Imperative of industrial harmony in Nigeria’s health sector

Nigeria’s health workers are at it again! The Joint Health Sector Union started another round of strike action last Wednesday, April 17. JOHESU, which draws its membership from the National Association of Nigerian Nurses and Midwives, Medical and Health Workers Union, Senior Staff Association of University Teaching Hospitals, Research Institutes and Associated Institutions, Nigeria Union of Allied Health Professionals and Non-academic Staff Union of Educational and Associated Institutes embarked on the industrial action after government failed to honour the agreement reached with the union on September 30, 2017.

JOHESU president, Mr. Josiah Biobelemoye, attributed the strike action to what he described as the “insensitivity and lackadaisical attitude of drivers of the health sector’’. He listed their demands to include upward adjustment of CONHESS Salary Scale, arrears of skipping of CONHESS 10 and employment of additional health professionals. Other demands are implementation of court judgments and upward review of retirement age from 60 to 65 years. Biobelemoye said that the union suspended its last nationwide strike on September 30, 2017 after signing a Memorandum of Terms of Settlement with the Federal Government.

According to him, the MoTS was supposed to be implemented within five weeks after the date of suspension of the strike. He, however, noted that six months after the suspension of the nationwide strike, government had yet to do anything tangible over the pending issues.

According to the JOHESU president, the union had on February 5 given a fresh 21-day ultimatum to enable the government meet the agreement reached. He said the union gave an additional 30 working days effective from March 5, after the expiration of the earlier 21 days’ ultimatum. Biobelemoye, who described the union members as peace lovers, emphasised that the 45 days was given simply because the union had the interest of the masses at heart. He therefore called on well-meaning Nigerians including traditional leaders, elder statesmen, opinion leaders and the general public to prevail on the government to implement the MoTS entered into with JOHESU. Biobelemoye explained that JOHESU members were not clamouring for equality with doctors but equity and justice, advising medical doctors and the Federal Ministry of Health to change their perception of the demands.

Truth be told, there is a frosty relationship between the two major unions in the health sector, that is, Nigerian Medical Association and JOHESU.  The non-doctors in the health sector believe that they are being maltreated and mistreated because they are not medical doctors. I listened to the JOHESU president on Radio Nigeria last week where he accused the Federal Government of giving preferential treatment to the medical doctors.  He said when doctors went on strike last year, government quickly sourced for money to pay them but a similar treatment is not being meted out to members of JOHESU. He recounted that as of September 2017 when JOHESU signed the memorandum with the Federal Government, the Federal Ministry of Health had yet to submit its budget for 2018. Unfortunately, JOHESU’s demand was not captured in the ministry’s 2018 budget. He linked all these to the fact that both the minister of health and minister of state in the Ministry of Health are medical doctors hence their sympathy for their colleagues working in the hospitals.

Whatever may be the issue, I think the Federal Government should stop being irresponsible. The impunity with which government at all levels breached signed agreements with different workers’ unions calls for concern. Why negotiating and signing agreement you don’t intend to honour or implement? For the sake of industrial harmony in the health sector, it is important for government to fairly and equitably treat all the unions in the sector.

As the JOHESU president explained, JOHESU members are not clamouring for equality with doctors but for equity and justice. Doctors alone cannot run health facilities. In fact, I learnt that doctors are just five per cent of medical workers while the remaining 95 per cent belong to JOHESU. The head cannot do without the neck and other parts of the body; hence, the need for fair treatment of all cadres of medical staff.

As things stand, for about a week now, all federal medical facilities have been grounded sequel to the JOHESU strike. The skeletal services being offered by medical doctors are not effective. Are the doctors going to process the patients, run laboratory tests, manage patients and perform the roles and functions of JOHESU members? Hundreds of lives might have been lost in the course of this strike as patients are forcefully discharged to go and seek medical support at the ‘Shylock’ private hospitals whose service charge is very prohibitive. Many patients are going to fall victim of quacks and charlatans who run unregistered and illegal clinics. There will also be those who will end up at the prayer sessions of many religious houses as well as herbal homes.

There is no way Nigeria will attain the goal of “Health for All” in as much as industrial crises still plague and persist in our country’s  health sector. As a panacea to reverse this ugly phenomenon, there is a need for full implementation of the Nigerian National Health Act 2014 which established the Basic Health Care Provision Fund to be financed from the Federal Government Annual Grant of not less than one per cent of its Consolidated Revenue Fund; grants by international donor partners as well as funds from any other sources.  It is the non-implementation of this Act in the past four years that is fuelling the crisis in the health sector.

Government at all levels should prioritise provisioning of qualitative and affordable health care services and ensure that health sector professionals are given their due rewards as at when due. The Federal Government should expedite action to resolve the ongoing JOHESU strike by simply honouring the 2017 agreement it signed with the labour union. Trying to cow the striking workers with the invocation of “No work, No Pay” service rule or hiring contract staff to do JOHESU members work are not the appropriate ways to address this labour crisis.