in response to the NMA published statement The Nigerian Medical Association (NMA) : A Major Cause of Poor Health Services in Nigeria The attention of the national leadership of Nigerian Union of Pharmacists/ Physiotherapists, Medical Scientists and other Allied Health Professionals (NUAHP) also known as NUPMTPAM has been drawn to press statements credited to the President and Secretary of Nigerian Medical Association – Drs. Enabulele and Pemu….. published by many national dailies between 27th September and 3rd October, 2012. The NMA was reported to have described the Joint Health Sector Unions (JOHESU) and Allied Health Professionals as ‘amorphous’ and their demands from government “illegitimate and unjustified”. They went further to ask the government not to grant those requests which they described as “reminiscent to stealing from Government” particularly on the issue of skipping or jumping a salary grade in the civil or public service. They also called on government to privatize the services of Physiotherapy, Radiographer, Pharmacy, Medical Laboratory and others in government hospitals. They threatened a strike and a request for elongation of CONMESS should our requests be granted by Government. Our initial reaction was to refrain from replying since we have always regarded the NMA as a sister organization and an important member of the health family who needs to work harmoniously in the health sector with us but several reasons compelled this rejoinder, namely: pressures from members of our Unions and professional associations nationwide, the need to properly educate the leadership of NMA who have exposed themselves as ignorant, arrogant, selfish and highly indisciplined. We also intend to satisfy the good people of Nigerian public who have the right to know the true position of things and to ensure that errors are corrected while records are properly kept. JOHESU/Allied Health Professionals JOHESU is a coalition of five recognized and duly registered trade/labour unions currently operating in the Health sector. The Unions are: Medical and Health Workers Union (MHWUW), National Association of Nigerian Nurses and Midwives (NANNM), Senior Staff Association of Universities, Teaching Hospitals, Research Institutes and Associated Institutions (SSAUTHRIAI), Non-Academic Staff Union of Educational and Associated Institutions (NASU) and Nigerian Union of Pharmacists, Physiotherapists, Medical Scientists and Professionals Allied to Medicine (NUPMTPAM) otherwise known as Allied Health Professionals. All these were first registered by Decree 22 o 1978 now Trade Unions Act Cap T14 2004 LFN. We challenge the NMA leaders to tell the public under which law their own association is registered. The NMA is neither registered as a Trade/Labour Union nor under the land perpetual act. Henceforth, the NMA is hereby warned to desist from operating as if it were a registered Trade Union otherwise litigation in court of justice awaits your leadership. Justification/Legality of JOHESU’S Demands In September, 2011, JOHESU submitted a list often demands to the Federal Government through the Federal Ministry of Health. The demands are: Request for the creation of the post of Director on salary level 17 (CONHESS 15) and the promotion of Deputy Directors who have been on the same grade since 2000 to the post of Director on salary level CONHESS 15. The call for the withdrawal of a circular illegally and unprocedurally issued by the office of Head of Service of the Federation through the connivance of the Minister of Health and NMA to deprive Health workers from further enjoying promotion from grade level 09 to 11 (the equivalent of civil service grade level 10-12) which has been in the health sector and civil service since Udoji Awards of 1974. A call for review of retirement age of Health Sector staff to 65 years in line with their counterparts in the Universities and Allied Institutions. The call or the restoration of Consultant’s status removed unjustly in December 2010 by the current Minister of Healthn NMA member from qualified health care professionals who have been enjoying the benefits via a Federal Government Circular of September 1976 which has not been superseded. The call for reconstituting the Boards of Management of Tertiary Health Institutions dissolved since September, 2011 whereas those of the Universities have been reconstituted over six months ago. The call for the release and immediate implementation of 2008 job Evaluation Report being delayed deliberately by NMA members. Request for implementation of National Industrial Court’s Ruling of March 2006 and the Collective Bargaining, Agreement of 2009 on Call, Shift, Specialist allowances and others. Request for immediate implementation of the recommendations of Abdullahi Bello Presidential Committee Report on Harmony in the Health Sector, submitted since November, 2011. The NMA is working hard against its implementation. A call on the Minister to convene a stakeholder’s conference to iron out the grey areas in the current National Health Bill so that when the National Assembly conducts a public hearing, a single voice from the Health Sector will be presented, thus accelerating the bill’s passage. The call for re-assignment of the two current Ministers of Health who are biased in favour of NMA and against other Health Professionals/Workers and their replacement with two new persons, one of whom should be an Allied Health Professional. We would be grateful if the NMA could point out anyone of these demands that is unjustified or illegitimate. The NMA leaders need a refresher course in semantics, laws of Nigeria, and Public decorum. Is Skipping/Jumping of a Grade Level in the Civil Service Legal? The statement of NMA on this issue shows that both NMA and the Honourable Minister of Health hold same opinion and both have been jointly attacking JOHESU indicating they are not properly informed or educated. Since Udoji awards of 1974, skipping of a grade level or more has been built into different salary structures to serve as an incentive to motivate civil or public servants. For instance, in the 70s, University Professors earned grade level 16 (the highest then), associate Professor/reader earned grade level 14. Note that grade level 15 was skipped. Similarly, we had the following then: Senior Lecturer= GL.13 Lecturer grade I=GL.11 Note: that (12) was skipped or jumped. In the civil service, since 1974 no Administrative Officers cadre was placed on GL .11. Up- til now, it is being skipped. However, in 1981, the Universities salary grading changed from sixteen to fifteen grade levels, courtesy the Cookey commission report. To convert sixteen to fifteen grade levels, one level was omitted and that was then called University Salary Scale (USS 10). In 1982, Onosode Commission recommended that Teaching Hospitals and Research Institutes should enjoy similar conditions of service with the Universities since they perform similar functions. Government accepted this, hence, USS was introduced in the Health Sector and Research Institutes. Up-til today, a 15-scale salary system operates in all Tertiary Institutions and all of them skip salary grade “10” at various times under various salary systems, namely: USS (1981/82) to EUSS/RUSS (1991) to HATISS (1993-2007) to CONTISS (2007) and now CONTISS and UASS (University) CONHESS (Health Sector) CONRISS (Research Institutes). Furthermore, the UASS 1-7 is equivalent to CONHESS 7-15 or the civil service CONPSS 08-17. This shows that the University Academic on UASS moves from 9-11, and 11-13 thus skipping twice, an equivalent of skipping three grade levels on Civil Service salary structure, but two on CONHESS. CONPSS CONHESS CONMESS Graduate Assistant= 108 07 _ Asst. Lecturer =209 08 _ Lecturer 2=310 09 01 (11)* (10)* 02 Lecturer 1=412 11 03 Senior Lecturer=5 13/14/15 12/13 04/05 Associate Professor=616 14 06 Professor=717 15 07 This write up has shown that skipping or jumping of a grade level or more is neither new nor strange nor illegal. It has been with us since early 70s or earlier and it is deliberately created to serve as an incentive such as double or triple promotion to motivate workers. Circular issued by Head of Service in 2010 and 2011. “Stealing from Government Purse” The NMA leadership accused JOHESU/ Allied Health Professionals of stealing from Government purse for insisting on the legal rights of her members to continue to skip Salary CONHESS 10. We demand an apology from NMA leaders within the next fifteen days of this publication or face a libel suit. Privatization of clinical services of Physiotherapy, Pharmacy. Laboratory etc A call for privatization by NMA of core services the government hospitals are rendering has clearly shown that the NMA leaders are out of tune with the purpose of government and the roles of Professional Association or Unions to the populace. We must distinguish between Public-Private Partnership and outright privatization. The former is a symbiotic and mutual relationship which will not leave either party at a loss. It is a gain-gain relationship but the latter, privatization, if a system where a party takes over the running of the business of the government and runs it to make maximum profit for his/ her own organization. This will leave the government hospital, the employees of government and the patients or clients of health services to be at a great loss. Workers will be retrenched, the few that are left will be over-worked and be paid less, patients will pay very high bills and the resultant effect is that the hospitals become inaccessible to the poor, the low and medium income earners, while unemployment will soar higher and the populace will be a great loser. Since health services should be the social right of individuals, citizens have the right of access to high quality health care. It has been observed that while NMA leaders suggest the privatization of services rendered by Allied Health Professionals, they are silent on their own services, a proof of selfishness and inconsiderateness. They are merely devising a means to divert numerous patients who will not be able to afford high bills in the privatized government hospitals to be seen in their own private clinics and hospitals as well as buy up the government health institutions. While we concede the right to make suggestion to NMA and others, we have a firm conviction that no responsible government will take such a decision without getting the opinions of majority stakeholders in the system. Giving the fact that members of JOHESU/Allied Health Professionals constitute over 80% of the health sector’s work force, the idea of privatization is not supported by us. Threat of Strike Should our Demands be Granted Five of our demands are currently, being looked into for implementation having jointly signed an agreement on the 10th May, 2012. Four others have been referred to the National Industrial Court for ruling. The tenth demand, the removal of the Health Ministers, is being pursued vigorously. We have no doubt in our minds that the demands shall be granted because they are legitimate and justified. If the NMA wants to enjoy the rights of labour Union, the association should apply for registration as such. Should NMA continue to embark on strike against the laws of the nation, appropriate litigation actions will be taken to check her excesses being an unregistered labour union and an illegal organization. Calling for Extension of CONMESS The NMA should not hide under the demands of JOHESU/Allied Health Professionals to call for the extension of CONMESS. It should be placed on record that the CONMESS as a salary structure was achieved illegally in 2009 when NMA secretly bargained with the government as if it were a registered trade union. We warned the Salaries, Incomes and Wages Commission then not to allow NMA to break ranks with the other Unions/Professional Associations but the government agencies collaborated with Prof. Osotimehin , former Health Minister, to give NMA a separate salary structure – CONMESS. As shown by Nigerian Television Authority in March 2009, the NMA leaders jubilated wildly and expressed joy and happiness in being given CONMESS. It is too early for NMA to call for an elongation. We recall how NMA was given MSS/MSSS in 1991 while others were discriminated against. This led to series of industrial crises which had not been fully resolved before Professor Osotimehin’s era which compounded the problem. The fact of the matter now is that the NMA has realized the error committed in having a separate salary structure in a health sector where NMA should play a prominent role to ensure unity and team spirit but it is the NMA that fuels disunity, crisis and indiscipline in the system. OBSERVATIONS/RECOMMENDATIONS We wish to draw the attention of NMA leaders/members to the need for repentance, re-assessment and reversal of action so that they can return to the larger fold of the health family. NMA leaders and members should bury their pride and be humble to know that others have a lot to contribute in the health sector and that no one is more important than the other whether junior staff, para medical worker, Administrative or other supportive staff. All should work collaboratively with the health care providers to achieve a peaceful atmosphere for achieving the desired goal. Unless the NMA leadership adopts a change in attitude, Nigeria’s health care system will be far from improvement. Signed: F.O. Faniran, M.Sc. FNSP Consultant Neuro/Community Physiotherapist National President, Nigerian Union of Allied Health Professionals (NUAHP/NUPMTPAM) Ile-Ife, Nigeria. 08060508721 O.C. Ogbonna Bsc, MSc Human Nutrition/Dietetics Member NDA RD National General Secretary, Nigerian Union of Allied Health Professionals (NUAHP/NUPMTPAM) Ile-Ife, Nigeria. 080363655
Posted on: Tue, 27 Aug 2013 05:57:54 +0000
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