has come out to debunk the union’s claim and there has been no assurance on whether or not it would review their demands.
Experts’ takes
According to health experts, incessant strikes by professionals usually come with preventable deaths for households and loss of revenues for the government.
They stated that apart from weakening the nation’s frail health system, it also denies poor access to care, promotes medical tourism and brain drain.
Baring her mind on the issue in a chat with Blueprint Weekend, a health expert, Mrs. Oyeola Adebayo, noted that private hospitals and maternity services usually charge exorbitant fees, whenever healthcare providers in Nigeria embark on strike.
Not only that, the available facilities, according to her, are also congested and over-stretched with the masses at the receiving ends.
“Not only that, that strike actions usually lead many to resort to self-help like self medication, patients would be stranded thereby leading to various complications arising from their actions and even deaths in some cases,” Mrs. Adebayo said.
Investigation
Blueprint Weekend’s findings showed that the nation’s health sector has not had it so good in recent times, as unresolved issues had led to unnecessary strikes by their workers with talks between it and government collapsing severally.
More worrisome is the fact that workers’ strike frequency from 2011 to 2021 has been so alarming with stakeholders playing little or no role to salvage the situation. In 2021, for instance, the National Association of Resident Doctors (NARD) alone ordered 61 per cent of health workers strikes in the country.
The longest of all the strikes within the period under study was the action by NARD on August 2 which lasted for 62 days. The association declared the strike over government failure to pay house officers’ salaries and the non-recruitment of house officers.
NARD, it would be recalled, was responsible for 11 of the 19 industrial actions recorded by the government within the period when it went on strike for 154 days out of the total 252 days of strike recorded by the government.
In 2013, the National Union of Allied Health Professionals (NUAHP) sought the abolition of the office of Deputy Chairman, Medical Advisory Committee introduced by the government. The strike lasted for seven days.
In the same year, NARD went on strike for ten days over non-payment of July-October salaries and other allowances owed its members. JOHESU embarked on strike three months after for three days over non-promotion of its members on CONHESS 14-15 as directors.
The NUAHP resumed the 16-day strike it suspended earlier, on October 16, over what it stated was the failure of the government to implement the Memorandum of Understanding signed with the association on August 20, 2013.
Afterwards, JOHESU again went on strike on November 12, 2014, demanding the adjustment of salaries for its members as the government did for the Nigerian Medical Association earlier that year.
The group embarked on another seven days strike that month, demanding the skipping of arrears and other issues.
The NARD embarked on another 25 days strike on June 1, 2015 where it was protesting skipping arrears, other benefits for its members, and other issues.
The same year, NMA scaled-down its services to ask for full implementation of Consolidated Medical Salary Structure (CONMESS) for its members. Just a week after NMA made its demand, JOHESU suspended services for seven days over non-payment of skipping salary arrears to its members in Federal Tertiary Institution, among other demands.
After its ultimatum on inclusion into the IPPIS expired on July 27, 2016, NARD proceeded on a seven days strike. Also, MHWUN protested the delay in releasing its members’ 2015 promotion interview results and consequently downed tools for two weeks in 2016.
Again, NMA and NARD jointly scaled-down services on September 4, 2017 following the failure of the government to meet NARD’s demand on skipping. The strike lasted for nine days. Between April and May 2018, JOHESU members suspended work for 44 days over a trade dispute on the upward adjustment of CONHESS.
On May 15, 2020, NARD embarked on a five-day strike over the universal implementation of the Medical Residency Training Act in all federal and state hospitals. The action also sought to ensure pay parity among doctors of equal cadre.
The association, again, embarked on a 10-day industrial action in September 2020 over the non-implementation of agreements it had with the government.
The NARD again scaled-down work for nine days between March 31 and April 8 this year over the failure of the government to pay house officers.
The association resumed its strike on April 12 over the government failure to pay hazard allowances to its members at the frontline of the Covid-19 pandemic. The group said it embarked on the strike also to protest the dismissal and reduction of wages of its members by the Kaduna state government. The strike lasted for ten days.
Going forward
With truce not being properly brokered in some instances between government and health workers; they may have to in the interim and with the look of things contend with the less than five per cent annual budgetary allocation to the sector.
Although experts and stakeholders have argued that such a budgetary allocation is not only poor for the sector, it has also been adduced that it is far low to the World Health Organization’s declarations and not sustainable for a developing country.
