NIGERIA The con versus the mess: lessons from the
last Lagos State doctors’ strike Dr Olufemi OmoloIu takes on the brave task of trying to take a step back from the strike and see what lessons can be learned
The latest installment of doctors’ strikes in Nigeria was recently played out. Unlike previous doctors’ strikes in the country the script was a bit different but the outcome probably the same. Hopefully lessons were learnt so that such incidences will not occur again. But in reality it appears doctors strikes have become a part of normal existence. It sounds a bit odd to make the foregoing summation but really it is not only doctors that go on strike. Just about every profession in this country has had its members go on strike at one time or the other. A Google search of ‘doctors strike’ will show that this has happened in many countries all over the world so it is not peculiar to Nigeria. Interestingly most doctors’ strikes have to do with money, so Nigerian doctors cannot be accused of being greedy. Maybe it is a doctors’ thing globally. I don’t think so. I also know for a fact that teaching doctors how to go on strike is not taught in medical schools. Why then do doctors’ strikes happen so frequently? I think it is probably because doctors feel undervalued and unappreciated and thus have to hit out when ‘pushed to the wall’. Doctors are often blackmailed by their consciences and the sections of the Hippocratic Oath that focus on service to humanity (not those sections that talk about self preservation) and thus making a strong case for better returns is often viewed with disdain by some members of the public. The recent doctors’ strikes in Lagos provide a good insight into the sentiments associated with doctors’ strikes and Governments responses.
Origin of the strikes It all started with the Federal Government of Nigeria approving a salary scale – the Consolidated Medical Salary Scale (CONMESS) – for doctors in its employ. The Nigerian Medical Association, however, insisted that the salary scale was to apply to all doctors employed by state governments as well. Some states complied while some insisted they could not meet up with the wage bill this salary scale resulted in. Lagos State, one of the richest states in Nigeria, and probably the state with the best health system and largest number of doctors, fell into the category of inability to pay. Negotiations broke down and a 3-month strike ensued in August 2009. An agreement was reached to implement a commensurate
Dr Olufemi Omololu is a Consultant in Obstetrics and Gynaecology with the Lagos Island Maternity Hospital. Email:
femomololu@yahoo.com
6 Africa Health Nigeria
salary scale in January 2011 leading to suspension of the strike. However the Lagos State salary scale did not mirror the CONMESS and another 6 weeks of strike ensued in March 2011 ending with yet another agreement to implement the salary scale. This was seemingly done but however doctors noticed a general ‘demotion’ as grade level and steps had been reduced and taxation was reportedly excessive. This led to yet another warning strike in April 2012. This time the Government responded. Strikes without proper notice were deemed illegal, thus doctors who joined the warning strike were queried. These queries and invitations to visit a disciplinary panel were ignored and an indefinite strike begun. Striking doctors were eventually sacked. Some doctors continued to work. New doctors were employed. A few doctors appealed and got their sacks rescinded. The NMA waded into the crisis. Threats of sanctioning doctors not involved in the strike and those taking up employment were trumpeted. Negotiations waved back and forth. Eventually the sacked doctors were recalled and discussions on the CONMESS were to continue while the doctors returned to work. This is the current state of affairs. One wonders if this is the end or if this issue has yet another chapter. The CONMESS issue as depicted above has evoked
several cons and messes: The cons • The Federal Government agreeing to a universal salary scale without the consultation of the State Governments.
• The State Government making promises and rescinding on them.
• The seeming demotion of the doctors. The messes • Doctors of all levels going on indefinite strike. • Complete shutdown of the health sector. • Doctors taking up the jobs of doctors involved in a struggle.
• The NMA issuing an empty threat which it did not have the power to carry out.
• Doctors ignoring authority by not responding to query letters.
• A seriously tainted relationship between the doctors and the Lagos state government.
• The pain, blood and tears of many sick people, their friends and relatives. Those who suffered or died during the strike. Was it worth it?
July 2012
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