AGREEMENTS REACHED OF BEHALF OF THE FEDERAL GOVERNMENT OF NIGERIA WITH THE JOINT HEALTH SECTOR UNIONS - POSITIONS OF MEDICAL AND DENTAL CONSULTANTS ASSOCIATION OF NIGEIA (MDCAN) We act as Counsel to the • Medical and Dental Consultants Association of Nigeria• (MDCAN) ( hereinafter referred to as our Client) on whose behalf we write this letter. We wish to draw the attention of Your Excellency to the agreements said to have been reached ata meeting that was held in Abuja, FCT between the Joint Health Sector Unions (JOHESU) and Assembly of Healthcare Professional Associations (AHPA), with the Secretary to the Govemment of the Federation (SGF), Senator Anyim Pius Anyim, GCON, Honourable Minister of Labour and Productivity, Honourable Minister of Health, Chairman, Salaries, Income and Wages Commission, Head of the Civil Service of the Federation, and other top government functionaries on 5th of June 2014. Three of,these agreements are of concern to our Client since they have grave implications for the management and survival of the health sector in Nigeria. Firstly, the meeting was said to have communicated that a circular No. MH/PM/138No/.11/f/9 of 16th May, 2014 had been released by Government, formally restoring consultancy status to other health care professionals and approving the payment of specialist allowance to other health care professionals other than medical and dental practitioners. In line with this so-called circular, JOHESU/AHPA have directed that all their members who are due and have satisfied the existing criteria, as upheld by a court judgment, for consultancy positions, should apply for the payment of the allowance with its accrued arrears with effectfrom 1st January, 2010 in line with the CONHESS Circular Reference SWC/S/04/S.410/VoI.11/349, dated 8th December 2009. Secondly, the meeting was said to have accepted JOHESU &AHPAs position and demand, and accordingly agreed to abolish the post of Deputy Chairman Medical Advisory Committee ( DCMAC). JOHESU/AHPA position is that the establishment and existence of that post is unlawful, and that no further appointment should be made into the post. Thirdly, the meeting was said to have agreed to refer a number of issues to the Yayale Ahmed Committee. These issues include the review of the process of appointment of Chief Medical Directors and Medical Directors of Teaching Hospitals and the agitation of JOHESU & AHPA that appointment of Chief Medical Directors and Medical Directors be made from permanent staff of the teaching hospitals rather than from the universities; the alleged lopsidedness of advertorial for appointment of CMDs/MDs, which is skewed in favour of medical and dental practitioners, and the agitation of JOHESU & AHPA that the appointment process be made open to all competent and qualified health professionals; the Abduffahi Beffo Presidential Committe Report on Harmony in the Health Sector; and the interpretation of the phrase medically qualified. Following the said meeting and agreements, JOHESU and AHPA held a meeting at the Medical and Health Workers Union Secretariat, Abuja, FCT on the 5th and 6th of June, 2014 to extensively review the meeting and agreements, and issued a communique wherein they stated that by resolution they had directed their members nationwide to ensure that the agreements were enforced in all institutions. medicalworldnigeria Your Excellency, our Client vehemently disagree with the reported agreements. As our Client has consistently maintained, they are an association of medical and dental consultants, who, exclusive of other professionals in the health sector, are known and addressed as consultants. Negotiating and agreeing with non-medical and dental practitioners in the health sector, and designating them consultants, such that there will now be multiplicity of consuttants in the teaching hospitals, is not acceptable; and even if it were, this cannot be done in the absence of associations of medical practitioners (NMA, MDCAN, etcetera). Before a person can be appointed a consultant in the medical profession, slhe must have obtained the requisite degrees of •Bachelor of Medicine and Bachelor of Surgery ( MB.,BS), must be a fellow of a post-graduate medical college either inNigeria or from any other recognized post- graduate medical college, and must have the required professional experience and expertise as a medical doctor. The post graduate medical colreges in Nigeria and West Africa being referred to here are the West Africa Post-Graduate Medical College. West Africa Post-Graduate College of Surgeon, and the National Post-Graduate Medical College of Nigeria. Under the scheme of service, as contained in the relevant Circular, issued by the Federal Ministry of Health, medical consultants who have the requisite qualification and who must have undergone a minimum level of professional training, are the ones, exclusive of other health professionals, to whom patients are assigned, and who, upon that assignment, are responsible for the management of patients. Further, under that exclusive assignment and management duty, it is the medical consultant that will determine who, apart from himself, has to join him to manage his patient, depending on the diagnosis, and whether the patient is suffering from a single ailment or multiple ailments. If the medical doctor to whom the patient is asslqned is a consultant in the field of medicine covering the patients ailment, but the diagnosis reveals that the patients primary ailment has implicated other organs of the body and occasioned secondary or consequential diseases over which the medical consultant has no specialization, it is still the duty of that medical consultant, managing the patient, to call in other consultants or specialists to assist him in managing his patient. Designating or appointing nurses, pharmacist or physiotherapist or laboratory technicians consultants in the hearth sectorls, therefore, an aberration, and a perversion of the order of care in the health sector. Under this order of care, there is no rule that can accommodate this designation or appointment of non-medical doctors as consultants or specialists, even if some managers of public hospitals in Nigeria want to invent the absurdity. In the medical profession, nurses, pharmacists and physiotherapists are not trained to make diagnosis and prescribe treatment. Members of our Client have genuine fears that the constitutionally guaranteed right of patients to life will be in jeopardy if non-medical doctors are appointed as consultants. When patients die or are dissatisfied with care, it is the Consultant that is sued rather than the nurse. Being medical doctors who swore to the Physicians Oath, and being medical and dental consultants-the eminent class inthe medical profession, members of MDCAN are duty-bound to protect lives of Nigerias and non-Nigerians who are passing through Nigeria;s health care delivery system. Your Excellency, the oddity and aberration of this agreement by the Federal Government of Nigeria and JOHESU & APHA on extension of consultancy statuses to all health professionals is not only that it is professionally and administratively perverse. It is also a legal absurdity. Following the determination of Suit No. NICN/ABJ/238/2012 (The Trade Union Memmbers of the Joint Health Sector Unions (JOHUSU), namely: (1) Medical and Health Workers Union of Nigeria; (2) National Association of Nigeira Nurses and Midwifes; (3) Senior Staff Association of Universities Teaching Hospital, Research Intitutes and Associated Institutions (4) Nigerian Union OfPharmacists, Medical Technologists and Professions Allied to Medicine; and (5) Non-Academic Staff Union of Educational and Associated Institutions V. Federal Ministry of Health) on Monday, the 22nd day of July, 2013, by • Hon. Justice B.A Adejumo ( Presiding Judge), Hon. Justice B.B Kanyip and Hon, Justice M.N. Esowe, where in the National Industrial Court held that a few non-medical and dental practitioners aberrantly appointed as consultants in University College Hospital, Ibadan should continue to enjoy that status, the Federal Ministry of Health medicalworldnigeria (that is the Federal Government of Nigeria) appealed that decision, and our Client, MDCAN also approached the National Industrial Court with an application to set aside the judgment. The Appeal and Application are pending in Courts. The law is well settled in Nigeria that once a civil matter is placed before a court or judicial tribunal for adjudication, parties to the court action most refrain from doing anything capable of over reaching, undermining or foisting a fait accompli on the court. Doing so will not only be tantamount to subverting the rule of law, but also will amount to treating the court with contempt, the punishment of which is imprisonment. No matter the impatience on the part of parties, they are under a legal obligation to await the outcome of the resolution or determination of the issues submitted to the court for adjudication. This was the golden rule laid down by the Supreme Court in the case of Gov. of Lagos State v. Ojukwu ( 1986) 1 NWLR. Pt. 18, pg 621 at 623, where it was stated that once the court is seised of a matter, no party has a right to take the matter into his own hands . medicalworldnigeria The so called agreement on the extension of consultancy status to all health professionals and the purported issuance of a circular to that effect is contemptuous of the Courts. It undermines and subverts the majesty, dignity and integrity of the Courts; it is illegal and it is an affront on the rule of law. Your Excellency, our Client also rejects the agreement to abolish the post of Deputy Chairman Medical Advisory Committee (DCMAC). Our Clients position is that the creation of that post, which has been in our teaching hospitals for more than twenty years, is within the administrative powers and competence of the governing boards of the teaching hospitals as defined in their respective governing statutes establishing them. This position, which facilitates smooth management of the teaching hospitals cannot be scrapped because of the whims and caprices of non-medicaldoctors, on the flimsy ground that they are excluded from consideration in the filling of that position. For the avoidance of any doubt, it is instructive that the University Teaching Hospitals ( Reconstitution of Boards, Etc) Act, Cap U 15, Vol. 15, Laws of the Federation of Nigeria, 2004, provides In Section 7 ( 4) Functions of the Board] that Subject to this Act, the Board shall have power to do anything, which, in its opinion, is calculated to facilitate the carrying out of its functions under this Act. Regarding the issues referred to YayaleAhmed Committee, which relate to the process of and eligibility for appointment of Chief Medical Directors and Medical Directors of Teaching Hospitals, and the agitation of JOHESU & AHPA that their members, who are not medical practitioners, be eligible for appointment, our Clients position is that the issue of headship and management of the teaching hospitals is not a political or labour issue that can or should be negotiated with an amalgam of associations of non-medical practitioners in the health sector. Suffice it to alert Your Excellency that when amalgamated unions or associations of non-medical doctors gang up and make the undesirability of appointing university based medical practitioners as chief medical directors and medical directors of teaching hospitals their principal demand, then, the very foundation of these tertiary health institutions (as teaching hospitals) is being threatened. It is only a system that has no knowledge of how the health sector functions that can give such an attempt any serious consideration, let alone acceding to such demand. Your Excellency, while our Client is committed to an interrupted and strike-free health care delivery system in the Country, our Client wishes to alert Your Excellency and the Federal Government of Nigeria that she is aware that the Nigerian Medical Association (NMA) has issued an ultimatum to the Federal Government of Nigeria over the issues raised in this letter and other issues. BE PUT ON NOTICE that our Client will fully comply with and enhance any directives (including embarking on a strike action or withdrawal of services) that the NMA may wish to issue at the expiration of the ultimatum. Our Client is constrained to tow this line, in spite of our Clients usual traditionalmoderation whenever there are strikes in the hospitals. The consequence is that no medical and dental consultant shall be available to render service in all our teaching hospitals, nationwide, in the event of such a strike action. In view of the several troubles our Country is going through, currently, Your Excellencys Government must do everything in its powers to ensure that the health sector is not thrown into a disarray on account of ill -motivated and ill-decided positions taken on behalf of Govemment by officials who seem not to be aware of, or care little about the havoc the decisions being taken by them will wreak on the health sector. It is for this reason that our Client hereby calls on Your Excellency to wade into these perennial issues of granting arbitrary, anti-health care delivery concessions in the health sector by agents and agencies of government, just to placate and appease some workers in the health sector, even when those concessions, on the long term, will lead to the destruction of the health care delivery system in our Country. It is high time the system stopped granting concessions that will ruin the health care delivery system to a resentful and conspiratorial segment of the health sector workforce on the altar of political expediency, and in the illusion that doing so is the best way to guarantee industrial harmony. Our Client is grateful to Your Excellency for taking a swift action on the issues raised in this letter. Your Faithfully medicalworldnigeria Jiti Ogunye, Esq Principal Soclicitor & Counsel Cc: 1. Honourable Minister of Health 2. Honourable Minister of Labour and Prosuctivity, 3. Secrtary to the Government of the Federation, 4. Attornery General of the Federation From medicalworldnigeria/2014/06/position-of-medical-and-dental-consultants-association-of-nigeria-mdcan-on-agreements-reached-on-behalf-of-the-fg-with-johesu/
Posted on: Tue, 24 Jun 2014 21:54:17 +0000
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