Pharm. Bola Adeniran is the Chairman of the Pharmaceutical Society of Nigeria (PSN), Lagos State Branch. In this interview with PharmaTimes WAIRE EMONEFE, she speaks on the lingering issue of strike actions in the health sector and the reasons behind it.
The health sector is in a continuous cycle of strikes. What really is the main reason for these reoccurring strike actions?
Thank you very much. What would you expect in a country where there is injustice, lack of equity, and unfairness? A country where people are being treated as animals, in every sector not just the health sector. I would need to give you the history of the whole issue, so that you can appreciate what is being discussed. The people on strike now are in the public service, they are employees of the government. Government has the National Salary Incomes and Wages Commission that determines the salary earned by all civil servants irrespective of which ministry one operates in. There are also certain yardsticks used to determine what a person earns. Everyone was on a unified salary grade level that was suitable because the commission took into cognisance the number of years that people spent in school.
All graduates that ran a 4 year course will come in at grade level 8, step 1 after his/ her compulsory youth service. The pharmacist that spent 5 years will be on grade level 8, step 2, and the doctors that spent 6 years will come in on grade level 8, step 3. The rationale behind this was simple: someone who had graduated earlier after 4 years will have started working and earning salary while the others will still be in school. So when the others that are just finishing school come in, there won’t be huge disparity between them and those that have graduated earlier. The fact that doctors and pharmacists also do housemanship or internship as the case may be, for one year, and the compulsory youth service for another year was also taken into consideration. So, when the pharmacists and doctors that have graduated are eventually ready to step into the labour market, they will be brought in at grade level 9, step 2 for pharmacists and grade level 9 step 3 for doctors. Remember that the person that graduated earlier after 4 years and came in at grade level 8, step 1 will have spent 3 years and done his promotion interview to be on grade level 9, step 1. This promotion for the non-pharmacist and non-doctor will be done taken into cognisance what the person was earning in his previous level, so that he/she won’t earn below as he/she is moving upward.
So, there was parity and relativity, and everything was going fine. Then Olikoye-Ransome Kuti who was the Health Minister at that time met with the then Head of State, Gen. Ibrahim Babangida and organised a new salary scale for doctors alone. The salary of doctors was removed from the unified salary scale and put on a separate scale of its own called Medical Salary Scale (MSS), and that was the beginning of our problems in the health sector. The CONMESS and CONHESS salary scale was later approved for doctors and other health workers respectively. Yet, while it was fully implemented for doctors, the same was not done for other health workers. If the minister that should handle all health affairs decides that he would just take care of only the doctors, then there is no equity or fairness.
The Nigerian Medical Association, which is the national body for doctors, are not in support of the JOHESU strike. What would you say is the reason behind this discord that exists between doctors and other health workers?
It has always been a matter of unfairness, marginalisation and injustice. Why should the doctor, who is also an employee like the pharmacist, lab scientist, nurses and the rest determine the salary that his other employees will earn? The doctors do not have the welfare of other health workers at heart. They are selfish and egoistic. We are all in the hospital because of the patient, so the patient should be the focus of everyone there. We are supposed to be working together as a team to ensure that the patient gets the best medical treatment available, and is well. However, doctors always want to prove that they are the bosses and the ones in charge and that they can do it all, when that is clearly not the case. If a patient comes in to see the doctors and he does his part, will the patient be okay? No. All other professionals will have to do their bit and they have been specially trained to carry out these duties. The doctor cannot render the services of a pharmacist neither can the pharmacist render the services of a doctor.
Everyone does what they ought to do for the patient including the cleaners because we obviously need to work in a clean environment, and the patient leaves the hospital feeling well and fulfilled. However, that is not the case as the doctors are saying that they are in charge. It’s not their fault, we put them in charge. Before we started putting doctors as ministers and commissioners of health, the health sector was handled by seasoned administrators and everything was going on smoothly. However, since doctors took up that position the health indices of the country has been going down. This brings me to the issue of the consultancy. Pharmacists have The West African Postgraduate College of Pharmacist; this institution has been accredited to train pharmacists to become consultants. They have been churning out pharmacists since they were inaugurated, yet the federal government has refused to give these pharmacists that have been trained as consultants their due as specialists in that field, just because doctors say otherwise.
What is the way forward to ending the strike in the health sector?
I believe the way forward is for government to listen and grant the members of JOHESU their demands. The issue of remuneration should be taken into consideration again. A committee should be formed that will sit down and weigh these issues all over again. All health workers should be on a unified salary scale using certain yardsticks like years and level of training to give everybody what they deserve. However, it must be done scientifically and equitably, not based on bias or sentiments. Another issue that should be considered if this strike syndrome will end is that, the minister and commissioner of health do not have to be doctors. We should be able to get seasoned administrators that would show no bias as it is done in other countries.
There should also be relativity. This simply means that an officer for instance, that has spent 3 years to rise to level 8 should collect same salary and allowance with any other officer that spent 3 years to get to the same level.