Year-in-year-out, labour and trade unions have tried to ensure their members’ rights are protected, especially on improved welfare. However, that of health workers, currently on-going, appears not to be on the popular side. REGINA OTOKPA reports
For decades, Nigerian workers have continued to press for better welfare packages and prompt payment of their entitlements from the government. This has led to series of strike actions by various unions fighting for workers’ rights.
The most recent is the agitation by health workers under the umbrella of Joint Health Sector Union (JOHESU). JOHESU comprises of Medical and Health Workers Union of Nigeria (MHWUN), National Association of Nigeria Nurses and Midwives (NANNM), Senior Staff Association of Universities, Teaching Hospitals, Research Institutes and Associated Institutions (SSAUTHRIAI), Nigeria Union of Allied Health Professionals (NUAHP) and Association of Medical Laboratory Scientists of Nigeria.
JOHESU’s Demands The first major bone of contention among the 15-point demands is the payment of over N20 billion adjusted Consolidated Health Salary Structure (CONHESS), which the government had already agreed to pay in 2017.
Others are immediate release of the harmonised scheme of service and circular on internship for nurses and midwives, upward adjustment of the CONHESS salary structure, immediate and full payment of arrears of salaries of CONHESS 10 skipping outstanding, payment of promotion arrears, same scale promotion/ redesignation, prioritisation of employment in the critical professional areas and enhanced entry point to accommodate all other graduates of other health care professionals.
Others are advertisement of CMD/MD’s appointment without prejudice to any particular profession, nonseparation of teaching hospitals from their teaching hospitals and the eligibility for specialist allowance to accommodate two members of JOHESU.
The demand also include board appointment to institutions, promotion of health workers at Federal Medical Centre Owerri, who were being punished for embarking on strike to same level with their counterparts, adjustment of retirement age from 60 to 65, and immediate set up of a collective bargaining agreement committee to look at headship allowance, administrative allowance, professional allowance, excess work load allowance, health and safety site allowance for JOHESU members.
The aggrieved workers claimed that previous administration of President Goodluck Jonathan agreed to implement these demands in 2015, but the Minister of Health, Prof Isaac Adewole, recently insisted that such was not the case, as there was no agreement between the Federal Government and JOHESU prior to the administration of President Muhammadu Buhari.
He maintained that what JOHESU brandished as 2014 agreement were minutes of meetings held with organs of Federal Government to reach a compromise, adding that JOHESU’s demands to be at par with doctors in terms of salary was neither practicable nor acceptable.
He said: “As a responsible government, we will do everything within our power to bring the ongoing strike action to an end as quickly as possible, but what JOHESU is asking for is parity with medical doctors which is neither practicable nor acceptable to the federal government.”
Adewole had said out of the 15 demands presented by JOHESU in September 2017, the government had implemented 14 while the last demand was being attended to, noting that the implication of when the agreement was reached is that JOHESU wants the government to pay arrears from 2014, and not September 2017, which the Buhari administration agreed to.
However, this is not the case, some of the 15-point demand by JOHESU has not been implemented contrary to claims by the Minister of Health. For example, the government has not increased the retirement age of JOHESU members from 60 to 65 years, skipping of Consolidated Health Salary Scale (CONHESS 10) arrears has not been paid as well as the implementation of the scale to scale promotion, especially on CONHESS 14 to 15. Other demands yet to be implemented includes employment of health workers to address the shortage of manpower in critical professional areas.
Poised to drive home their demands, especially the non-implementation of the new salary structure for other workers just as was done for doctors since 2014, the national wing of JOHESU withdrew their services at all federal health institutions on April 18, 2018.
The Government’s failure to arrive at a compromise after several meetings with the aggrieved health workers, two weeks after, led to an expansion of the strike from federal health institutions to states and local government hospitals on May 9. Meeting to receive and analyse the report of a six-member technical committee set up about two weeks ago to unravel the modalities to implement the adjusted CONHESS, the government and leadership of JOHESU, however, rejected the report and dissolved the committee, on the grounds that the report did not meet both parties’ expectations.
The national incomes, salaries and wages commission was immediately mandated to meet with JOHESU to produce a more acceptable template for implementation and to be presented at a rescheduled meeting.
Despite government’s effort to reach an agreement with the striking health workers, the Nigerian Medical Association, NMA, has been a bone in the throat. Only recently, the new leadership of the union led by the President, Dr Francis Faduyile, had threatened to down tools should the Federal Government accede to any of JOHESU’s demands that violates its collective bargaining agreement with government in January 2014.
While claiming that allowing JOHESU assess to leadership positions in health facilities would only put the life of more Nigerians at risk of preventable deaths, NMA insists that JOHESU’s demands were not only an aberration considering international best practice that will add no value to clinical/patients’ care, but certainly worsens morbidity and mortality indices in Nigeria. “It is also pertinent to once again remind the government about the concluding part of our letter no.
NMA/PRE/SG/03/0751 of 21st March 2014, which states, “In view of the above, the NMA painfully wishes to inform the Federal Government of Nigeria that any award to the non-medically qualified health professionals that violates the January and July agreements of 2014 shall result in the resumption of the suspended withdrawal of service of 2014.
Please take this as a notice sir,” NMA said. “The above reminder is predicated on the extension of the ongoing strike action embarked upon by the amorphous body called JOHESU, to States and Local government areas, the basis of which is to strengthen its callous and ill motivated agitation for pay parity between her members and doctors with the resultant erosion of relativity and further hierarchical distortion in the health sector vis-àvis her clandestine romance with some top government officials.
“We oppose vehemently, any adjustment in CONHESS salary scale with resultant pay parity between doctors and healthcare professionals allied to medicine, and hereby reaffirm that relativity is sacrosanct. “The demand for Headship of Departments/units in the hospital by members of JOHESU/AHPA will lead to unprecedented chaos in the health sector with ripple effect on the health of Nigerians.
We reaffirm our rejection of this demand.” Uncomfortable with NMA’s interference, the Minister of Labour and Employment, Sen. Chris Ngige, advised the association to be cautious in interrupting and meddling with the ongoing discussions between the health workers and the government to allow for a more peaceful and generally acceptable resolutions.
JOHESU had earlier accused Ngige and Adewole, who are both medical doctors, of bias and meting out unfair treatment to members of the union, with claims JOHESU was soliciting for equal rights with medical doctors.
The national Chairman of JOHESU, Comrade Josiah Biobelemoye, had noted that the lingering strike was as a result of the unfavourable moves by the Federal Ministry of Health to frustrate all efforts of the union and the government from reaching an amicable settlement.
“The Federal Ministry of Health treat us like slaves; one of the lies they are telling Nigerians is that we are asking for equal salary with the doctors . Can you imagine that a doctor entering Civil Service enters with grade level 12 while we enter with level 8 and it takes nine years for our members to get to grade level 12,” he said.
“Since government has not shown enough commitment to tow the part of honour and meet our demands, especially, the core demanding for the upward adjustment of CONHESS salary structure as agreed in the Memorandum of Terms of Settlement signed on 30th September, 2017 with JOHESU.
“After three rounds of meetings held on Thursday, 26th April, 2nd and 7th May respectively, at the instance of the Minister of Labour and Employment to find a way forward, the Federal Ministry of Health is thwarting all efforts at reaching an amicable settlement of the issues of our demands, especially the upward adjustment of COHNESS salary structure.
“CONHESS review is the upward adjustment of the CONHESS Salary table on-line with the same principles used in adjusting the CONMESS table for medical doctors who work with use n the health team.
“Our own demand for the adjustment of CONHESS that affects over 85 per cent of the workforce nationwide has been frustrated, and part of the reason for this is that the minister of health as well as the minister of state for health are all medical doctors, while the minster of labour labour and employment, who should be neutral umpire in trade disputes is equally a medical doctor.”
If these issues are not properly attended to and addressed urgently, prospects of the ongoing strike being called off would continue to be a mirage. This has a huge consequence on the health of a vast majority, as the poor masses who are unable to attain health care services from private health facilities will continue to suffer unjustly.