INTERVIEW: What Nigerian govt must do to end health workers strike – JOHESU Vice Chairman

April 24, 2018Ebuka Onyeji

Vice Chairman of the Joint Health Sector Union (JOHESU), Ogbonna Chimela

Ogbonna Chimela is the National Vice Chairman of the Joint Health Sector Union (JOHESU). He also doubles as the President of the Nigerian Union of Allied Health Professionals (NUAHP).

In this interview with PREMIUM TIMES‘ Ebuka Onyeji, Mr Chimela speaks on the implications if the ongoing strike by JOHESU is allowed to linger and why the demands of the union is non-negotiable. He also explained the genesis of the protracted rivalry between medical doctors and other health workers among other sundry issues in the health sector.

JOHESU, the association of health workers apart from medical doctors and dentists, embarked on an indefinite strike last Wednesday and has crippled healthcare delivery in many parts of the country.

Excerpts:

PT: What do you think will happen in the health sector if government fails to meet your demands and the strike continues?

Chimela: Total collapse of the health sector is what will happen. In the committee of nations when the mortality and mobility rate were rolled out, Nigeria was ranked 179 out of 183 nations that was even when we had full compliment of all the staff in the health sector but now that 95 per cent of the work force has withdrawn services, your guess is as sure as mine. The indices will nosedive and we will further depreciate in the ranking and its not the best for our health system.

PT: When will state and local governments join the strike?

Chimela: Already, we are counting their days because when we started our strike on Wednesday, we ordered their leaders to give 15 days ultimatum to them and that will expire on the 2nd of May and if the government does not meet our demands on or before that day, then the state and local government health institution staffers will now join the strike, it will be a complete shutdown of the sector as we warned.

PT: Is the union not worried about the impact and the immediate effect of this strike on the lives of the patients who desperately need care?

Chimela: Its not the joy of anybody that issues like this should be played down or politicised but the truth is that the government of the day is not sensitive to the plight of the masses that is why they are taking our issue lackadaisically. We have shown enough restraint. Like I always say, we have tried because we know we belong to the essential service department and we are not supposed to withdraw our services.

But since the government is fully aware of this, why won’t they address the issue immediately and not allow it linger? We are pushing the bulk of blame back to the government, if they really mean well for the masses, they should quickly resolve the matter, its not us that have issues or are to be blamed, it is the government.

PT: Can you give a detailed breakdown of your demands from the government and why it is sacrosanct to the union that it prompted a strike?

Chimela: The first problem is the issue of understaffing in our various hospitals across the nation, the number of professionals that are rendering services to numerous patients are very few, the government will always tell us that there is an embargo on employment and that there is no money to employ new staff but we noticed that as we are on strike, they engaged the services of locum staff. Locum staff is people you engage in a strike or emergency situation and you start paying them almost what you pay normal staff.

Natioal Hospital Abuja

So if the government has money to employ locum staff at this strike period, why cant’ they use that money to employ more staff when the workers are at work so we can have more staff? We demand more staff because we are being over worked. The second issue is skipping of CONHESS salary and its arrears. In 2013, that matter was taken to the Industrial Court of Nigeria in Abuja and Justice Adejumo was the one who presided and gave the final verdict that it is our entitlement and that government should pay us.

The government agreed but they keep telling us they are compiling since 2013 till date. They have not paid it, and the most annoying thing is that the Nigerian Medical Association (NMA) has been paid skipping arrears even though they are not on CONHESS, they are on CONMESS and skipping arrears is meant for CONHESS but because they are the drivers of the system, they get what ever they want.

This is another contemptuous issue that we are not happy about.

{Consolidated Medical Salary Structure, CONMESS, is the salary structure for medical and dental officers in the federal public service while Consolidated Health Salary Structure, CONHESS, is the salary structure for pharmacists, medical laboratory, nurses and other health workers in the health sector of the federal public service}.

The third demand is the major one, the issue of adjusted CONHESS salary. Permit me to take the story back to 2009, when CONMESS and CONHESS was first approved by the government. In 2014, the government in her wisdom adjusted the salary of NMA, we now asked for our own to be done but the NMA told government not do it for us that if they do that they are going to down tools. Up till now, that has been their stand and this is the reason government has been very slow on the matter.

The government knows the truth, they said they have undertaken the financial implication of the adjustment which was made clear on the 30th of September when we struck an engagement with them called terms of settlement. The government signed and we signed. They said we should just give them five weeks and they will go ahead and implement it. I think they have been taking proactive steps to implement this before the NMA went on air to say if they do so there will be crisis in the system.

The question now, is the NMA the employer of labour? Is the NMA the salaries and wages commission? Why will NMA negotiate their own entitlement and welfarism and when it comes to our own, they will want to block us, that is discrimination, that is nepotism and favouritism on the part of the government and we say no to that.

PT: What does the least paid JOHESU worker get as remuneration?

Chimela: I will take it in two folds. In JOHESU, we have both skilled and unskilled staff as members, that is, professionals and non-professionals. For the professionals, the least paid is on grade level 8 and if you put all his pay together because he’s like an intern coming into the system, what he collects in a month is N120,000 If he (or she) is on call duty. But those who are not on call duty only get N90,000 monthly. As for the unskilled staff, they collect the minimum wage, which is N18,000.

PT: So if the government finally implements the salary adjustment, what will the least paid skilled staffer collect?

Chimela: It will be a 20 per cent increase on the worker’s normal salary. For instance, the least paid that collects N120,000 will now take home an additional N24,000 which will now make his/her total remuneration N144,000.

PT: Are you not worried about how it will affect the remuneration of your members if the government enforces the ‘no work no pay’ rule as it threatened?

Chimela: Well, in that case, that will be the supreme sacrifice we shall pay to get our demands because there is no gain without pain. If that is the case, let it be so but however we can cite other institutions like the universities and schools. When ASUU goes on strike and comes back they are still paid for the period of strike. Its only in the health sector that our minister is the sole pioneer of ‘no work no pay’ even when they are at fault. We are challenging that rule because the government failed in their duty and we have that privilege by law to express our displeasure. Should we now be purnished for showing our displeasure? Should we allow ourselves to be oppressed and suppressed in our own country? So they should not misinterpret it because government is at fault now because we followed the due process of declaring strike.

PT: There has being a lot rivalry, disaffection, acrimony and bitterness between NMA and JOHESU over the years especially when it comes to salary issues or who gets what in the health sector, so can you give a brief on this dispute among both groups and possibly how best it can be resolved?

Chimela: Actually we are supposed to see ourselves as team players, whether you are the goal keeper or the striker or the defender. Every department of that team is important and when you undermine a particular department then your team will be very weak. In 1985, when the late Professor Olukoye Ransom Kuti was the Minister of Health, that was when this dichotomy in salary structure came up. Ab-initio we were in one single salary structure whether you are medical practitioner or among other health workers.

prof. Isaac Adewole. Minister of Health

The difference is just entry point but when the late Olukoye came, being a medical doctor, he made the salary structure of medical practitioners were different from others. That was the beginning of the acrimony and discrimination. From that period upwards there was a lot of turmoil and strikes. In 1991, a circular was made to address the issues so we will all come back to the same salary structure but it was met with stiff opposition by the NMA again and it was like that till President Obasanjo came in.

In 2007, (President) Obasanjo put up a committee that evaluated who does the most work in the health sector and who should be paid more. The then permanent secretary of ministry of labour, Mrs Agali Gorimakpa was the chairman of that committee. At the end of the day, when the committee report came, it recommended that there should be one salary structure for all of us and it should be called harmonised tertiary salary structure. But when the report was read, the NMA wrote a minority report saying they are not interested, that what they want is let there be medical salary structure. So the committee in their wisdom recommended CONMESS for doctors and CONHESS for other health workers.

The indices they used is that when you come to grade level 11, the basic salary of ours and doctors will be the same but other allowances and bonuses will be different. In 2014, the NMA salary structure was adjusted upwards, we said ours should be done same way but the NMA opposed it and that was how the acrimony started again. So in order to solve this problem, each professional should respect and appreciate the input of other professionals and that is the international best practice.

In Canada, about three months ago, the salaries of medical doctors were increased by their government but they rejected it and said let it be given to other health workers because they deserve it. That is how it is done in civilised countries.

PT: We learnt that JOHESU members are agitating for the post of Chief Medical Directors (CMD) in tertiary institutions, why do you think your members deserve that position?

Chimela: In 1985, decree 10 was promulgated and that decree was what guides the appointment of CMDs and you will see in one of the phrases, subsection 5 of it (says) that the occupant of the position of CMD must be medically qualified. For us, we now looked at it, can you say a pharmacist is not medically qualified? Or a medical lab scientist and even when you look at it, the CMDs don’t give injections to people or conduct surgeries? What they do is administrative work so if other health care professionals are well grounded in administrative knowledge, then there is nothing stopping us from taking up that position.

PT: How far have you gone in your move to take up the position of CMD?

Chimela: Justice Usman Bello was the one that was appointed to look into this issue in 2013 and 2014. His committee resolved that for peace to reign, if the CMD is a medical doctor, the Chairman, Medical Advisory Committee should come from the JOHESU group and we should take turns just like the PDP sharing formula. For instance, if the CMD is from NMA and his vice from JOHESU this year, then in the next four years, when another election will be conducted for the leadership position, the CMD will be zoned to JOHESU while NMA will be vice because if you have all the excos from one particular group, policy making will be skewed. However, this recommendation is yet to be followed.

PT: One of the key focus areas of the health ministry is Public Private Partnership (PPP), what is your take on this program?

Chimela: It is not this administration that started PPP, it was started by Obasanjo’s administration. It would have been a good and laudable project if it was done in the true spirit of the initiative. In the original format, you are not supposed to lose any staff, those private owners who have equipment that government hospitals don’t have will bring it in, bring experts to train people and the government will now sit down and discuss how the profit made from it will be shared with the private owners.

All these brain scanning machines, most hospitals do not have them but there are some wealthy Nigerians who can bring it and you will be using it to generate money and that is what PPP should be. They can build laboratory and give to the government and the profit from it will be shared. What the government is doing now is privatisation and commercialisation which is different. They will make the cost of things very high because the essence of the initiative is now profit making and not for the masses.

We have seen a sample of it at the Garki General Hospital in Abuja where the normal PCV used to cost N100 but is now N250. To open a card, which was N800 then, is now increased to N2,500. When President Buhari heard about it, he killed the initiative in 2015 saying he did not want to impoverish Nigerians and that was why they kept quiet for sometime, now they are coming back with it and we are saying its is not profitable to the masses.

PT: What is your final appeal to the authorities, the general public on this strike?

Chimela: For the public, we want appeal to them to bear with us, we are not callous or wicked people, it is the government that has pushed us to the wall and we have just used the only weapon they seem to respect. We believe in no distant time, if the public also joins in calling on the government, this strike will not linger. There are no more negotiation because the government had already reached an agreement with us and signed it, so nothing again to negotiate. The only thing we may look at as agreement is how many months of the arrears are they (government) going to pay because it is now four years since 2014 till date.

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